USE OF THERMAL AND 3D IMAGING TO QUANTIFY ARTHRITIS

使用热成像和 3D 成像来量化关节炎

• 批准号: 7806547
• 负责人: Raphael Hirsch
• 金额: $ 20.55万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7806547
• 关键词: 3-Dimensional; Adrenal Cortex Hormones; Anti-Tumor Necrosis Factor Therapy; Arthralgia; Arthritis; Childhood; Chronic Childhood Arthritis; Clinic Visits; Clinical; Clinical Research; Clinical assessments; Devices; Disease; Disease remission; Dose; Drug Delivery Systems; Evaluation; Goals; Hand functions; Health; Heating; Image; Inflammation; Inflammation Mediators; Inflammatory; Injection of therapeutic agent; Interobserver Variability; Intervention; Joints; Lasers; Magnetic Resonance Imaging; Measurement; Measures; Metacarpophalangeal joint structure; Methodology; Oral; Outcome Assessment; Patient Care; Patient Monitoring; Patients; Pattern; Peripheral; Pharmaceutical Preparations; Physicians; Questionnaires; Recording of previous events; Reporting; Reproducibility; Research Design; Rheumatoid Arthritis; Rheumatology; Self Assessment; Surface; Swelling; Synovitis; Testing; Therapeutic Intervention; Time; Variant; Wrist; clinical remission; cohort; cost; functional status; improved; prototype; public health relevance; response; sensor; tool

DESCRIPTION (provided by applicant): One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. It can even be difficult to determine whether inflammation is present or absent. Carefully designed studies have repeatedly shown poor We have built a prototype device using well-established sensors-specifically 3-dimensional (3D) laser line triangulation digitizer cameras and thermal infrared cameras-to rapidly quantify surface swelling and heat in arthritic joints. This Arthritis Surface Imager produces results within minutes. Thus it could become a routine component of the rheumatology clinic visit, allowing for the replacement of the current subjective and unreliable joint assessment with a quantitative and highly-reproducible measure that can be used to monitor patients over time. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis. The first Specific Aim is to test the hypothesis that surface imaging will provide an earlier and more sensitive measure of change in active arthritis and functional status than do physician's assessment and patient's self-assessment A cohort of patients with JRA and RA will be followed longitudinally before and during the course of a therapeutic intervention. Change in arthritis, as measured by the Arthritis Surface Imager will be compared to well-established and validated clinical measures, including 1) physician's assessment of joint tenderness and swelling and 2) patient's self-assessment of joint pain. Correlation will also be made with changes in functional status, as assessed by components of the Childhood Health Assessment Questionnaire (CHAQ) and Health Assessment Questionnaire (HAQ) that pertain to hand function. We will also examine predictors of change in functional status. The second Specific Aim will test the hypothesis that surface imaging can improve the accuracy of remission measurement. It has recently been reported that patients in clinical remission often have MRI evidence of continued synovitis, demonstrating that current clinical measures of inactivity do not correlate well with true remission. Our Preliminary Studies suggest that many patients with a history of arthritis have abnormal joint thermal patterns even when asymptomatic. Patients with clinically-inactive disease will be imaged by MRI to determine whether patients with subclinical arthritis can be identified by the Arthritis Surface Imager. Low-cost, time-efficient tools that produce a set of reliable, reproducible and objective measures of the inflammatory state of the joint would improve the assessment of outcome in arthritis clinical studies, and ultimately will improve patient care. This proposal focuses on the wrist and metacarpophalangeal (MCP) joints, which make up 22 of the 28 joints in the Disease Activity Score (DAS) 28. Methodologies developed here could be readily applied to other peripheral joints. reproducibility of physician assessment of the number of swollen and/or tender joints. PUBLIC HEALTH RELEVANCE: One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. We have built a prototype device using well-established sensors to rapidly quantify surface swelling and heat in arthritic joints. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis.

描述（由申请人提供）：在护理风湿性关节炎（RA）和青少年风湿性关节炎（JRA）患者的最大挑战之一是量化任何给定关节的疾病活动程度。甚至很难确定是否存在炎症。精心设计的研究一再表明，我们已经建立了一个原型设备，使用完善的传感器，特别是三维（3D）激光线三角测量数字化相机和热红外相机，以快速量化关节炎关节的表面肿胀和热量。关节炎表面成像仪在几分钟内产生结果。因此，它可以成为风湿病临床访视的常规组成部分，允许用定量和高度可重复的测量替代当前主观和不可靠的关节评估，可用于随时间推移监测患者。我们研究的目的是验证这一假设，即该成像仪可以改善关节炎的临床评估。第一个具体目标是检验以下假设：表面成像将提供比医生评估和患者自我评估更早和更敏感的活动性关节炎和功能状态变化的测量。在治疗干预之前和期间，将纵向跟踪患有JRA和RA的患者队列。将通过关节炎表面成像仪测量的关节炎变化与完善且经验证的临床测量进行比较，包括1）医生对关节压痛和肿胀的评估和2）患者对关节疼痛的自我评估。还将与功能状态的变化进行相关性分析，如儿童健康评估问卷（CHAQ）和健康评估问卷（HAQ）中与手功能相关的部分所评估的。我们还将研究功能状态变化的预测因素。第二个特定目标将测试表面成像可以提高缓解测量的准确性的假设。最近有报道称，临床缓解的患者通常有持续滑膜炎的MRI证据，表明目前的临床活动测量与真正的缓解没有很好的相关性。我们的初步研究表明，许多有关节炎病史的患者即使无症状也有异常的关节热模式。将通过MRI对临床非活动性疾病患者进行成像，以确定是否可以通过关节炎表面成像仪识别亚临床关节炎患者。低成本，时间效率高的工具，产生一套可靠的，可重复的和客观的测量关节的炎症状态将改善关节炎临床研究的结果评估，并最终将改善患者的护理。该提案侧重于腕关节和掌指关节（MCP），它们在疾病活动性评分（DAS）28中占28个关节中的22个。这里开发的方法可以很容易地应用到其他周边关节。医生评估肿胀和/或压痛关节数量的重现性。 公共卫生相关性：在照顾风湿性关节炎（RA）和青少年风湿性关节炎（JRA）患者的最大挑战之一是量化任何给定关节的疾病活动程度。我们已经建立了一个原型设备，使用成熟的传感器来快速量化关节炎关节的表面肿胀和热量。我们研究的目的是验证这一假设，即该成像仪可以改善关节炎的临床评估。