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Image Guidance Method for Diabetic Foot Surgery

糖尿病足手术的图像引导方法

基本信息

批准号：
7999884
负责人：
Irving Weinberg
金额：
$ 38.03万
依托单位：
WEINBERG MEDICAL PHYSICS, LLC
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-01 至 2011-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7999884
关键词：
Abattoirs Academia Address Adoption Anaerobic Bacteria Animal Experiments Animal Model Animals Anoxia Biological Assay Biological Models Biomedical Engineering Biophysics Blood Burn injury Businesses Capital Caring Cells Child Chills Clinical Clinical Protocols Clinical Trials Collaborations Collection Commerce Community Hospitals Computer Assisted Computer software Current Procedural Terminology Codes Custom Data Analyses Debridement Decubitus ulcer Development Devices Diabetes Mellitus Diabetic Foot Diabetic wound Elements Employee Endoscopy Engineering Environment Equipment Europe Excision Eye FDA approved Face Family suidae Feedback Fibrosis Fluorescence Funding Gamma Rays Goals Gold Guidelines Heart Hemoglobin Hospitals Human Image Image-Guided Surgery Imaging Device Incentives Income India Inflammatory Inpatients Institution Intellectual Property International Investments Knowledge Label Lead Learning Legal patent Length Length of Stay Letters Licensing Life Limb Salvage Magic Magnetic Resonance Imaging Marketing Medical Medical Imaging Medical center Medicare Methods Mission Mitochondria Modeling NADH National Institute of Diabetes and Digestive and Kidney Diseases Nature Necrosis Nosocomial Infections Operative Surgical Procedures Optics Orthopedics Osteomyelitis Patient Noncompliance Patients Penetration Phase Physicians Physics Physiological Pilot Projects Podiatry Preparation Price Procedures Production Protocols documentation Proxy Publications Publishing Quality of life Quantum Dots Radioactive Receiver Operating Characteristics Reporting Research Design Resected Residual state Resolution Respiration Safety Sales Sampling Scientist Signal Transduction Silicon Sinus Site Source Specimen Speed Staging Stream Study Section Suggestion Surgeon Surgical margins System Tail Technology Tetracyclines Third-Party Payer Time Tissue Model Tissue Viability Tissues Traction UV sensitive United States National Institutes of Health Validation Vendor Welding Wing Work Yeasts aged base bone clinical application commercial application cost design design and construction detector diabetic diabetic patient digital distraction experience fluorescence microscope foot hospital bed improved innovation instrumentation interest intraoperative imaging killings manufacturing process millimeter miniaturize molecular imaging nanomaterials new technology novel oncology optical sensor oxidation pathogen payment phase 1 study preference programs public health relevance radiotracer research study response sensor success symposium tool wound

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this project is to improve the care of diabetic patients undergoing surgery for treatment of osteomyelitis. This improvement will be attained by providing immediate intraoperative imaging feedback to podiatrists and surgeons as to whether surgical margins are clear of involvement, and whether remaining tissues are healthy. Often, patients reside in hospital beds while pathological assessment of tissue specimens is pending, adding to overall care costs and exposing patients to potential nosocomial infection. A rapid and reliable method of assessing surgical margins intraoperatively could potentially reduce hospital stays. Providing additional confidence might allow surgeons and podiatrists to be more conservative in their resections, thereby improving patients' quality of life. The commercial market for diabetic osteomyelitis care has been estimated at $10 billion annually, with a similar amount for non- bone wound care. The project takes advantage of recent innovations in miniaturized fluorescence microscopes, and applies lessons learned in oncology imaging, towards the goal of rapid identification of surgical margins for osteomyelitis patients. Follow-on applications for the technology to be developed in this project include decubitus ulcer debridement, and other wound care challenges. Unlike prior imaging approaches that employed exogenous contrast materials (e.g., tetracycline, labeled radiotracers) we propose to use endogenous optically-active markers (e.g., mitochondrial NADH) to rapidly assess tissue viability in this important clinical application. The project is distinguished by a cross-cutting academic-industrial collaboration including experts in medical imaging, wound care, and sensor engineering and physics. Since the original application, and in response to the suggestions of the reviewers, our group has conducted preliminary experiments validating the basic physiological assumptions that the project is based on. The results of these pilot studies are included in the revised application. PUBLIC HEALTH RELEVANCE: The overall goal of this project is to improve the care of diabetes patients undergoing surgery for treatment of osteomyelitis. This improvement will be attained by providing immediate intraoperative imaging feedback to podiatrists and surgeons as to whether surgical margins are clear of involvement, and whether remaining tissues are healthy. Often, patients reside in hospital beds while pathological assessment of tissue specimens is pending, adding to overall care costs and exposing patients to potential hospital-acquired infections. A rapid and reliable intraoperative method of assessing surgical margins could potentially reduce hospital stays. Providing additional confidence might allow surgeons and podiatrists to be more conservative in their resections, thereby improving patients' quality of life.

描述（由申请人提供）：本项目的总体目标是改善接受骨髓炎手术治疗的糖尿病患者的护理。这种改善将通过向足科医生和外科医生提供即时术中成像反馈来实现，以确定手术切缘是否清晰，以及剩余组织是否健康。通常，患者在组织标本的病理学评估悬而未决时居住在医院病床上，这增加了整体护理成本并使患者暴露于潜在的医院感染。一种快速可靠的术中评估手术切缘的方法可能会减少住院时间。提供额外的信心可能会让外科医生和足科医生在切除时更加保守，从而提高患者的生活质量。糖尿病骨髓炎护理的商业市场估计为每年100亿美元，非骨伤口护理的市场规模类似。该项目利用了最近在微型荧光显微镜方面的创新，并应用了肿瘤成像方面的经验教训，以实现快速识别骨髓炎患者手术切缘的目标。该项目中开发的技术的后续应用包括褥疮溃疡清创和其他伤口护理挑战。与采用外源性造影材料（例如，四环素，标记的放射性示踪剂），我们建议使用内源性光学活性标记（例如，线粒体NADH）以在该重要临床应用中快速评估组织活力。该项目的特点是跨领域的学术-工业合作，包括医学成像，伤口护理，传感器工程和物理方面的专家。从最初的申请开始，为了响应评审员的建议，我们的团队进行了初步实验，验证了该项目所基于的基本生理假设。这些初步研究的结果包括在修订后的申请中。公共卫生相关性：该项目的总体目标是改善接受骨髓炎手术治疗的糖尿病患者的护理。这种改善将通过向足科医生和外科医生提供即时术中成像反馈来实现，以确定手术切缘是否清晰，以及剩余组织是否健康。通常情况下，患者住在医院病床上，而组织标本的病理评估悬而未决，增加了整体护理成本，并使患者暴露于潜在的医院获得性感染。一种快速可靠的术中评估手术切缘的方法可能会减少住院时间。提供额外的信心可能会让外科医生和足科医生在切除时更加保守，从而提高患者的生活质量。