Evaluation of obstructive sleep apnea with long range 3D endoscopic FDOCT

描述(由申请者提供)：阻塞性睡眠呼吸暂停(OSA)是影响美国1800-2000万人的主要医疗问题。阻塞性睡眠呼吸暂停综合症患者睡眠不集中、慢性疲劳、白天嗜睡、注意力不集中和记忆问题，其后果包括增加机动车事故的风险，以及发展有猝死风险的心血管疾病。目前的金标准诊断方法，夜间多导睡眠图不方便，不能提供有关上呼吸道结构和解剖的信息，也不能确定OSA患者上呼吸道阻塞的位置，这对选择适当的治疗方法，特别是手术干预具有重要意义。该项目的长期研究目标是开发一种模式，以提供额外的解剖学信息，作为传统睡眠研究的有价值的补充研究，用于(1)睡眠和清醒时的实时容量气道解剖成像；(2)OSA的生理学研究；以及(3)有助于为潜在的外科候选人选择最合适的治疗方案的阻塞部位。该项目建议开发和测试一种创新的高速远程内窥镜傅立叶域光学相干断层扫描(FDOCT)系统，该系统能够非侵入性地实时获取定量解剖信息，如上呼吸道横截面积和形状，以确定OSA的特征。开发的系统将通过模型模型和体外动物成像进行测试和优化。然后，在试点临床研究中，将对患有阻塞性呼吸暂停的受试者进行FDOCT扫描，并与标准的夜间多导睡眠图进行比较和关联。拟议的研究培训计划将在生物医学和临床研究的方法和实施方面提供出色的经验和指导，这将补充候选人在工程和光学方面的现有专业知识。为这个K25项目组建了一支导师团队，他们是呼吸道生理学、睡眠医学和生物医学成像方面的公认专家和领导者。共同导师陈忠平博士是加州大学欧文分校贝克曼激光研究所和生物医学工程教授，在光学成像方法和翻译研究的开发方面拥有成熟的记录。共同导师、加州大学欧文分校肺科中心教授兼肺内科主任Matthew Brenner博士在开发新的激光诊断技术以转化为临床肺部和重症监护医学的研究中也取得了类似的成功。共同导师、加州大学欧文分校驻院医学教授、退伍军人长滩医疗系统肺部和重症监护科主任Catherine Sason博士拥有睡眠医学、肺部医学、内科医学和重症监护方面的董事会认证，在呼吸生理学方面拥有30多年的经验。她曾担任《美国呼吸与危重病医学杂志》编辑委员会成员和《呼吸护理》编辑委员会成员。共同导师Michael Dickel博士是弗吉尼亚州长滩医学中心睡眠障碍实验室的工作人员，他是一名获得董事会认证的睡眠医学专家，在睡眠医学、睡眠生理学、睡眠研究、统计和培训肺部研究员方面拥有丰富经验。这一职业奖项的机会将为候选人提供宝贵的指导、培训和资源，以进一步发展他的研究技能，并在实验室和临床的密切监督下扩大他在进行实验方面的知识和经验，从而通过完成这项拟议的项目而提升到独立研究人员的水平。

DESCRIPTION (provided by applicant): Obstructive sleep apnea (OSA) is a major medical problem that affects 18-20 million people in the United States. Patients with OSA suffer from fragmented sleep, chronic fatigue, daytime sleepiness, lack of concentration and memory problems with consequences including increased risk of motor vehicle accidents and the development of cardiovascular diseases with risk for sudden death. The current gold standard diagnostic modality, overnight polysomnography is inconvenient, unable to provide information on upper airway structure and anatomy, and cannot identify the obstruction sites of upper airway in OSA patients which is important in choosing the appropriate treatment, especially surgical intervention. The long-term research goal of this project is to develop a modality to provide additional anatomic information as a valuable complimentary study to conventional sleep studies for (1) real time volumetric airway anatomy imaging during sleep and while awake; (2) physiological investigation of OSA; and (3) identification of obstruction sites that aids in choosing the most appropriate treatment for potential surgical candidates. The project proposes development and testing of an innovative high speed long range endoscopic Fourier domain optical coherence tomography (FDOCT) system capable of non-invasive real time acquisition of quantitative anatomic information such as cross sectional area and shape of upper airway for the characterization of OSA. The developed system will be tested and optimized with phantom models and ex vivo animal imaging. Then, in pilot clinical studies, FDOCT scanning will be performed in subjects with obstructive apneas, compared and correlated with standard overnight polysomnography. The proposed research training program will provide excellent experience and mentoring in the methods and conduct of biomedical and clinical research that will complement the candidate's existing expertise in engineering and optics. A team of mentors who are recognized experts and leaders in airway physiology, sleep medicine and biomedical imaging have been assembled for this K25 program. Co-mentor Dr. Zhongping Chen, professor of Beckman Laser Institute and biomedical engineering at University of California Irvine has an established track record in the development of optical imaging methods and translational research. Co-mentor Dr. Matthew Brenner, Professor and Chief of Pulmonary Medicine at the Lung Center at the University of California Irvine has experienced similar success in the study of development of new laser diagnostic technologies for translation to clinical pulmonary and critical care medicine. Co-mentor Dr. Catherine Sassoon, Chief of Division of Pulmonary & Critical Care in VA Long Beach Healthcare System and Professor of Medicine in Residence, UC Irvine, is board certified in Sleep Medicine, Pulmonary, Internal Medicine and Critical Care with over 30 years of experience in respiratory physiology. She has serves as a member of Editorial Board of American Journal of Respiratory and Critical Care Medicine and Editorial Board of Respiratory Care. Co-mentor Michael Dickel, Ph.D., Staff of Sleep Disorders Laboratory in VA Long Beach Medical Center, is a board-certified sleep medicine specialist with extensive experience in Sleep Medicine, sleep physiology, sleep research, Statistics and training Pulmonary Fellows. The opportunities of this career award will provide the candidate valuable mentorship, training, and resources to further develop his research skills and expand his knowledge and experience in the conduct of experimentation both in the laboratory and in the clinic under the close supervision, leading to advancement to independent researcher level by completion of this proposed project.