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

描述（由申请人提供）：阻塞性睡眠呼吸暂停（OSA）是影响美国1800万至2000万人的主要医学问题。患有OSA的患者患有睡眠不完整、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和发展具有猝死风险的心血管疾病。目前诊断OSA的金标准--夜间多导睡眠图不方便，不能提供上气道结构和解剖信息，也不能确定OSA患者上气道的阻塞部位，而阻塞部位对选择合适的治疗方法，尤其是外科手术干预非常重要。该项目的长期研究目标是开发一种提供额外解剖信息的模式，作为传统睡眠研究的宝贵补充研究，用于（1）睡眠期间和清醒时的真实的实时气道容积解剖成像;（2）阻塞性睡眠呼吸暂停综合症的生理学研究;（3）识别阻塞部位，帮助为潜在的手术候选人选择最合适的治疗方法。该项目提出了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）系统的开发和测试，该系统能够非侵入性真实的实时采集定量解剖信息，如上气道的横截面积和形状，以表征OSA。将使用体模模型和离体动物成像对开发的系统进行测试和优化。然后，在初步临床研究中，将在阻塞性呼吸暂停受试者中进行FDOCT扫描，与标准过夜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行为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。一个导师团队谁是公认的专家和领导者在气道生理学，睡眠医学和生物医学成像已组装为这个K25计划。共同导师陈忠平博士是贝克曼激光研究所和加州尔湾大学生物医学工程教授，在光学成像方法和转化研究的发展方面有着良好的记录。共同导师Matthew Brenner博士是加州大学欧文分校肺部中心的教授和肺部医学主任，他在研究新的激光诊断技术的发展以转化为临床肺部和重症监护医学方面取得了类似的成功。共同导师凯瑟琳·沙宣博士是弗吉尼亚州长滩医疗保健系统肺部和重症监护科科长，也是加州大学欧文分校住院医学教授，拥有睡眠医学、肺部、内科和重症监护方面的委员会认证，在呼吸生理学方面拥有30多年的经验。她曾担任《美国呼吸和重症监护医学杂志》和《呼吸护理》编辑委员会成员。共同导师迈克尔迪克尔，博士，VA长滩医疗中心睡眠障碍实验室的工作人员是一名委员会认证的睡眠医学专家，在睡眠医学、睡眠生理学、睡眠研究、统计学和培训肺研究员方面拥有丰富的经验。该职业奖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，并扩大他在实验室和诊所进行实验的知识和经验，并在密切监督下，通过完成该拟议项目，晋升为独立研究员。

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.