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 - 2000万人的主要医学问题。阻塞性睡眠呼吸暂停症患者会出现睡眠断断续续、慢性疲劳、白天嗜睡、注意力不集中和记忆力问题，其后果包括机动车事故风险增加、心血管疾病发展和猝死风险增加。目前的金标准诊断方式，夜间多导睡眠图不方便，不能提供上呼吸道结构和解剖信息，不能识别OSA患者上呼吸道阻塞部位，这对选择合适的治疗特别是手术干预至关重要。该项目的长期研究目标是开发一种模式，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气道体积解剖成像；(2) OSA的生理调查；(3)确定梗阻部位有助于为潜在的手术候选人选择最合适的治疗方法。该项目建议开发和测试一种创新的高速远程内窥镜傅里叶域光学相干断层扫描（FDOCT）系统，该系统能够无创实时获取定量解剖信息，如横断面积和上呼吸道形状，用于OSA的表征。开发的系统将通过幻影模型和离体动物成像进行测试和优化。然后，在试点临床研究中，FDOCT扫描将在阻塞性呼吸暂停的受试者中进行，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行为方面提供出色的经验和指导，以补充候选人在工程和光学方面的现有专业知识。一个导师团队是气道生理学、睡眠医学和生物医学成像领域公认的专家和领导者，已经为这个K25项目聚集在一起。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，在光学成像方法和转化研究方面有着良好的发展记录。共同导师Matthew Brenner博士，加州大学欧文分校肺中心教授兼肺医学主任，在研究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方面取得了类似的成功。联合导师Catherine Sassoon博士是VA长滩医疗保健系统肺部和重症监护部门的负责人，也是加州大学欧文分校的常驻医学教授，她在睡眠医学、肺部、内科和重症监护方面获得了委员会认证，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危重病医学杂志和呼吸护理编辑委员会的成员。共同导师Michael Dickel博士是VA长滩医疗中心睡眠障碍实验室的工作人员，是一名经过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、统计和培训肺病研究员方面拥有丰富的经验。该职业奖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，并在实验室和诊所的密切监督下扩展他的实验知识和经验，从而通过完成该拟议项目晋升为独立研究员水平。

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.