Non-Invasive Evaluation of Transplant Kidney using OCT

使用 OCT 对移植肾进行无创评估

• 批准号: 9259961
• 负责人: MOSHE LEVI
• 金额: $ 38.78万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9259961
• 关键词: Acute Kidney Failure; Algorithms; Architecture; Area; Biological; Biology; Biomedical Engineering; Biometry; Blood flow; Caliber; Cellular biology; Clinic; Clinical Research; Clinical Trials; Collaborations; Data; Detection; Devices; Diagnostic; Dimensions; Evaluation; Excision biopsy; Guidelines; Hand; Histopathology; Human; Image; Imaging Device; Imaging technology; Immunologics; In Situ; Individual; Investigation; Ischemia; Kidney; Kidney Diseases; Kidney Transplantation; Light; Magnetic Resonance Imaging; Measures; Morphologic artifacts; Morphology; Motion; Operating Rooms; Optical Biopsy; Optical Coherence Tomography; Pancreas Transplantation; Paper; Pathology; Patients; Procedures; Proximal Kidney Tubules; Publishing; Renal Blood Flow; Renal function; Renal tubule structure; Research Personnel; Resolution; Roentgen Rays; Source; Speed; Structure; System; Technology; Three-Dimensional Image; Time; Tissue imaging; Tissues; Translating; Translations; Transplantation; Tubular formation; Ultrasonography; base; experience; functional status; glomerular function; human imaging; image processing; imaging modality; imaging study; imaging system; innovation; kidney cortex; kidney imaging; multidisciplinary; novel; optical imaging; prospective; public health relevance

DESCRIPTION (provided by applicant): There is currently a worldwide shortage of kidneys for transplantation due mainly to the fact that there is no reliable means to determine their viability (i.e., kidneys stored for long periods of time, etc.). Also, following transplantation, kidneys oftn do not function immediately and their status is unclear. Previously, we have shown that the histopathology of living, superficial, kidney proximal convoluted tubules is a good indicator of kidney viability and post-transplant renal function. Indeed, the histopathology of superficial proximal tubules reflects the status of the proximal convoluted kidneys throughout the entire kidney cortex. It is important, however, that proximal convoluted tubules are imaged in a non-invasive and living state because of their well- established dramatic sensitivity to ischemia (i.e. such as associated with excision biopsies). Optical coherence tomography (OCT) is an emerging imaging technology that can obtain high resolution, non-invasive, cross- sectional images of biological tissues in situ and in real time. In our recently published papers, we have demonstrated that OCT will provide novel non-invasive, real-time histopathological information of the kidney that is impossible to obtain using any other known procedure. In a preliminary clinical trial (27 patients) of living human donor kidneys, we have demonstrated that OCT imaging of human kidney histopathology both prior to and following their transplant can be used to predict post-transplant renal function. Furthermore, these preliminary trials have demonstrated that OCT imaging of human donor kidneys with a hand-held unit in the operating room is safe and that the entire kidney can be evaluated within a short period of time. Finally, we have recently demonstrated that OCT can be used in a Doppler mode (DOCT) to image renal blood flow, even in individual glomeruli (i.e., glomerular blood flow). These DOCT images provide an additional measure of renal/glomerular function and pathology. In this proposal, we will develop an advanced ultrahigh-speed swept- source OCT/DOCT imaging system to evaluate the histopathology of human donor kidneys prior to and following renal transplant. These OCT/DOCT imaging studies will be correlated with post-transplant renal function in order to develop imaging guidelines and associated algorithms for OCT evaluation of kidney viability for transplant. The proposed studies will increase the number of healthy kidneys available for transplantation by making the most efficient use of available donor kidneys, eliminating the possible use of bad donor kidneys (i.e., excessively damaged ischemic or diseased kidneys), providing a measure of expected post-transplant renal function, and allowing better distinction between post-transplant immunological rejection and ischemic- induced acute renal failure.

描述(申请人提供)：目前全球肾移植短缺的主要原因是没有可靠的方法来确定其存活能力。 (即，长时间储存的肾脏等)。此外，移植后，TN的肾脏不能立即发挥作用，其状态尚不清楚。以前，我们已经证明活的、浅表的、肾脏近端曲管的组织病理学是肾脏存活和移植后肾功能的良好指标。事实上，浅层近端小管的组织病理学反映了近端曲折肾脏在整个肾皮质中的状态。然而，重要的是，近曲小管的成像是在非侵入性和活的状态下进行的，因为它们对缺血(例如，与切除活检相关)具有广泛的敏感性。光学相干层析成像(OCT)是一种新兴的成像技术，它可以实时、原位地获得高分辨率、无创的生物组织断层图像。在我们最近发表的论文中，我们已经证明OCT将提供新的非侵入性、实时的肾脏组织病理学信息，这是使用任何其他已知程序无法获得的。在对活体人类供体肾脏的初步临床试验中(27名患者)，我们已经证明，移植前后人类肾脏组织病理学的OCT成像可以用来预测移植后的肾功能。此外，这些初步试验表明，在手术室使用手持设备对人类供体肾脏进行OCT成像是安全的，可以在短时间内对整个肾脏进行评估。最后，我们最近证明，OCT可以在多普勒模式(DOCT)下用于成像肾血流，甚至在单个肾小球(即肾小球血流)中也可以。这些DOCT图像提供了肾/肾小球功能和病理的额外测量。在这项计划中，我们将开发一种先进的超高速扫描源OCT/DOCT成像系统来评估肾移植前后人类供体肾脏的组织病理学。这些OCT/DOCT成像研究将与移植后的肾功能相关联，以开发用于OCT评估移植肾存活能力的成像指南和相关算法。拟议的研究将增加可供移植的健康肾脏的数量，方法是最有效地利用可用的供体肾脏，消除使用不良供体肾脏(即过度受损的缺血或病变肾脏)的可能性，提供移植后预期肾功能的衡量标准，并更好地区分移植后免疫排斥反应和缺血引起的急性肾功能衰竭。

项目成果

Mannitol infusion within 15 min of cross-clamp improves living donor kidney preservation.

• DOI: 10.1097/tp.0000000000000154
• 发表时间: 2014-10-27
• 期刊: Transplantation
• 影响因子: 6.2
• 作者: Andrews PM;Cooper M;Verbesey J;Ghasemian S;Rogalsky D;Moody P;Chen A;Alexandrov P;Wang HW;Chen Y
• 通讯作者: Chen Y

Indoor Localization of Hand-Held OCT Probe Using Visual Odometry and Real-Time Segmentation Using Deep Learning.

• DOI: 10.1109/tbme.2021.3116514
• 发表时间: 2022-04
• 期刊: IEEE transactions on bio-medical engineering