Continuous Monitoring and Management of Vaginal Health via Multifunctional OCT/OCTA Endoscopy

项目总结 绝经期泌尿生殖系统综合征(GSM)影响高达50%的女性，并对 他们在总体健康和性功能方面的生活质量。激素疗法是最重要的 通常进行补充天然雌激素的程序，但与健康风险相关 长期治疗是存在的。最近，一种替代疗法被提出，使用分数二氧化碳微米 可能使无法接受激素治疗的患者受益的消融。尽管激光微电子 消融术在皮肤科显示了明显的益处，但在女性骨盆内科仍有争议。 主要问题是，在没有明确的适应症的情况下，对良性疾病进行常规的侵入性活组织检查 泌尿生殖系统改变、组织反应的病理生理学和导致顽固性症状的因素 人们对此仍然知之甚少。因此，这是一个研究领域，将极大地受益于非侵入性 光学相干层析成像(OCT)等成像技术。我们的长期目标是提供 通过筛选将从激光治疗中受益最大的患者来进行个性化的患者管理， 优化激光持续时间和剂量，并评估后续护理的必要性。为了实现这一目标，我们 将开发一种结合OCT和OCT血管造影的护理点式内窥镜成像系统 (OTA)在阴道激光治疗期间同时获得结构和功能变化的信息 治疗。在此基础上，提出了用1.7μm中心波长扫描源激光对500μm进行成像 比传统的1.3μm激光器更深。我们将通过以下具体工作实现我们的目标 目标。目的1：设计和开发1.7μm OCT/OCTA系统和多功能内窥镜成像系统 探测器。目的2：通过评估集成内窥镜在人体内的重复性 不同人口统计组别的阴道组织完整性。目的3：研究激光消融的效果 在几种激光疗法的时间过程中，并了解组织反应。内窥镜检查 OCT/OCTA系统将在妇科实践中作为一种无创活检工具，它可以无创地 侵入性地，提供有关组织的结构和功能信息。这将为临床医生提供 科学家们用一种重要的工具来筛选将从激光中受益的患者，监测 激光治疗的进展，评估激光治疗后的组织反应，并进一步 个体化治疗策略。预计拟议的研究将对以下方面产生重大影响 影像引导激光治疗与GSM的管理。

PROJECT SUMMARY Genitourinary Syndrome of Menopause (GSM) affects up to 50% of women and negatively affects their quality of life with regard to general health and sexual function. Hormone therapy is the most commonly performed procedure to supplement the natural estrogen, but health risk associated with long-term therapy exists. Recently, an alternative therapy has been proposed using fractional CO2 micro- ablation that may benefit patients that cannot receive hormone therapies. Although laser micro- ablation showed a clear benefit in dermatology, it remains controversial in female pelvic medicine. The main problem is that, without a clear indication to routinely perform an invasive biopsy for benign genitourinary changes, the pathophysiology of tissue response and factors leading to refractory symptoms remain poorly understood. Thus, this is an area of research that would greatly benefit from non-invasive imaging technologies such as Optical Coherence Tomography (OCT). Our long-term goal is to provide individualized patient management by screening patients who will benefit the most from laser therapy, optimize the laser duration and dose, and assess the need for follow-up care. To achieve this goal, we will develop a point-of-care endoscopic imaging system that combines OCT and OCT angiogram (OCTA) to obtain simultaneous information on structural and functional changes during the vaginal laser treatment. We further proposed to use 1.7 μm center wavelength swept-source laser to image 500 μm deeper than the traditional 1.3 μm laser. We will achieve our objectives by pursuing the following specific aims. Aim 1: Design and develop a 1.7 μm OCT/OCTA system and a multifunctional endoscope imaging probe. Aim 2: Establish the reproducibility of the integrated endoscope in human subjects by assessing vaginal tissue integrity in different demographic groups. Aim 3: Investigate the effects of laser ablation over a time course of several laser therapies and understand the tissue response. The endoscopic OCT/OCTA system will serve as a noninvasive biopsy tool in the gynecological practice and it can, non- invasively, provides structural and functional information about the tissue. This will provide clinicians and scientists with an important tool to screening the patients that will benefit from the laser, monitor the progression of laser therapy, and evaluate the tissue response from the laser treatment and further individualize treatment strategies. The proposed research is expected to have a significant impact on image-guided laser therapy and the management of GSM.