A Miniaturized and High-frequency Acoustic Imaging System for Oral Health and Diseases of the Head and Neck

项目总结 牙周炎和口腔疾病很普遍，对生活质量有重大的负面影响。放射摄影术 是影像检查的标准，但仅限于对硬组织的评估。在过去的三年里，我们有 研究表明，超声成像对口腔健康具有显著的优势，包括非侵入性和真实性。 牙周探诊深度、牙釉质结合部、牙龈厚度、牙周炎的时间评价 灌流/缺氧和临床附着丧失。然而，这一领域的进一步临床工作受到 超声换能器太大了--它们太大了，无法接触到后牙。虽然较小 传感器存在，它们不能以成像小特征所需的高频(&gt；40 MHz)运行 与口腔健康有关的尺码。因此，我们建立了学术和产业三方合作伙伴关系，以 改进和最终确定这些用于口腔健康的设备。加州大学圣迭戈分校的Jokerst博士担任PI，并率先使用 口腔健康中的光声成像。Visualsonics Corp.是我们的工业合作伙伴-Jokerst博士的初步报告 数据是在Visualsonics设备上收集的，该公司在开发方面有20年的跟踪记录 高频换能器，包括最近批准的510K人类使用的系统。临床合作伙伴是 凯西·陈博士是南加州大学牙周病学的主席，他将在人体受试者身上验证该系统。 这项工作的目标1将建造和验证一种小型曲棍球杆式传感器。虽然这个设计已经是 20 MHz以上的普通曲棍球杆传感器不可用。AIM 2将把半导体激光器集成到 用于光声成像以补充超声的系统。AIM 3将开发图像处理算法 自动导出口腔健康指标，如临床附着丧失和探查深度。是这样的 自动图像处理对于广泛的临床接受度至关重要。AIM 4将在健康状态下验证该设备 以及与临床黄金标准进行比较的患病人类受试者。这项工作的意义在于 基于牙周病的广泛流行和声学的显著新见解 影像在诊断和治疗计划中提供帮助。创新成果包括非侵入性制图， 牙骨质牙釉质结合部的直接测量、非侵入性生物分型和炎症的3D图 在植入物附近。这项工作是可行的，因为所有三个合作伙伴的记录以及他们的历史 协作。这对NIH来说是一项很好的投资，因为没有小型化和高频(&gt；40 MHz)超声换能器可用，尽管空间分辨率大幅提高 频率优惠。该提案提供了所有风险范围的可交付成果，并且超声波换能器具有很高的 可能取得成功的影响远远超出口腔健康：在内窥镜、头颈部的应用 疾病，以及经直肠/经阴道成像是显而易见的。

PROJECT SUMMARY Periodontitis and oral disease are widespread with major and negative impacts on quality of life. Radiography is the standard of care in imaging but is limited to assessment of hard tissue. In the last three years, we have shown that ultrasound imaging offers significant advantages to oral health including non-invasive and real- time assessment of the periodontal probing depths, cementoenamel junction, gingival thickness, gingival perfusion/hypoxia, and clinical attachment loss. However, further clinical work in this field is limited by the large size of the ultrasound transducers—they are simply too large to access the posterior teeth. While smaller transducers exist, they cannot operate at the high frequency (>40 MHz) needed to image the small feature sizes involved in oral health. Therefore, we have established a three-way academic-industrial partnership to refine and finalize these devices for oral health. Dr. Jokerst at UCSD serves as PI and pioneered the use of photoacoustic imaging in oral health. VisualSonics Corp. is our industrial partner—Dr. Jokerst’s preliminary data was collected on VisualSonics equipment, and this company has a 20-year track record in developing high-frequency transducers including recent 510k-approved systems for human use. The clinical partner is Dr. Casey Chen who is Chair of Periodontology at USC and who will validate the system with human subjects. Aim 1 of the work will build and validate a small hockey stick-style transducer. While this design is already common, hockey stick transducers above 20 MHz are not available. Aim 2 will integrate diode lasers into the system for photoacoustic imaging to complement ultrasound. Aim 3 will develop image-processing algorithms to automatically export metrics of oral health such as clinical attachment loss and probing depth. Such automated image-processing is critical to broad clinical acceptance. Aim 4 will validate this device in healthy and diseased human subjects with comparisons to clinical gold standards. The significance of this work is based on the widespread prevalence of periodontal disease and the remarkable new insight that acoustic imaging offers in diagnosis and treatment planning. The innovative outcomes include non-invasive charting, direct measurements of the cementoenamel junction, noninvasive biotyping, and 3D maps of inflammation near implants. The work is feasible because of the track record of all three partners as well as their history of collaboration. This is a good investment for NIH because there is no miniaturized and high-frequency (>40 MHz) ultrasound transducer available despite the dramatic improvement in spatial resolution that high frequency offers. The proposal offers deliverables at all ranges of risk and the ultrasound transducer is highly likely to succeed with implications well beyond oral health: Applications in endoscopy, head and neck diseases, as well as transrectal/transvaginal imaging are obvious.