Absolute Measurement of Cerebral Blood Flow Using Diffuse Optics

描述（由申请人提供）：中枢神经系统（CNS）疾病管理中的临床干预措施主要基于各种次要信息的推断以及临床医生的个人或集体经验，而不是直接测量脑功能，特别是脑血流量（CBF）。事实上，用于测量微脉管系统中的CBF的非侵入性、连续的床旁仪器对于各种CNS疾病如中风、出血和头部创伤的管理是非常期望的。目前使用的诊断有局限性。例如，可用的模态传递的信息不足（例如，选定动脉内的速度的经颅多普勒超声测量）或相对不可接近（氙吸入CT、动脉自旋标记MRI、PET）。这个建议的前提是，一个新开发的光学技术可以用来测量绝对CBF。弥散相关光谱（DCS）提供了新的，非侵入性的医疗诊断工具，其相对测量的能力最近已被证明在完整的人脑的功能激活研究。DCS的进一步发展预计将产生临床影响。为此，本建议以系统的方式解决DCS的缺点。问题如：“信号的生物起源是什么？”“，"正在探测哪个组织体积？"和"绝对的皮质CBF可以被估计吗？通过计算机模拟、组织模拟体模实验和体内研究来解决。如果成功，将进行试点临床试验和进一步开发仪器。我们希望在短时间内，这项技术的临床实用性将得到确立。该项目的另一个副作用是，其他疾病和器官的其他临床应用将是可行的。中枢神经系统（CNS）疾病管理中的临床干预措施主要基于临床医生的各种次要信息和经验的推断，而不是直接测量脑血流量（CBF）。用于测量微血管系统中的CBF的非侵入性、连续的床旁仪器对于各种CNS疾病（诸如中风、出血和头部创伤）的管理将是高度期望的。这项被提议的光学技术将朝着填补这一空白迈出一大步。

DESCRIPTION (provided by applicant): Clinical interventions in central nervous system (CNS) disease management base decisions on primarily deductions from a variety of secondary information and on the individual or collective experience of clinicians rather than direct measurements of brain function, and in particular cerebral blood flow (CBF). A non-invasive, continuous, bed-side instrument for measurement of CBF in the micro-vasculature would, in fact, be highly desirable for management of a variety of CNS disorders such as stroke, hemorrhage, and head trauma. Diagnostics in current use have limitations. For example, available modalities deliver either insufficient information (e.g. transcranial Doppler Ultrasound measurement of velocity within selected arteries) or are relatively inaccessible (Xenon inhalation CT, arterial spin labeling MRI, PET). The premise of this proposal is that a newly developed optical technique can be used to measure absolute CBF. Diffuse correlation spectroscopy (DCS) offers new, non-invasive medical diagnostic tools whose capabilities for relative measurements have recently been demonstrated in functional activation studies of intact human brain. Further developments in DCS are expected to have a clinical impact. To that end, this proposal addresses the shortcomings of DCS in a systematic way. Questions such as; ``What is the biological origin of the signal?'', ``Which tissue volume is being probed?'' and ``Can the absolute, cortical CBF be estimated?'' are addressed via computer simulations, experiments on tissue simulating phantoms and via in vivo studies. If successful, pilot clinical trials and further development of the instrumentation will follow. We expect that in a short time period, the clinical utility of this technology will be established. Another side-benefit of this project will be that other clinical applications in other diseases and organs will be feasible. Clinical interventions in central nervous system (CNS) disease management base decisions on primarily deductions from a variety of secondary information and experience of clinicians rather than direct measurements of cerebral blood flow (CBF). A non-invasive, continuous, bed-side instrument for measurement of CBF in the micro-vasculature would be highly desirable for management of a variety of CNS disorders such as stroke, hemorrhage, and head trauma. The proposed optical technique will take a big step towards fullfiling this void.