Infrared Skin Imaging to Transform Noninvasive Diagnosis and Management of Skin Disease

红外皮肤成像改变皮肤病的无创诊断和治疗

• 批准号: 10254984
• 负责人: Leonid Shmuylovich
• 金额: $ 35.87万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-14 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10254984
• 关键词: Address; Adult; Affect; American; Appearance; Appointment; Award; Axilla; Benign; Biopsy; Cessation of life; Child; Chronic; Cicatrix; Clinic; Clinical; Color; Communities; Coupled; Cutaneous; Data; Dermatologist; Dermatology; Devices; Diagnosis; Diagnostic; Disease; Disease Marker; Disease Progression; Engineering; Ensure; Epidermis; Face; Furuncles; Future; Grant; HRK gene; Hemoglobin; Hidradenitis Suppurativa; Histologic; Histology; Human; Image; Imaging technology; Inflammation; Inflammatory; Inguinal region; Joints; Lead; Leadership; Length; Lesion; Light; Limb structure; Lipids; Malignant - descriptor; Measures; Medicine; Melanins; Mentors; Methods; Microscopic; Modality; Nature; Neoplasms; Optics; Patients; Penetration; Photography; Physicians; Physiological; Pigments; Pilot Projects; Population; Positioning Attribute; Procedures; Process; Productivity; Psoriasis; Publishing; Radiology Specialty; Redness; Research; Research Personnel; Running; Scalp structure; Scientist; Severity of illness; Short Waves; Silicon; Skin; Skin Cancer; Skin Pigmentation; Skin Tissue; Source; Standardization; System; Technical Expertise; Technology; Testing; Tissues; Training; Translating; Treatment outcome; Universities; Validation; Vision; Visual; Visualization; Washington; Water; Work; absorption; accurate diagnosis; base; career; catalyst; chromophore; chronic inflammatory skin; cost; detector; experience; human subject; imaging modality; improved; in vivo; light scattering; medical schools; microscopic imaging; neoplastic; new technology; non-invasive imaging; noninvasive diagnosis; novel; optical imaging; pre-clinical; professor; reflectance confocal microscopy; skin color; skin disorder; success; tenure track; tissue phantom; virtual

Project Summary/Abstract Skin disease affects 1 in 4 Americans and costs $75 billion annually. Diagnosis relies upon visual inspection, but the subjective nature of visual assessment can lead to death from skin cancer misdiagnosis or suffering from misdiagnosis of a treatable chronic inflammatory condition. Non-white Americans make up 40% of the population and face further challenges, because disease can appear more subtly in pigmented skin, leading to systematic underdiagnosis and undertreatment. Skin biopsy is more objective but not all patients, particularly children, tolerate invasive procedures, and there are concerns about overutilization and low diagnostic yield of biopsies. Thus there is an urgent need for objective technologies that can quantitatively assess cutaneous inflammation and neoplasms across diverse skin types, and that can provide noninvasive alternatives to skin biopsy. Macroscopic optical imaging modalities may be able to address this need, but mostly depend on Silicon(Si)-based photodetectors, which constrains what these devices can measure because in the range where Si-based detectors are most sensitive (400-950 nm), melanin and hemoglobin are the dominant chromophores, while lipid and water are essentially invisible. With respect to microscopic optical imaging modalities, reflectance confocal microscopy (RCM) provides an alternative to biopsy. However, conventional RCM is limited to depths of 200-350 µm, and therefore deeper lesion margins may be missed and disease processes that extend beyond the epidermis are inaccessible. The short wave infrared (SWIR) spectral range (900-1700 nm) extends beyond the reach of Si-based detectors, and is characterized by increased water and lipid absorption, and decreased melanin absorption. In recent work we found that noninvasive SWIR imaging provides high contrast visualization of cutaneous inflammation that can be used to derive quantitative measures of inflammation that decrease linearly with disease progression. These considerations inform the central hypothesis that SWIR imaging will support objective assessment of inflammatory and neoplastic skin diseases regardless of skin pigmentation. In Aim 1 we will develop a macroscopic SWIR imaging modality and test its ability to assess disease severity in representative chronic inflammatory conditions in patients with diverse skin types. In Aim 2 we will develop a microscopic SWIR imaging modality and test its ability to surpass existing optical imaging depth limitations and also to differentiate benign from malignant lesions. These aims will be achieved through technical expertise in the Shmuylovich lab, with preclinical validation in skin mimicking phantoms followed by pilot studies in human subjects. This work represents a paradigm shift in cutaneous imaging whereby novel research-grade infrared imaging will be clinically translated to quantitatively assess disease across the full spectrum of diverse skin types, and at length scales ranging from whole body photography to virtual histology. These new technologies will have the potential to provide all patients with access to accurate diagnosis and management of skin disease and improve treatment outcomes.

项目摘要/摘要 皮肤病影响着四分之一的美国人，每年造成750亿美元的损失。诊断依赖于肉眼检查， 但视觉评估的主观性可能会导致皮肤癌、误诊或痛苦的死亡。 误诊为可治愈的慢性炎症性疾病。非白人美国人占美国人总数的40% 并面临进一步的挑战，因为疾病可以更微妙地出现在有色素的皮肤中，导致 系统性诊断不足和治疗不足。皮肤活检更客观，但不是所有患者，尤其是 儿童，容忍侵入性手术，并担心过度使用和低诊断率 活组织检查。因此，迫切需要能够定量评估皮肤的客观技术 各种皮肤类型的炎症和肿瘤，可以提供皮肤的非侵入性替代品 活组织检查。宏观光学成像方式可能能够满足这一需求，但主要取决于 硅(Si)基光电探测器，这限制了这些设备可以测量的内容，因为在范围内 在硅基探测器最灵敏的地方(400-950 nm)，黑色素和血红蛋白占主导地位 生色团，而脂肪和水基本上是看不见的。关于显微光学成像 反射共聚焦显微镜(RCM)提供了活组织检查的另一种方法。然而，传统的 RCM限于200-350微米的深度，因此可能会漏掉更深的病变边缘，从而导致疾病 延伸到表皮之外的突起是不可触及的。短波红外光谱范围 (900-1700 nm)超出了硅基探测器的范围，其特点是水分增加和 脂肪吸收减少，黑色素吸收减少。在最近的工作中，我们发现无创的SWIR成像 提供皮肤炎症的高对比度可视化，可用于得出定量 随着疾病进展而线性减少的炎症指标。这些考虑因素使 中心假设SWIR成像将支持对炎性和肿瘤性皮肤的客观评估 疾病与皮肤色素沉着无关。在目标1中，我们将开发一种宏观SWIR成像方式和 测试其在具有代表性的慢性炎症性疾病中评估疾病严重性的能力 皮肤类型多样。在目标2中，我们将开发一种显微SWIR成像方式，并测试其超越能力 现有的光学成像深度有限，也无法区分良恶性病变。这些目标 将通过Shmuylovich实验室的技术专长以及皮肤模拟的临床前验证来实现 幻影之后是对人类受试者的先导研究。这项工作代表了皮肤领域的范式转变 新的研究级红外成像将被临床转化为定量评估的成像 各种皮肤类型的疾病，以及从全身到全身的长度范围的疾病 从摄影到虚拟组织学。这些新技术将有可能为所有患者提供 获得皮肤病的准确诊断和管理，并改善治疗结果。