Development of photoacoustic tomography for non-invasive, label-free imaging of tissue perfusion in chronic wounds

开发用于慢性伤口组织灌注非侵入性、无标记成像的光声断层扫描技术

• 批准号: 10569031
• 负责人: Jun Xia
• 金额: $ 45.13万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569031
• 关键词: 3-Dimensional; Acoustics; Address; Affect; Agreement; Ambulatory Care Facilities; American; Amputation; Angiography; Ankle; Biometry; Blood; Blood Vessels; Chronic; Circulation; Clinic; Clinical; Clinical Trials; Clinical and Translational Science Awards; Collaborations; Contrast Media; Control Groups; County; Data; Decision Making; Detection; Development; Diffusion; Disease; Doppler Ultrasound; Ensure; Evaluation; Generations; Geometry; Goals; Guidelines; Hemoglobin; Hospitals; Hybrids; Image; Intervention; Label; Lasers; Leg Ulcer; Light; Lighting; Location; Medical center; Microcirculation; Modality; Monitor; Neuropathy; Operative Surgical Procedures; Optics; Outcome; Oxygen; Patients; Penetration; Performance; Perfusion; Photoplethysmography; Positioning Attribute; Quality of life; Resolution; Rotation; Scheme; Secure; Signal Transduction; Skin; Stasis Ulcer; Surgeon; System; Systems Development; Techniques; Testing; Three-Dimensional Imaging; Time; Tissue imaging; Tissues; Toes; Transducers; Treatment Cost; Ulcer; United States National Institutes of Health; Universities; Venous; Visit; Visual; Visualization; Work; X-Ray Computed Tomography; absorption; blood perfusion; chronic ulcer; chronic wound; clinical risk; clinical translation; computer science; decubitus ulcer; design; diabetic; diabetic patient; effectiveness analysis; feasibility testing; follow-up; foot; hemodynamics; high resolution imaging; image processing; imaging capabilities; imaging modality; imaging platform; imaging system; improved; indexing; innovation; mortality; multidisciplinary; nephrotoxicity; optoacoustic tomography; photoacoustic imaging; portability; pressure; prevent; programs; reconstruction; revascularization surgery; systems research; tool; treatment group; treatment planning; two-dimensional; ultrasound; wound; wound care; wound healing; wound treatment

Project summary Chronic leg ulcers are affecting approximately 6.5 million Americans and the disease includes venous stasis ulcers, arterial ulcers, pressure ulcers, and diabetic (neuropathic) ulcers. They are associated with significant mortality (28% over two years), reduced quality of life (nonambulatory), and high treatment costs (>$25 billion/yr in the U.S.). Since many chronic ulcers have underlying vascular insufficiency, accurate assessment of blood perfusion to the wound is critical to treatment planning and monitoring. However, existing clinical tests fail to meet this need in practice. Without timely information on circulation, a patient may need to wait months after the revascularization surgery before any additional intervention can be planned. An accurate, noninvasive tool for circulation assessment would greatly improve post-surgical decision making and clinical outcomes of wound patients. This project aims to develop a three-dimensional (3D) wound assessment system using photoacoustic tomography (PAT), a hybrid modality that detects optical absorption in tissue through the photoacoustic effect. The conversion of optical absorption into acoustic waves breaks through the optical diffusion limit, allowing for high-resolution imaging in three dimensions. Since hemoglobin serves as the major endogenous contrast at near-infrared wavelengths, PAT provides label-free, three-dimensional imaging of hemoglobin distribution, which is closely related to circulation. While PAT has shown promising results in vascular imaging, various hurdles have prevented its application in wound evaluation. Capitalizing on the recent innovations in photoacoustic system development and image processing, the team will address these hurdles and develop a PAT-based wound imaging system with unique advantages in terms of spatial resolution, penetration depth, and portability. To ensure successful implementation of the project, the PI has gathered a multidisciplinary team with expertise in photoacoustic imaging, wound healing, vascular surgery, biostatistics, and computer science. The project has also secured support from the region’s busiest vascular clinic located at Buffalo Generation Hospital and Erie County Medical Center and their outpatient clinics. More importantly, the team has already worked together and acquired preliminary data through support from the University at Buffalo’s NIH Clinical and Translational Science Awards (CTSA) Program. Through the four-year project, the team will achieve the following aims: Aim 1: Develop a versatile, high-resolution 3D photoacoustic imaging system that can be easily rotated and positioned to image any regions on the foot; Aim 2: Validate the system at vascular clinics and identify photoacoustic features of tissue perfusion; and Aim 3: Test the feasibility of using PAT to monitor tissue perfusion and guide post-surgical assessment and treatment planning.

项目摘要 慢性腿部溃疡正在影响大约650万美国人，这种疾病包括静脉淤滞 溃疡、动脉溃疡、压力性溃疡和糖尿病（神经性）溃疡。它们与重要的 死亡率（2年内28%）、生活质量下降（卧床）和治疗费用高（> 250亿美元/年 在美国）。由于许多慢性溃疡都有潜在的血管功能不全， 对伤口的灌注对于治疗计划和监测是至关重要的。然而，现有的临床试验未能 在实践中满足这一需求。如果没有及时的血液循环信息，患者可能需要等待数月后， 在计划任何额外的干预之前，进行血运重建手术。一种精确的非侵入性工具， 循环评估将大大改善术后决策和伤口的临床结局 患者本计画旨在开发一个利用光声技术的三维伤口评估系统 断层扫描（PAT），一种通过光声效应检测组织中的光吸收的混合模态。 光吸收到声波的转换突破了光扩散极限，允许 高分辨率的三维成像。由于血红蛋白作为主要的内源性对比剂， 近红外波长，PAT提供了无标记的，血红蛋白分布的三维成像， 与流通密切相关。虽然PAT在血管成像中显示出有希望的结果，但各种障碍 阻碍了其在伤口评估中的应用。利用光声领域的最新创新 系统开发和图像处理，该团队将解决这些障碍，并开发一个基于PAT 创伤成像系统在空间分辨率、穿透深度和便携性方面具有独特的优势。 为了确保项目的成功实施，PI组建了一个具有专业知识的多学科团队 在光声成像、伤口愈合、血管外科、生物统计学和计算机科学中。该项目 我还获得了该地区最繁忙的血管诊所的支持，该诊所位于布法罗世代医院和伊利 县医疗中心及其门诊部。更重要的是，团队已经在一起工作， 通过布法罗大学的NIH临床和转化科学的支持获得了初步数据 奖项（CTSA）计划。通过四年的项目，该团队将实现以下目标：目标1：发展 一种多功能、高分辨率的3D光声成像系统，可轻松旋转和定位以成像 目的2：在血管诊所使用该系统，并识别 目标3：测试使用PAT监测组织灌注并指导术后的可行性 评估和治疗计划。