Transcutaneous Raman Spectroscopy for Diagnosis of Diabetic Osteomyelitis

描述（由申请人提供）：用于诊断糖尿病骨髓炎的经皮拉曼光谱 糖尿病足溃疡常常导致跖骨或跟骨骨髓炎，这是一种严重的并发症，可能需要长期服用抗生素、手术清创甚至截肢来进行治疗。目前可用于诊断糖尿病足骨髓炎的方法不足且昂贵。开发一种非侵入性诊断设备来定义糖尿病骨髓炎特有的跖骨成分和质量的变化，将有可能成为当前临床标准的一种经济有效的诊断辅助手段。多年来，我们和其他人一直使用近红外光谱作为平台技术来定义体内骨骼质量。我们的方法采用一种特定类型的近红外光谱，称为拉曼光谱，我们将我们的体内使用方法称为经皮拉曼光谱（TRS）。我们的长期转化目标是开发一种 TRS 设备，专门用于测定患有足部溃疡的糖尿病患者的跖骨和跟骨骨成分和质量，以诊断骨髓炎。在此应用中，我们提出了三个具体目标，使我们能够开始将 TRS 作为诊断设备进行转化开发。具体目标 1：使用手术治疗或截肢期间获得的骨样本确定糖尿病骨髓炎特征性的拉曼光谱模式。具体目标 2：开发经过优化的 TRS 设备探针/探测器原型，以确定应用于人足底表面时的跖骨和跟骨成分和质量。具体目标 3：对正常健康志愿者中的 TRS 装置探头/探测器原型进行初步横断面研究，以确定表征正常跖骨和跟骨的成分和质量的拉曼光谱模式。 公共卫生相关性：糖尿病患者经常出现足部溃疡，这些溃疡可能导致足骨感染。早期诊断感染的足骨将改善治疗。我们建议开发一种手持设备，使用激光来识别糖尿病足溃疡患者受感染的骨骼。

DESCRIPTION (provided by applicant): Transcutaneous Raman Spectroscopy for Diagnosis of Diabetic Osteomyelitis Diabetic foot ulcers often lead to metatarsal or calcaneal osteomyelitis, a serious complication that can require prolonged administration of antibiotics, surgical debridement or even amputation for curative treatment. Current methods available for the diagnosis of diabetic foot osteomyelitis are inadequate and costly. The development of a non-invasive diagnostic device to define changes in metatarsal bone composition and quality that are specific for diabetic osteomyelitis would have potential as a cost-effective diagnostic adjunct to current clinical criteria. For many years we and others have been using near infrared spectroscopy as a platform technology to define bone quality in vivo. Our methods employ a specific type of near-infrared spectroscopy known as Raman spectroscopy and we have termed our approach to in vivo use as Transcutaneous Raman Spectroscopy (TRS). Our long-term translational goal is to develop a TRS device specifically for determination of metatarsal and calcaneal bone composition and quality in diabetic patients with foot ulcers for the diagnosis of osteomyelitis. In this application we have proposed three specific aims that will allow us to begin the translational development of TRS as a diagnostic device. Specific Aim 1: Determine the Raman spectral patterns that are characteristic for diabetic osteomyelitis using samples of bone obtained during surgical treatment or amputation. Specific Aim 2: Develop TRS device probe/detector prototypes optimized to determine metatarsal and calcaneal bone composition and quality when applied to the plantar surface of the human foot. Specific Aim 3: Perform an initial cross-sectional study of the TRS device probe/detector prototypes in normal healthy volunteers to define the Raman spectral patterns that characterize composition and quality of normal metatarsal and calcaneal bone. PUBLIC HEALTH RELEVANCE: Patients with diabetes frequently get foot ulcers and these ulcers can lead to infection of foot bones. Early diagnosis of infected foot bones would improve treatment. We propose to develop a hand held device that would use laser light to identify infected bone in patients with diabetic foot ulcers.