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法糖尿病足溃疡通常导致跖骨或跟骨骨髓炎，这是一种严重的并发症，可能需要长期给予抗生素、手术清创或甚至截肢以进行治愈性治疗。目前用于诊断糖尿病足骨髓炎的方法是不充分的和昂贵的。开发一种非侵入性诊断装置来确定糖尿病骨髓炎特异性跖骨成分和质量的变化，将有可能作为当前临床标准的具有成本效益的诊断辅助手段。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，我们将我们的方法在体内使用称为经皮拉曼光谱（TRS）。我们的长期转化目标是开发一种TRS器械，专门用于确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。在本申请中，我们提出了三个具体目标，这将使我们能够开始TRS作为诊断设备的转化开发。具体目标1：使用手术治疗或截肢过程中获得的骨样本确定糖尿病骨髓炎的特征拉曼光谱模式。具体目标二：开发优化的TRS器械探头/探测器原型，以确定应用于人足跖面时的跖骨和跟骨成分和质量。具体目标3：在正常健康志愿者中对TRS器械探头/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：糖尿病患者经常患足溃疡，这些溃疡可导致脚骨感染。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，该设备将使用激光来识别糖尿病足溃疡患者的感染骨。

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.