Transcutaneous Raman Spectroscopy for Diagnosis of Diabetic Osteomyelitis

糖尿病足溃疡通常会导致跖骨或跟骨骨髓炎，这是一种严重的并发症，需要长期使用抗生素、手术清创甚至截肢才能治愈。目前可用于诊断糖尿病足骨髓炎的方法是不充分和昂贵的。开发一种非侵入性诊断设备来确定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，我们将我们的方法称为经皮拉曼光谱（TRS）。我们的长期转化目标是开发一种TRS装置，专门用于糖尿病足部溃疡患者跖骨和跟骨组成和质量的测定，用于骨髓炎的诊断。在本应用程序中，我们提出了三个具体目标，这将使我们能够开始TRS作为诊断设备的翻译开发。具体目标1：利用手术治疗或截肢期间获得的骨骼样本，确定糖尿病骨髓炎的特征拉曼光谱模式。具体目标2：开发TRS设备探针/检测器原型，优化用于测定人足的足底表面的跖骨和跟骨组成和质量。具体目标3：在正常健康志愿者中对TRS装置探针/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组成和质量的拉曼光谱模式。

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.