RII Track-4: Diffuse Optical Imaging for Early Detection of Diabetic Polyneuropathy

非技术性描述糖尿病多发性神经病（DPN）是一种常见的糖尿病疾病，导致下肢感觉丧失。 如果不加以控制，这种情况可能导致组织创伤，溃疡，感染，最终截肢。由于小神经纤维支配小血管，因此通过监测组织灌注和血流的变化可以进行早期检测。在本项目中，PI将联合收割机漫射光学与基于激光的成像技术相结合，以生成能够突出显示DPN标记物（包括足部组织灌注和血液流速）的个人特定热图。结合肤色和疾病的模型将通知成像数据，以确保空间热图对于DPN检测是准确和可靠的。这种低成本、非侵入性的方法将为常规监测提供机会，提供早期检测小神经纤维损伤并降低进一步并发症的风险。此外，该项目建立了缅因州大学蒂尔伯里生物光子学小组与波士顿大学BOTLab之间的合作，这将导致几项研究。糖尿病多发性神经病（DPN）是一种常见的糖尿病并发症，是感觉丧失，特别是在下肢，并增加组织创伤的风险，导致溃疡，感染和截肢的风险增加。目前的筛查方法无法量化早期神经损伤，尽管出现了几种早期症状，包括：烧灼感、瘙痒、坐立不安和热感觉差。目前的金标准测定是由于成本和/或侵入性程度，这表明需要一种新的方法。小神经纤维支配汗腺和小动脉，当受损时，汗液和血液流动特性都会改变。一些功能性小神经纤维测试是基于排汗的损失和有节奏的血流特征的改变;然而，每种方法的兴奋性都因低特异性或肤色和疾病的并发症而减弱。在这个建议中，我们将建立一个三波长的时间调制的空间频域成像（TM-SFDI）和激光散斑对比成像（LSCI）系统的宽场成像的血液流速和浓度的氧合和脱氧血红蛋白。2层蒙特卡罗方法将最大限度地减少由于肤色和疾病引起的误差，并且还将告知投影到组织上的最佳空间频率的选择，以最大限度地提高氧合血红蛋白和脱氧血红蛋白的灵敏度。总的来说，TM-SFDI/LSCI系统是一种低成本、非侵入性的方法，用于纵向监测糖尿病患者。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Non-Technical DescriptionDiabetic polyneuropathy (DPN) is a common diabetic condition that results in the loss of sensation in the lower limbs. If left unchecked, this condition can lead to tissue trauma, ulcerations, infections and ultimately amputation. Since small nerve fibers innervate small blood vessels, early detection is possible by monitoring changes in tissue perfusion and blood flow. In this project, the PI will combine diffuse optics with laser-based imaging techniques to generate person-specific heat maps capable of highlighting DPN markers that include tissue perfusion and blood flow rates in feet. A model incorporating skin tones and disorders will inform the imaging data to ensure the spatial heat maps are accurate and reliable for DPN detection. This low-cost, non-invasive approach will provide opportunities for routine monitoring, providing earlier detection of small nerve fiber damage and reducing the risk of further complications. Additionally, this project establishes collaborations between the Tilbury Biophotonics group at the University of Maine with the BOTLab at Boston University which will result in several studies. Technical DescriptionDiabetic polyneuropathy (DPN), a common diabetic complication, is the loss of sensation particularly in the lower limbs and increases the risk of tissue trauma, resulting in ulcerations, infections and increased risk of amputation. Current screening approaches are unable to quantify early nerve damage despite the onset of several early symptoms including: burning, itching, restlessness, and poor thermal sensation. Current gold standard assays are due to cost and or degree of invasiveness suggesting that a new approach is needed. Small nerve fibers innervate both sweat glands and small arterioles and when damaged, both perspiration and blood flow characteristics are altered. Several functional small nerve fiber tests are based on the loss of perspiration and alterations of the rhythmic blood flow characteristics; yet excitement of each approach is dampened by low specificity or complications of skin tones and disorders. In this proposal we will build a three-wavelength Time Modulated Spatial Frequency Domain Imaging (TM-SFDI) and Laser Speckle Contrast Imaging (LSCI) system for wide-field imaging of both blood flow rates and concentrations of oxy- and deoxygenated hemoglobin. A 2-layer Monte Carlo method will minimize error due to skin tones and disorders and will also inform the selection of optimal spatial frequencies projected onto the tissue to maximize sensitivity of oxy- and deoxygenated hemoglobin. Collectively, the TM-SFDI/LSCI system is a low-cost, non-invasive approach for longitudinally monitoring diabetics.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.