System for documenting and tracking skin lesions

项目摘要 本STTR提案的目标是开发一个纵向跟踪位置的系统， 患者身体上所有色素性皮肤病变的形态学变化。拟议的软件将建立在 先前开发的全身摄影（TBP）系统，称为Lumo扫描仪，可以提供 在整个身体表面都有前所未有的分辨率。皮肤癌，包括黑色素瘤和非黑色素瘤 黑色素瘤是美国最常见的癌症类型。早期识别可疑人员 初级保健环境中的色素性病变（SPL）可改善黑色素瘤预后，并可能导致20- 治疗成本降低一倍。所提出的设备显著减少了临床医生进行以下操作所需的时间： 记录病变并做出诊断决策，从而使医疗保健系统能够更好地科普 皮肤科医生的短缺所提出的技术是新颖的，因为它：1）提供了一种 指病变位置的标准化方式，2）允许皮肤科医生保持完整的历史记录， 记录每个病变3）检测显著变化（演变）的病变和4）帮助皮肤科医生发现 癌症病变在其非常早期的阶段，以改善患者的整体预后。 该项目团队已经开发了一个全身摄影（TBP）系统，这是不同于商业 因为它避免了使用皮肤镜的需要，并且可以产生足够的图像， 分辨率，可用于皮肤癌的早期检测。该器械已收到IRB， 已安装在约翰霍普金斯（JHU）门诊中心进行首次临床研究。通过你阅读这个 JHU的100例患者研究正在审查中，在该研究中，基于扫描的检查的有效性将被 与传统的临床和皮肤镜皮肤检查相比， 在该提案中，团队打算开发一种时间研究工具，该工具可以随时间推移跟踪所有PSL， 参与者的姿势和体重在扫描过程中的变化。这样的系统将使临床医生能够 随着时间的推移准确监测患者的PSLs，记录先前识别的病变的任何变化，并检测 在护理点出现新病变。在该项目的两个阶段中，该团队还将专注于检测 改进病变并优化扫描软件，以提供更好的用户界面， 诊断色素性皮肤病变（PSL），同时减少皮肤科医生完全检查 记录患者感兴趣的病变。 尽管一些文献表明黑色素瘤的恶性度是过度筛查的结果， 虽然死亡人数没有明显增加，但其他人认为，低死亡率是由于更好的 筛选无论如何，人们一致认为，病理学家研究了太多的病变。Lumo 扫描仪与本项目中开发的设施相结合，将使技术人员能够在 准确的扫描，从而使皮肤科医生花费更少的记录高危患者。而且这 新的设备将使远程皮肤病学在缺乏皮肤科医生的地区成为可能。另夕h 所提出的设备还可以用于诊断和准确地监测治疗的功效 银屑病、特应性皮炎和其它炎性皮肤病。牛皮癣和特应性皮炎也是 严重的全球性问题。在美国，牛皮癣影响约800万人，而约3160万人 美国人患有某种形式的湿疹，包括特应性皮炎。

Project Summary The objective of this STTR proposal is to develop a system for longitudinally tracking the locations and morphologic changes to all Pigmented Skin Lesions on the patient’s body. The proposed software will build on a previously developed Total Body Photography (TBP) system, called Lumo Scanner, that can provide unprecedented resolution across the entire body surface. Skin cancers, including both melanoma and non- melanoma, are the most common type of cancer in the United States. Early-stage identification of suspicious pigmented lesions (SPLs) in primary care settings can lead to improved melanoma prognosis and a possible 20- fold reduction in treatment cost. The proposed device significantly reduces the clinicians’ time required for documenting lesions and for making diagnostic decisions, thereby allowing the healthcare system to better cope with the forecasted shortages of dermatologists. The proposed technology is novel in that it: 1) provides a standardized way of referring to lesions’ locations, 2) allows dermatologists to maintain a complete historical record of every lesion 3) detect significantly changed (evolved) lesions and 4) assists dermatologists in finding cancerous lesions at their very early stages to improve overall patient prognosis. The project team has already developed a Total Body Photography (TBP) system that is unlike the commercially available systems in that it obviates the need for using a dermatoscope and can produce images of sufficient resolution that can be used for early detection of skin cancers. This device has already received an IRB and has been installed at Johns Hopkins (JHU) Outpatient Center for its first clinical study. By your reading of this proposal is under review, JHU’s 100-patient study in which the efficacy of scan-based examinations will be compared with the efficacy of traditional clinical and dermatoscopic-based skin examinations, is well on its way. Within this proposal team intends to develop a temporal study tool that can follow all PSLs over time regardless of participants’ pose and weight changes between scanning sessions. Such a system will enable clinicians to accurately monitor patients’ PSLs over time, document any changes in previously identified lesions, and detect new lesions at the point of care. Within, the two phases of this project, the team will also focus on detecting evolved lesions and optimizing the scanning software to provide a better user interface for following and diagnosing pigmented skin lesions (PSL) while reducing the amount of time it takes for the dermatologist to fully document the patients lesions of interest. Though some literature suggests the epidemy in melanoma is the result of over-screening as evidenced by the number of deaths not increasing commensurately, others suggest that the low death-rate is the result of better screening. Regardless, there is unanimous agreement that too many lesions are studied by pathologists. Lumo Scanner when combined with the facilities developed in this project, will enable technicians perform highly accurate scans and thus allow the dermatologist to spend less documenting the high-risk patients. Also, this novel device will enable teledermatology in areas where there is a scarcity of dermatologists. Additionally, the proposed device can also be used for diagnosing and accurately monitoring the efficacy of therapies for psoriasis, atopic dermatitis, and other inflammatory skin conditions. Psoriasis and atopic dermatitis are also serious global problems. In the United States, psoriasis affects about 8 million people while about 31.6 million people in the United States have some form of eczema, including atopic dermatitis.