Near InfraRed Layered Imaging of Tissue Hemodynamics (NIR-LITH)

项目总结/摘要 糖尿病足溃疡（DFU）与显著的发病率和死亡率相关， 5-与无DFU的糖尿病患者相比的年死亡率[3，4]。这些戏剧性的统计数据背后的原因 与缺乏用于监测伤口进展或恶化状况的客观度量有关。评估 功能性灌注是预测伤口愈合的最大未满足的需求之一。当前临床实践 仍然严重依赖于对伤口的视觉观察和临床检查，这种方法成功地 即使在非常有经验的临床医生中，愈合或截肢水平存活的预测也很差。拟议 创新的解决方案将补充目前的护理标准，通过提供DFU的特征， 客观指标，并将提供常规目视检查和临床试验期间可能遗漏的详细信息 仅评估。该解决方案将允许临床医生为患者选择适当的管理策略。 通过提供与潜在受损循环相关的清晰图像，本文的目的是 提出的工作是提供成像的DFU和周围组织的三维血液动力学图， 在0至0.5 cm的深度范围内具有可控的0.1 mm深度分辨率， 微循环灌注和血流动力学。这种方法将提供客观和即时的评估 DFU和手术伤口愈合潜力，并将帮助临床医生进行更准确，更快的治疗 决策在复杂的情况下，它将帮助外科医生选择一个水平截肢，仍然能够愈合，减少 手术次数和住院时间。我们称之为NIR-LITH（近红外）系统 组织血流动力学的分层成像）。本文提出的系统利用非接触式光学- 基于Vivonics先前开发的组织活力评估系统，以提供客观指标 在清创过程中向外科医生提供组织活力的信息。为了实现这一总体目标， 提出了以下具体目标： 目标1：增强第一代原型以提高深度辨别能力。可控 本任务的目标是用于组织层区分（0.1 mm）的深度成像能力（0- 0.5 cm）。 目标2：开发用于深度辨别和体模测试和表征的算法。 目标3：系统评价：与L.拉弗里大学 德克萨斯西南医学中心（UTSW）将被招募进行这项任务和金标准分析 将与NIR-LITH结果进行比较。

Project Summary/Abstract Diabetic foot ulcers (DFU) are associated with significant morbidity and mortality, with a 2.5x higher risk of 5-year mortality compared to diabetic patients without DFUs [3, 4]. The reason behind these dramatic statistics is tied to the lack of objective metrics for monitoring wound progress or deteriorating conditions. Assessment of functional perfusion is one of the biggest unmet needs for predicting wound healing. Current clinical practices still rely heavily on visual observation and clinical examination of the wound, an approach in which successful prediction of healing or amputation level survival is poor even among very experienced clinicians. The proposed innovative solution will complement the current standards of care for the characterization of DFUs by providing objective metrics and will provide details that can be missed during routine visual inspections and clinical assessments only. This solution will allow the clinician to select an appropriate management strategy for the specific case by providing clear images relative to potentially compromised circulation. The aim of the herein proposed work is to provide a three-dimensional hemodynamic map of the imaged DFU and surrounding tissue, with a controllable ≈1 mm depth resolution over a depth from 0 to 0.5 cm to assess different degrees of microcirculatory perfusion and hemodynamics. This approach will provide objective and immediate assessment of DFU and surgical wound healing potential and will help clinicians make more accurate and faster treatment decisions. In complex cases, it will help surgeons select a level amputation that will still be able to heal, reducing the number of surgeries and the length of hospitalizations. We call this system NIR-LITH (Near InfraRed Layered Imaging of Tissue Hemodynamics). The system herein proposed leverages a non-contact optical- based system for tissue viability assessment, previously developed at Vivonics, to provide objective metrics about tissue viability to surgeons during debridement procedures. In order to achieve this overarching goal, the following specific aims have been proposed:  Aim 1: Enhance first generation prototype to improve depth discrimination capabilities. Controllable depth imaging capabilities (0-0.5cm) for tissue layers discrimination (≈1 mm) is the goal of this task.  Aim 2: Develop algorithm for depth discrimination and phantom testing and characterization.  Aim 3: System evaluation: thirty DFU patients in collaboration with Dr. L. Lavery at the University of Texas Southwestern Medical Center (UTSW) will be recruited for this task and gold standard analysis will comparted against the NIR-LITH results.