Dual-modality FLIm and PSOCT for intravascular imaging of plaque in patients

双模态 FLIm 和 PSOCT 用于患者斑块血管内成像

• 批准号: 10306091
• 负责人: Brett E Bouma
• 金额: $ 66.75万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10306091
• 关键词: Address; Applications Grants; Arterial Fatty Streak; Biochemical; Cardiac; Cardiac Catheterization Procedures; Cardiovascular system; Catheterization; Catheters; Cause of Death; Cholesterol; Classification; Clinical; Clinical Management; Collagen; Collection; Consent; Coronary; Coronary Arteriosclerosis; Coronary artery; Data; Data Set; Databases; Decision Making; Development; Devices; Diagnostic; Documentation; Donor person; Engineering; Evaluation; Event; Extracellular Matrix; Family suidae; Fluorescence; Foam Cells; Future; Goals; Heart Transplantation; Histologic; Histopathology; Human; Hybrids; Image; Imaging Device; Imaging Techniques; Intervention; Investigation; Knowledge; Label; Lateral; Lead; Lesion; Link; Maps; Measurement; Microscopic; Modality; Modeling; Morphology; Optical Tomography; Optics; Pathology; Patients; Performance; Preclinical Testing; Procedures; Process; Reproducibility; Resolution; Risk Management; Rupture; Sampling; Specimen; Speed; Structure; System; Techniques; Testing; Time; Tissues; Visual; acute coronary syndrome; base; coronary lesion; data acquisition; design; detector; disorder prevention; experience; first-in-human; fluorescence lifetime imaging; human data; human imaging; human subject; imaging approach; imaging system; improved; improved outcome; in vivo; in vivo imaging; information display; innovation; insight; macrophage; meetings; novel; optical frequency domain imaging; percutaneous coronary intervention; personalized management; personalized medicine; polarimetry; preclinical evaluation; prototype; solid state; statistics; tomography; validation studies

PROJECT SUMMARY/ABSTRACT The clinical management of coronary artery disease (CAD) and the prevention of acute coronary syndromes (ACS) require knowledge of the underlying atherosclerotic plaque pathobiology. Current intravascular standalone imaging techniques are limited in their ability to evaluate processes that lead to plaque progression and sudden changes in plaque structure (e.g. rupture or erosion) conducive to ACS in humans. Hybrid intravascular imaging systems hold premises for a more comprehensive evaluation of plaque pathobiology in patients and are urgently needed. Our goal is to address this need through the development of an intravascular imaging approach capable of simultaneous assessment of changes in plaque biochemical composition and morphology associated with critical pathobiological processes in patients. We propose to advance an intravascular imaging system combining two complementary label-free optical techniques, specifically, Fluorescence Lifetime Imaging (FLIm) and Polarization Sensitive Optical Coherent Tomography (PSOCT) via an innovative bimodal imaging catheter suitable for percutaneous coronary imaging (PCI). This dual-modality approach should 1) yield great insight into the interplay of biochemical-morphological features that have a key role in plaque progression, destabilization and/or remodeling and 2) enable immediate display this information in near real-time, in a visual format useful for guiding personalized management of coronary lesions at the time of cardiac catheterization. The proposed technique will be able to perform safe and rapid co-registered measurement of (1) time-resolved fluorescence decays in multiple spectral emission bands, and (2) polarization- resolved optical tomographic data in a single pullback. To achieve our goal, we will first construct a FLIm-PSOCT catheter system including a freeform reflective optic providing optimized optical performance for both FLIm and PSOCT (Aim 1). Second, to demonstrate FLIm-PSOCT’s performance for fast and simultaneous/synergetic assessment of critical biochemical features associated with distinct morphological features, we will use the proposed hybrid system to image human coronary samples (ex vivo), with histopathology corroboration (Aim2). Finally, we will deploy this system in patients (first-in-human) to evaluate plaques during cardiac catheterization and determine clinical feasibility (Aim 3). The successful completion of this study will demonstrate the clinical feasibility and utility of intracoronary FLIm-PSOCT for assessment of critical plaque features likely to cause ACS. If such features can be reliably detected, the patients undergoing PCI procedures may benefit from personalized treatment of these plaques and improved outcome.

项目概要/摘要 冠状动脉疾病（CAD）的临床管理和急性冠状动脉综合征的预防 (ACS) 需要了解当前血管内动脉粥样硬化斑块的病理学基础。 独立成像技术评估导致斑块进展过程的能力有限 斑块结构的突然变化（例如破裂或侵蚀）有利于人类发生混合型 ACS。 血管内成像系统为更全面地评估斑块病理学提供了前提 我们的目标是通过开发血管内治疗来满足这一需求。 成像方法能够同时评估斑块生化成分的变化和 我们建议推进一种与患者关键病理生物学过程相关的形态学。 血管内成像系统结合了两种互补的无标记光学技术，具体来说， 荧光寿命成像 (FLIm) 和偏振敏感光学相干断层扫描 (PSOCT) 通过 一种适用于经皮冠状动脉成像 (PCI) 的创新双模态成像导管。 方法应该 1）深入了解具有关键作用的生化形态特征的相互作用 在斑块进展、不稳定和/或重塑中的作用以及 2) 能够立即显示此信息 近实时，以可视化格式，有助于指导当时冠状动脉病变的个性化管理 所提出的技术将能够安全、快速地进行联合注册。 测量 (1) 多个光谱发射带中的时间分辨荧光衰减，以及 (2) 偏振 为了实现我们的目标，我们首先构建一个 FLIm-PSOCT。 导管系统包括自由曲面反射光学器件，为 FLIm 和 FLIm 提供优化的光学性能 PSOCT（目标 1），展示 FLIm-PSOCT 的快速、同步/协同性能。 评估与不同形态特征相关的关键生化特征，我们将使用 提出的混合系统对人类冠状动脉样本（离体）进行成像，并进行组织病理学验证（Aim2）。 最后，我们将在患者身上部署该系统（首次在人体中）以评估心导管插入术期间的斑块 并确定临床可行性（目标 3）。本研究的成功完成将证明临床可行性。 冠状动脉内 FLIm-PSOCT 评估可能导致 ACS 的关键斑块特征的可行性和实用性。 如果能够可靠地检测到这些特征，接受 PCI 手术的患者可能会受益于个性化治疗 治疗这些斑块并改善结果。