Image Guidance Method for Diabetic Foot Surgery

糖尿病足手术的图像引导方法

基本信息

批准号：
7999884
负责人：
Irving Weinberg
金额：
$ 38.03万
依托单位：
WEINBERG MEDICAL PHYSICS, LLC
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-01 至 2011-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7999884
关键词：
Abattoirs Academia Address Adoption Anaerobic Bacteria Animal Experiments Animal Model Animals Anoxia Biological Assay Biological Models Biomedical Engineering Biophysics Blood Burn injury Businesses Capital Caring Cells Child Chills Clinical Clinical Protocols Clinical Trials Collaborations Collection Commerce Community Hospitals Computer Assisted Computer software Current Procedural Terminology Codes Custom Data Analyses Debridement Decubitus ulcer Development Devices Diabetes Mellitus Diabetic Foot Diabetic wound Elements Employee Endoscopy Engineering Environment Equipment Europe Excision Eye FDA approved Face Family suidae Feedback Fibrosis Fluorescence Funding Gamma Rays Goals Gold Guidelines Heart Hemoglobin Hospitals Human Image Image-Guided Surgery Imaging Device Incentives Income India Inflammatory Inpatients Institution Intellectual Property International Investments Knowledge Label Lead Learning Legal patent Length Length of Stay Letters Licensing Life Limb Salvage Magic Magnetic Resonance Imaging Marketing Medical Medical Imaging Medical center Medicare Methods Mission Mitochondria Modeling NADH National Institute of Diabetes and Digestive and Kidney Diseases Nature Necrosis Nosocomial Infections Operative Surgical Procedures Optics Orthopedics Osteomyelitis Patient Noncompliance Patients Penetration Phase Physicians Physics Physiological Pilot Projects Podiatry Preparation Price Procedures Production Protocols documentation Proxy Publications Publishing Quality of life Quantum Dots Radioactive Receiver Operating Characteristics Reporting Research Design Resected Residual state Resolution Respiration Safety Sales Sampling Scientist Signal Transduction Silicon Sinus Site Source Specimen Speed Staging Stream Study Section Suggestion Surgeon Surgical margins System Tail Technology Tetracyclines Third-Party Payer Time Tissue Model Tissue Viability Tissues Traction UV sensitive United States National Institutes of Health Validation Vendor Welding Wing Work Yeasts aged base bone clinical application commercial application cost design design and construction detector diabetic diabetic patient digital distraction experience fluorescence microscope foot hospital bed improved innovation instrumentation interest intraoperative imaging killings manufacturing process millimeter miniaturize molecular imaging nanomaterials new technology novel oncology optical sensor oxidation pathogen payment phase 1 study preference programs public health relevance radiotracer research study response sensor success symposium tool wound

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this project is to improve the care of diabetic patients undergoing surgery for treatment of osteomyelitis. This improvement will be attained by providing immediate intraoperative imaging feedback to podiatrists and surgeons as to whether surgical margins are clear of involvement, and whether remaining tissues are healthy. Often, patients reside in hospital beds while pathological assessment of tissue specimens is pending, adding to overall care costs and exposing patients to potential nosocomial infection. A rapid and reliable method of assessing surgical margins intraoperatively could potentially reduce hospital stays. Providing additional confidence might allow surgeons and podiatrists to be more conservative in their resections, thereby improving patients' quality of life. The commercial market for diabetic osteomyelitis care has been estimated at $10 billion annually, with a similar amount for non- bone wound care. The project takes advantage of recent innovations in miniaturized fluorescence microscopes, and applies lessons learned in oncology imaging, towards the goal of rapid identification of surgical margins for osteomyelitis patients. Follow-on applications for the technology to be developed in this project include decubitus ulcer debridement, and other wound care challenges. Unlike prior imaging approaches that employed exogenous contrast materials (e.g., tetracycline, labeled radiotracers) we propose to use endogenous optically-active markers (e.g., mitochondrial NADH) to rapidly assess tissue viability in this important clinical application. The project is distinguished by a cross-cutting academic-industrial collaboration including experts in medical imaging, wound care, and sensor engineering and physics. Since the original application, and in response to the suggestions of the reviewers, our group has conducted preliminary experiments validating the basic physiological assumptions that the project is based on. The results of these pilot studies are included in the revised application. PUBLIC HEALTH RELEVANCE: The overall goal of this project is to improve the care of diabetes patients undergoing surgery for treatment of osteomyelitis. This improvement will be attained by providing immediate intraoperative imaging feedback to podiatrists and surgeons as to whether surgical margins are clear of involvement, and whether remaining tissues are healthy. Often, patients reside in hospital beds while pathological assessment of tissue specimens is pending, adding to overall care costs and exposing patients to potential hospital-acquired infections. A rapid and reliable intraoperative method of assessing surgical margins could potentially reduce hospital stays. Providing additional confidence might allow surgeons and podiatrists to be more conservative in their resections, thereby improving patients' quality of life.

描述（由申请人提供）：该项目的总体目标是改善接受手术治疗骨髓炎的糖尿病患者的护理。通过向足病医生和外科医生提供手术边缘是否没有参与以及剩余的组织是否健康的术中术中成像的反馈来实现这一改善。通常，患者居住在医院的病床中，而组织标本的病理评估正在等待，增加了整体护理成本，并使患者暴露于潜在的医院感染中。术中评估手术边缘的快速可靠方法可能会减少住院。提供额外的信心可能会使外科医生和足病医生在切除术上更加保守，从而改善了患者的生活质量。糖尿病性骨髓炎护理的商业市场估计为每年100亿美元，非骨伤口护理的数量相似。该项目利用了微型荧光显微镜的最新创新，并应用了在肿瘤学成像中学习的经验教训，目的是快速鉴定骨髓炎患者的手术边缘。该项目将开发该技术的后续应用包括decubitus溃疡清创术和其他伤口护理挑战。与先前采用外源性对比材料（例如四环素，标记的放射性示意剂）的成像方法不同，我们建议使用内源性光活性标记（例如线粒体NADH）在这一重要的临床应用中快速评估组织可行性。该项目的特点是通过跨裁切的学术工业合作，包括医学成像，伤口护理以及传感器工程和物理的专家。由于最初的应用以及审核者的建议，我们的小组进行了初步实验，以验证项目基于的基本生理假设。这些试点研究的结果包括在修订的应用中。公共卫生相关性：该项目的总体目标是改善接受手术治疗骨髓炎的糖尿病患者的护理。通过向足病医生和外科医生提供手术边缘是否没有参与以及剩余的组织是否健康的术中术中成像的反馈来实现这一改善。通常，患者居住在医院病床中，而组织样本的病理评估正在待处理，增加了整体护理成本，并使患者暴露于潜在的医院获得的感染中。评估手术边缘的快速可靠的术中方法可能会减少住院。提供额外的信心可能会使外科医生和足病医生在切除术上更加保守，从而改善了患者的生活质量。