USE OF THERMAL AND 3D IMAGING TO QUANTIFY ARTHRITIS

使用热成像和 3D 成像来量化关节炎

• 批准号: 7567325
• 负责人: Raphael Hirsch
• 金额: $ 17.87万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7567325
• 关键词: 3-Dimensional; Adrenal Cortex Hormones; Anti-Tumor Necrosis Factor Therapy; Arthralgia; Arthritis; Childhood; Chronic Childhood Arthritis; Clinic Visits; Clinical; Clinical Research; Clinical assessments; Devices; Disease; Disease remission; Dose; Drug Delivery Systems; Evaluation; Goals; Hand functions; Health; Heating; Image; Inflammation; Inflammation Mediators; Inflammatory; Injection of therapeutic agent; Interobserver Variability; Intervention; Joints; Lasers; Magnetic Resonance Imaging; Measurement; Measures; Metacarpophalangeal joint structure; Methodology; Oral; Outcome Assessment; Patient Care; Patient Monitoring; Patients; Pattern; Peripheral; Pharmaceutical Preparations; Physicians; Questionnaires; Recording of previous events; Reporting; Reproducibility; Research Design; Rheumatoid Arthritis; Rheumatology; Self Assessment; Surface; Swelling; Synovitis; Testing; Therapeutic Intervention; Time; Variant; Wrist; clinical remission; cohort; cost; functional status; improved; prototype; public health relevance; response; sensor; tool

DESCRIPTION (provided by applicant): One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. It can even be difficult to determine whether inflammation is present or absent. Carefully designed studies have repeatedly shown poor We have built a prototype device using well-established sensors-specifically 3-dimensional (3D) laser line triangulation digitizer cameras and thermal infrared cameras-to rapidly quantify surface swelling and heat in arthritic joints. This Arthritis Surface Imager produces results within minutes. Thus it could become a routine component of the rheumatology clinic visit, allowing for the replacement of the current subjective and unreliable joint assessment with a quantitative and highly-reproducible measure that can be used to monitor patients over time. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis. The first Specific Aim is to test the hypothesis that surface imaging will provide an earlier and more sensitive measure of change in active arthritis and functional status than do physician's assessment and patient's self-assessment A cohort of patients with JRA and RA will be followed longitudinally before and during the course of a therapeutic intervention. Change in arthritis, as measured by the Arthritis Surface Imager will be compared to well-established and validated clinical measures, including 1) physician's assessment of joint tenderness and swelling and 2) patient's self-assessment of joint pain. Correlation will also be made with changes in functional status, as assessed by components of the Childhood Health Assessment Questionnaire (CHAQ) and Health Assessment Questionnaire (HAQ) that pertain to hand function. We will also examine predictors of change in functional status. The second Specific Aim will test the hypothesis that surface imaging can improve the accuracy of remission measurement. It has recently been reported that patients in clinical remission often have MRI evidence of continued synovitis, demonstrating that current clinical measures of inactivity do not correlate well with true remission. Our Preliminary Studies suggest that many patients with a history of arthritis have abnormal joint thermal patterns even when asymptomatic. Patients with clinically-inactive disease will be imaged by MRI to determine whether patients with subclinical arthritis can be identified by the Arthritis Surface Imager. Low-cost, time-efficient tools that produce a set of reliable, reproducible and objective measures of the inflammatory state of the joint would improve the assessment of outcome in arthritis clinical studies, and ultimately will improve patient care. This proposal focuses on the wrist and metacarpophalangeal (MCP) joints, which make up 22 of the 28 joints in the Disease Activity Score (DAS) 28. Methodologies developed here could be readily applied to other peripheral joints. reproducibility of physician assessment of the number of swollen and/or tender joints. PUBLIC HEALTH RELEVANCE: One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. We have built a prototype device using well-established sensors to rapidly quantify surface swelling and heat in arthritic joints. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis.

描述（由申请人提供）：护理类风湿关节炎 (RA) 和幼年类风湿关节炎 (JRA) 患者的最大挑战之一是量化任何特定关节的疾病活动程度。甚至很难确定是否存在炎症。精心设计的研究一再表明效果不佳。我们使用成熟的传感器（特别是 3 维 (3D) 激光线三角测量数字化仪相机和热红外相机）构建了原型设备，以快速量化关节炎关节的表面肿胀和热量。这款关节炎表面成像仪可在几分钟内产生结果。因此，它可以成为风湿病门诊的常规组成部分，从而可以用可用于长期监测患者的定量且高度可重复的测量来取代当前主观且不可靠的联合评估。我们研究的目的是检验该成像仪可​​以改善关节炎的临床评估的假设。第一个具体目标是检验以下假设：表面成像将比医生评估和患者自我评估更早、更灵敏地测量活动性关节炎和功能状态的变化。将在之前对一组 JRA 和 RA 患者进行纵向随访。以及在治疗干预过程中。通过关节炎表面成像仪测量的关节炎变化将与成熟且经过验证的临床测量进行比较，包括 1) 医生对关节压痛和肿胀的评估以及 2) 患者对关节疼痛的自我评估。还将与功能状态的变化建立关联，通过儿童健康评估问卷 (CHAQ) 和健康评估问卷 (HAQ) 中与手部功能相关的部分进行评估。我们还将检查功能状态变化的预测因素。第二个具体目标将检验表面成像可以提高缓解测量准确性的假设。最近有报道称，处于临床缓解期的患者经常有持续滑膜炎的 MRI 证据，这表明目前临床上不活动的测量结果与真正的缓解没有很好的相关性。我们的初步研究表明，许多有关节炎病史的患者即使没有症状，也有异常的关节热模式。患有临床非活动性疾病的患者将通过 MRI 进行成像，以确定关节炎表面成像仪是否可以识别患有亚临床关节炎的患者。低成本、省时的工具能够产生一套可靠、可重复和客观的关节炎症状态测量结果，将改善关节炎临床研究的结果评估，并最终改善患者护理。该提案重点关注腕关节和掌指关节 (MCP)，它们构成了疾病活动评分 (DAS) 28 中 28 个关节中的 22 个。这里开发的方法可以很容易地应用于其他外周关节。医生评估肿胀和/或压痛关节数量的可重复性。 公共卫生相关性：护理类风湿关节炎 (RA) 和幼年类风湿关节炎 (JRA) 患者的最大挑战之一是量化任何特定关节的疾病活动程度。我们使用成熟的传感器构建了一个原型设备，可以快速量化关节炎关节的表面肿胀和热量。我们研究的目的是检验该成像仪可​​以改善关节炎的临床评估的假设。