Optical Tomographic Imaging of Peripheral Arterial Disease

周围动脉疾病的光学断层成像

• 批准号: 8580503
• 负责人: ANDREAS H HIELSCHER
• 金额: $ 46.94万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8580503
• 关键词: Accounting; Address; Affect; Air; Algorithms; Amputation; Angioplasty; Ankle; Arteries; Biological Markers; Blood Vessels; Bypass; Case-Control Studies; Classification; Clinical Research; Code; Data; Detection; Development; Devices; Diabetes Mellitus; Diagnosis; Diagnostic; Diagnostic Procedure; Diagnostic tests; Diffusion; Disease; Disease Progression; Distal; Early Diagnosis; Ensure; Gangrene; Head; Health; Image; Image Analysis; Individual; Kidney Diseases; Lead; Leg; Light; Lower Extremity; Machine Learning; Magnetic Resonance Angiography; Maps; Measurement; Measures; Medical; Methods; Modality; Monitor; Myocardial Infarction; Operative Surgical Procedures; Optics; Pain; Patients; Perfusion; Peripheral Nervous System Diseases; Peripheral arterial disease; Physicians; Physiologic pulse; Preventive; Procedures; Process; Property; Reporting; Risk; Sensitivity and Specificity; Series; Statistical Methods; Stroke; Symptoms; System; Techniques; Technology; Testing; Time; Tissues; Treatment outcome; Ulcer; Ultrasonography; United States; Vascular Diseases; blood perfusion; data acquisition; design; diabetic; diabetic patient; evaluation/testing; experience; foot; healthy volunteer; image reconstruction; indexing; instrument; light emission; non-diabetic; novel; older patient; optical imaging; post intervention; prototype; public health relevance; screening; success; theories; tissue phantom; tool; treatment response; vascular bed

DESCRIPTION (provided by applicant): We propose to build and test a dynamic vascular optical tomographic imaging (DVOTI) system that can be used to detect and monitor peripheral arterial disease (PAD). PAD is estimated to affect approximately 8 to 12 million individuals in the United States. However, the disease is considerably under-diagnosed, since most patients are asymptomatic and no single reliable screening modality has been established. Most of the undiagnosed and untreated patients are diabetics. They commonly suffer from peripheral neuropathy and hence do not sense and report symptoms (such as pain) that are early signs of the disease. Consequently more than 60% (~65,000 per year) of all lower extremity amputations in the United States are performed in diabetic patients with PAD. With the number of diabetic patients expected to triple and reach almost 100 million by 2050, the problems related to undiagnosed PAD will only rise in the years to come The most widely used diagnostic test for PAD, determination of the ankle-brachial index (ABI) in conjunction with pulse-volume recordings (PVR), is known to be unreliable for diabetics. And even in non- diabetics, ABI with PVR and all other existing diagnostic tests (such as Duplex Ultrasound or Magnetic resonance angiography), only provides accurate information about proximal occlusions in major arteries of the leg. However, none of these tests assess the distal perfusion of the foot where most complications, such as ulcers and gangrene, typically occur. Monitoring the success of surgical interventions, such as angioplasty or bypass surgery, suffers from the same shortcomings, as physicians are limited to the same suite of tests that are inadequate to assess the perfusion of the foot. Dynamic VOTI promises to overcome the limitations of current diagnostic and monitoring techniques and has the potential to initiate a paradigm shift concerning how vascular diseases are assessed. In preliminary studies we have shown that DVOTI can provide three-dimensional time-series images that provide valuable information about the perfusion of the vascular bed in feet of PAD patients. The near-infrared light used in the instrument has no adverse health effects and measurements can be repeated frequently to monitor post interventional progress. Therefore, we believe that DVOTI will prove to be a safe and accurate method to diagnose and monitor PAD in non-diabetic and diabetic patients.

描述（由申请人提供）：我们建议构建和测试一个动态的血管光学层析成像（DVOTI）系统，该系统可用于检测和监测外周血动脉疾病（PAD）。据估计，PAD会影响大约8至1200万个人 美国。但是，由于大多数患者无症状，并且没有建立单一可靠的筛查方式，因此该疾病的诊断不足。大多数未诊断和未经治疗的患者都是糖尿病患者。它们通常患有周围神经病，因此没有感觉并报告症状（例如疼痛），这些症状是该疾病的早期迹象。因此，在美国所有下肢截肢术中，有超过60％（每年约65,000）在患有PAD的糖尿病患者中进行。到2050年，随着糖尿病患者的数量预计将达到三倍并达到近1亿次，与未诊断的PAD有关的问题只会在这些年份中增加，这是用于PAD的最广泛使用的诊断测试，确定脚踝 - 野手指数（ABI）与脉搏量录音（PVR）结合使用，众所周知，这是无处不在的。即使在非糖尿病患者中，ABI也具有PVR和所有其他现有的诊断测试（例如双工超声或磁共振血管造影），仅提供有关腿部主要动脉近端闭塞的准确信息。但是，这些测试均未评估脚的远端灌注，其中大多数并发症（例如溃疡和坏疽）通常发生。监测手术干预措施（例如血管成形术或旁路手术）的成功遭受了相同的缺陷，因为医生仅限于评估脚部灌注的相同测试套件。 动态投票有望克服当前诊断和监测技术的局限性，并有可能引发有关如何评估血管疾病的范式转变。在初步研究中，我们表明DVOTI可以提供三维的时间序列图像，这些图像提供了有关PAD患者英尺的血管床灌注的宝贵信息。仪器中使用的近红外光没有不良的健康效果，可以经常重复测量以监测介入后进度。因此，我们认为DVOTI将被证明是一种安全，准确的方法，用于诊断和监测非糖尿病和糖尿病患者的PAD。