Continuous Monitoring and Management of Vaginal Health via Multifunctional OCT/OCTA Endoscopy

通过多功能 OCT/OCTA 内窥镜持续监测和管理阴道健康

• 批准号: 10297772
• 负责人: ZHONGPING CHEN
• 金额: $ 194.69万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2024-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10297772
• 关键词: Ablation; Adverse effects; Affect; Aftercare; Alternative Therapies; Angiography; Area; Atrophic; Beds; Benign; Biochemistry; Biomechanics; Biopsy; Blood Vessels; Blood coagulation; Burn injury; California; Carbon Dioxide; Caring; Cicatrix; Clinic; Clinical; Communities; Dermatology; Devices; Disease; Dose; Effectiveness; Endometrial Carcinoma; Endoscopes; Endoscopy; Epithelial; Estrogens; Evaluation; Female; Functional disorder; Future; Genitourinary system; Goals; Health; Image; Imaging Device; Imaging technology; Injury; Institutes; Lasers; Lead; Leadership; Life; Low-Level Laser Therapy; Medical; Medical center; Medicine; Menopausal Symptom; Menopausal Syndrome; Menopause; Molecular Biology; Monitor; Nail plate; Optical Coherence Tomography; Patient Monitoring; Patients; Pelvis; Physicians; Physiological; Procedures; Psoriasis; Quality of life; Reconstructive Surgical Procedures; Refractory; Reproducibility; Research; Risk; Safety; Scientist; Sex Functioning; Source; Structure; Supervision; Symptoms; System; Technology; Thick; Time; Tissues; Treatment Protocols; Universities; Vagina; Validation; Woman; alternative treatment; base; clinical translation; density; design; female reproductive system; follow-up; hormone therapy; human subject; image guided; imaging probe; imaging system; individualized medicine; ineffective therapies; insight; malignant breast neoplasm; microbiome; microbiome research; minimally invasive; negative affect; non-invasive imaging; novel therapeutics; patient screening; personalized management; point of care; prototype; reproductive organ; research study; response; screening; side effect; technology development; tool; treatment effect; treatment optimization; treatment strategy; wound healing

PROJECT SUMMARY Genitourinary Syndrome of Menopause (GSM) affects up to 50% of women and negatively affects their quality of life with regard to general health and sexual function. Hormone therapy is the most commonly performed procedure to supplement the natural estrogen, but health risk associated with long-term therapy exists. Recently, an alternative therapy has been proposed using fractional CO2 micro- ablation that may benefit patients that cannot receive hormone therapies. Although laser micro- ablation showed a clear benefit in dermatology, it remains controversial in female pelvic medicine. The main problem is that, without a clear indication to routinely perform an invasive biopsy for benign genitourinary changes, the pathophysiology of tissue response and factors leading to refractory symptoms remain poorly understood. Thus, this is an area of research that would greatly benefit from non-invasive imaging technologies such as Optical Coherence Tomography (OCT). Our long-term goal is to provide individualized patient management by screening patients who will benefit the most from laser therapy, optimize the laser duration and dose, and assess the need for follow-up care. To achieve this goal, we will develop a point-of-care endoscopic imaging system that combines OCT and OCT angiogram (OCTA) to obtain simultaneous information on structural and functional changes during the vaginal laser treatment. We further proposed to use 1.7 μm center wavelength swept-source laser to image 500 μm deeper than the traditional 1.3 μm laser. We will achieve our objectives by pursuing the following specific aims. Aim 1: Design and develop a 1.7 μm OCT/OCTA system and a multifunctional endoscope imaging probe. Aim 2: Establish the reproducibility of the integrated endoscope in human subjects by assessing vaginal tissue integrity in different demographic groups. Aim 3: Investigate the effects of laser ablation over a time course of several laser therapies and understand the tissue response. The endoscopic OCT/OCTA system will serve as a noninvasive biopsy tool in the gynecological practice and it can, non- invasively, provides structural and functional information about the tissue. This will provide clinicians and scientists with an important tool to screening the patients that will benefit from the laser, monitor the progression of laser therapy, and evaluate the tissue response from the laser treatment and further individualize treatment strategies. The proposed research is expected to have a significant impact on image-guided laser therapy and the management of GSM.

项目摘要 更年期（GSM）的泌尿生殖综合征影响多达50％的妇女，并对 他们在一般健康和性功能方面的生活质量。激素疗法是最多的 通常执行的程序来补充自然雌激素，但与之相关的健康风险 长期治疗存在。最近，已经提出了一种替代疗法 消融可能使无法接受马龙疗法的患者受益。虽然激光微 - 消融在皮肤病学方面具有明显的好处，在女性骨盆医学中仍然存在争议。 主要问题是，没有明确的迹象表明对良性进行侵入性活检 泌尿生殖器变化，组织反应的病理生理学和导致难治症状的因素 保持不当理解。这是一个研究领域，将大大受益于非侵入性 成像技术，例如光学相干断层扫描（OCT）。我们的长期目标是提供 个性化患者管理通过筛查将从激光治疗中受益最大的患者， 优化激光持续时间和剂量，并评估对后续护理的需求。为了实现这一目标，我们 将开发出护理点的内窥镜成像系统，该系统结合了OCT和OCT血管造影 （八方）在阴道激光期间获得有关结构和功能变化的同时信息 治疗。我们进一步建议使用1.7μm中心波长扫描源激光器来图像500μm 比传统的1.3μm激光更深。我们将通过追求以下特定的特定目标来实现我们的目标 目标。 AIM 1：设计和开发1.7μmOCT/OCTA系统和多功能内窥镜成像 探测。目标2：通过评估确定人类受试者中综合内窥镜的可重复性 不同人口组的阴道组织完整性。目标3：研究激光消融的影响 在几种激光疗法的时间过程中，了解组织反应。内窥镜 OCT/OCTA系统将在妇科实践中作为无创的活检工具，它可以非 - 在侵入性上，提供有关组织的结构和功能信息。这将为临床医生提供 以及具有重要工具来筛查将从激光中受益的患者的科学家，监视 激光治疗的进展，并评估激光治疗的组织反应并进一步 个性化的治疗策略。拟议的研究预计将对 图像引导的激光疗法和GSM的管理。