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: 10677774
• 负责人: Brett E Bouma
• 金额: $ 69.93万
• 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/10677774
• 关键词: Address; Applications Grants; Arterial Fatty Streak; Authorization documentation; 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; Documentation; Engineering; Evaluation; Event; Extracellular Matrix; Family suidae; Fluorescence; Foam Cells; Future; Goals; Heart Transplantation; Histologic; Histopathology; Human; Hybrids; Image; Imaging Device; Imaging Techniques; Intervention; Knowledge; Label; Lateral; Lesion; Link; Macrophage; Measurement; Microscopic; Modality; Modeling; Morphology; Optical Tomography; Optics; Pathology; Patient Admission; Patients; Performance; Preclinical Testing; Prevention; Procedures; Process; Reproducibility; Resolution; Risk Management; Rupture; Sampling; Specimen; Speed; Structure; System; Techniques; Testing; Time; Tissues; Visual; acute coronary syndrome; authority; calcification; coronary lesion; data acquisition; design; detector; diagnostic value; experience; first-in-human; fluorescence lifetime imaging; human data; human imaging; human subject; imaging approach; imaging capabilities; imaging modality; imaging system; improved; improved outcome; in vivo; information display; innovation; insight; meetings; novel; optical frequency domain imaging; percutaneous coronary intervention; personalized management; personalized medicine; polarimetry; preclinical evaluation; prototype; solid state; statistics; tissue mapping; 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.

项目摘要/摘要 冠状动脉疾病（CAD）的临床管理和预防急性冠状动脉综合征 （ACS）需要了解潜在的动脉粥样硬化斑块病理生物学。电流血管内 独立成像技术的评估能力有限 以及斑块结构的突然变化（例如破裂或侵蚀）向人类的ACS导电。杂交种 血管内成像系统持有前提，以更全面地评估斑块病理学 病人，迫切需要。我们的目标是通过血管内的发展来满足这一需求 成像方法能够同时评估斑块生化组成的变化和 与患者关键病理生物学过程相关的形态。我们建议推进 血管内成像系统结合了两种完整标签的光学技术，特别是 荧光寿命成像（FLIM）和极化敏感的光学相干断层扫描（PSOCT）通过 一种适用于经皮冠状成像（PCI）的创新双峰成像导管。这种双重模式 方法应1）对具有钥匙的生化特征的相互作用产生深入了解 在牙菌斑进度，不稳定和/或重塑以及2）立即显示此信息中的作用 在接近实时的视觉格式中，可用于指导当时的冠状动脉病变的个性化管理 心脏导管插入术。提出的技术将能够执行安全和快速的共同注册 （1）在多个光谱发射带中的（1）时间分辨荧光衰减，以及（2）极化 - 单个回调中解析了光学断层扫描数据。为了实现我们的目标，我们将首先构建一个flim-psoct 导管系统（包括自由形式反射性光学）为FLIM和 PSOCT（AIM 1）。第二，展示Flim-Psoct的快速和同时/协同性的表现 评估与不同形态特征相关的关键生化特征，我们将使用 提出的杂种系统以对人类冠状动脉样品进行成像（EX VIVO），并具有组织病理学佐证（AIM2）。 最后，我们将将该系统部署在患者（人类第一）中，以评估心脏导管插入期间的斑块 并确定临床可行性（AIM 3）。这项研究的成功完成将证明临床 冠状动脉内FLIM-PSOCT的可行性和效用，以评估可能引起AC的关键斑块特征。 如果可以可靠地检测到此类功能，那么接受PCI程序的患者可能会受益于个性化 处理这些斑块并改善结果。