Optical Tomographic Imaging of Peripheral Arterial Disease

周围动脉疾病的光学断层成像

基本信息

批准号：
9338285
负责人：
ANDREAS H HIELSCHER
金额：
$ 55.73万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9338285
关键词：
Address Affect Air Algorithms Amputation Analysis of Variance Anatomy Angioplasty Ankle Arteries Blood Vessels Bypass Case-Control Studies Classification Clinical Research Code Data Detection Development Devices Diabetes Mellitus Diagnosis Diagnostic Diagnostic Procedure Diagnostic tests Diffusion Dimensions Disease Disease Progression Distal Early Diagnosis Ensure Evaluation Foot Ulcer Gangrene Geometry Head Health Image Image Analysis Individual Kidney Diseases Lead Leg Light Lower Extremity Machine Learning Magnetic Resonance Angiography Measurement Medical Methods Modality Monitor Myocardial Infarction Operative Surgical Procedures Optics Pain Patients Perfusion Peripheral Nervous System Diseases Peripheral arterial disease Physicians Physiologic pulse Preventive measure 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 accurate diagnosis blood perfusion data acquisition design diabetic diabetic patient experience foot healthy volunteer image reconstruction imaging biomarker imaging system indexing instrument light emission non-diabetic novel older patient optical imaging post intervention prospective prototype public health relevance screening spatiotemporal success theories tissue phantom tool treatment response vascular bed

项目摘要

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）：我们建议构建并测试动态血管光学断层成像（DVOTI）系统，该系统可用于检测和监测外周动脉疾病（PAD）。据估计，PAD 影响美国约 8 至 1200 万人。然而，这种疾病的诊断率相当低，因为大多数患者没有症状，而且尚未建立单一可靠的筛查方式。大多数未经诊断和未经治疗的患者都是糖尿病患者。他们通常患有周围神经病变，因此无法感知和报告疾病早期征兆的症状（例如疼痛）。因此，在美国，超过 60%（约每年 65,000 例）的下肢截肢手术是在患有 PAD 的糖尿病患者中进行的。预计到 2050 年，糖尿病患者数量将增加三倍，达到近 1 亿，与未确诊的 PAD 相关的问题在未来几年只会增加最广泛使用的 PAD 诊断测试，测定踝肱指数 (ABI)众所周知，与脉搏量记录 (PVR) 结合使用对于糖尿病患者来说是不可靠的。即使在非糖尿病患者中，ABI 结合 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）也只能提供有关腿部主要动脉近端闭塞的准确信息。然而，这些测试都没有评估足部远端灌注，大多数并发症（如溃疡和坏疽）通常发生在远端灌注。监测血管成形术或搭桥手术等外科手术的成功与否也存在同样的缺点，因为医生仅限于同一组测试，而这些测试不足以评估足部的灌注。动态 VOTI 有望克服当前诊断和监测技术的局限性，并有可能引发血管疾病评估方式的范式转变。在初步研究中，我们表明 DVOTI 可以提供三维时间序列图像，提供有关 PAD 患者足部血管床灌注的有价值信息。该仪器使用的近红外光不会对健康产生不利影响，并且可以经常重复测量以监测介入后的进展。因此，我们相信 DVOTI 将被证明是一种安全、准确的方法来诊断和监测非糖尿病和糖尿病患者的 PAD。