Dynamic OCE with acoustic micro-tapping for in vivo monitoring of skin graft surgeries

具有声学微敲击功能的动态 OCE，用于皮肤移植手术的体内监测

• 批准号: 10613941
• 负责人: IVAN PELIVANOV
• 金额: $ 60.24万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10613941
• 关键词: 3-Dimensional; 4D Imaging; Acceleration; Acoustics; Age; Air; Algorithms; Angiography; Anisotropy; Area; Back; Benchmarking; Binding; Biomechanics; Body mass index; Breast; Cicatrix; Clinic; Clinical; Clinical Protocols; Collagen; Cornea; Cosmetics; Coupled; Data; Dermatology; Donor person; Elasticity; Ensure; Environment; Esthetics; Face; Feedback; Forearm; Future; Gender; Goals; Human; Image; Imaging Device; Inflammation; Magnetic Resonance Imaging; Maps; Measurement; Measures; Mechanics; Medical; Methods; Modeling; Modulus; Monitor; Neck; Operative Surgical Procedures; Optics; Organ Transplantation; Outcome; Patients; Persons; Phase; Plastic Surgical Procedures; Population; Postoperative Procedures; Procedures; Process; Proliferating; Property; Protocols documentation; Radiation; Radiology Specialty; Reconstructive Surgical Procedures; Recovery; Resolution; Robot; Robotics; Sampling; Site; Skin; Skin graft; Structure; Subcutaneous Tissue; Surgical Oncology; System; Techniques; Testing; Therapeutic; Thick; Time; Tissue Donors; Tissue Grafts; Tissues; Transplantation; biomechanical model; clinical application; clinical efficacy; clinical translation; elastography; experimental study; foot; graft healing; healing; healthy volunteer; human subject; improved; in vivo; in vivo imaging system; in vivo monitoring; innovation; instrument; reconstruction; structural imaging; tool; ultrasound

Abstract The goal of this project is a develop a non-contact, non-invasive clinical tool to characterize, image and monitor skin grafting procedures using quantitative, volumetric, sub-mm resolved maps of Young's modulus based on Optical Coherence Elastography (OCE). Factors related to or directly defined by skin's elastic properties (such as contractions and shearing forces) are among the most common complications of full thickness skin graft (FTSG) procedures. In addition, the recipient site functions best when its elastic properties are matched by transplanted donor tissue. With tens of millions of aesthetic procedures performed every year in the USA alone, surgical cosmesis is clearly critical, especially when procedures are performed on the face, neck or breast. Currently there are no clinical tools, or even methods, that can quantitatively map skin's Young's modulus and anisotropy in vivo. We propose to map these parameters in skin using a non-contact, fully non-invasive method, with sub-mm spatial resolution and nearly in real time. We hypothesize that quantifying skin elasticity in vivo will enable significant innovation within all areas of plastic surgery, burn surgery, oncologic surgery, and dermatology that modify a patient's tissue quality and elastic properties through medical, radiologic, or surgical intervention. To achieve our objective, we propose a new non-contact OCE method. Our approach is based on: (i) acoustic micro-tapping (AµT) using ultrasound propagating in air to launch mechanical waves in soft media with the highest efficiency and best resolution among all non-contact wave-excitation methods, (ii) state-of-the-art real- time 4-D PhS-OCT imaging to track wave propagation, and (iii) reconstruction of volumetric maps of Young's modulus and anisotropy using imaged wavefields in skin analyzed with a transversally isotropic model. SA1 will focus on refining previously developed analytic and numerical models of mechanical wave propagation in skin considering its layered anisotropic structure, and developing algorithms to reconstruct skin's moduli. Then, SA2 will develop a robotized AµT-OCE imaging system for in vivo skin measurements in a clinical environment. We will perform routine measurements of skin elastic moduli in vivo on healthy volunteers to understand normal variability in skin elastic properties in a representative population of normal human subjects to help define the level of expected improvements possible in matching skin elastic properties in FTSG procedures. SA3 will focus on in vivo monitoring changes in grafted skin elastic properties during grafting procedures in the clinic, including pre-operative mapping of skin's elastic properties in donor and recipient sites and mapping longitudinal changes in fundamental structural and elastic parameters of FTSGs and surrounding tissue over the reconstruction process. If successful, this project can be the starting point for multiple continuation projects testing whether new methods and clinical protocols can be developed using information from OCE to help select the best donor tissue for grafting and guide post-surgery procedures.

抽象的 该项目的目的是开发一种非接触，非侵入性临床工具来表征，图像和 使用定量的，体积，亚MM分辨率的Young的图表监测皮肤移植程序 基于光学相干弹性学（OCE）的模量。 与皮肤的弹性特性有关或直接定义的因素（例如收缩和剪切力）是 在全厚度皮肤移植（FTSG）程序的最常见并发症中。此外，收件人 当位点弹性特性与移植的供体组织匹配时，其功能最佳。数千万 在仅在美国每年执行的美学程序中，手术宇宙显然至关重要，尤其是 当在面部，颈部或乳房上执行程序时。目前没有临床工具，甚至没有 可以在体内定量地绘制皮肤的模量和各向异性的方法。我们建议映射这些 使用非接触，完全非侵入的方法，具有亚MM空间分辨率和 几乎是实时的。我们假设量化体内的皮肤弹性将在内部实现重大创新 整容手术的所有区域，烧伤手术，肿瘤手术和皮肤病学，可修饰患者组织 通过医学，放射线或手术干预的质量和弹性特性。 为了实现我们的目标，我们提出了一种新的非接触式OCE方法。我们的方法基于：（i）声学 微敲击（AµT）使用在空气中传播的超声传播，以在软介质中发射机械波 在所有非接触性波兴奋的方法中，效率最高和最佳分辨率，（ii）最先进的实地 时间4-D PHS-OCT成像跟踪波传播的时间，以及（iii）重建杨的体积图 使用横向各向同性模型分析的皮肤中使用成像波场的模量和各向异性。 SA1将专注于精炼先前开发的机械波的分析和数值模型 考虑其分层各向异性结构并开发重建算法的皮肤传播 皮肤的模量。然后，SA2将开发一个机器人的AµT-OCE成像系统，以用于体内皮肤测量 临床环境。我们将在体内对皮肤弹性模量进行常规测量 志愿者了解正常的代表性人群中皮肤弹性特性的正常变异性 人类受试者有助于定义匹配皮肤弹性特性的预期改进水平 在FTSG程序中。 SA3将重点放在体内监测期间移植皮肤弹性特性的变化上 诊所中的移植程序，包括供体弹性特性的术前映射和 FTSG的基本结构和弹性参数的纵向变化和绘制纵向变化 并在重建过程中周围的组织。如果成功，这个项目可能是 多个延续项目测试是否可以使用新方法和临床方案开发 来自OCE的信息可帮助选择最佳的供体组织，用于嫁接和指导手术后程序。