Beth Israel Deaconess Medical Center, Division of Hematology∕Oncology, Department of Medicine, Boston, Massachusetts 02215, USA.
J Biomed Opt. 2011 Aug;16(8):086015. doi: 10.1117/1.3614566.
Oxygenation measurements are widely used in patient care. However, most clinically available instruments currently consist of contact probes that only provide global monitoring of the patient (e.g., pulse oximetry probes) or local monitoring of small areas (e.g., spectroscopy-based probes). Visualization of oxygenation over large areas of tissue, without a priori knowledge of the location of defects, has the potential to improve patient management in many surgical and critical care applications. In this study, we present a clinically compatible multispectral spatial frequency domain imaging (SFDI) system optimized for surgical oxygenation imaging. This system was used to image tissue oxygenation over a large area (16×12 cm) and was validated during preclinical studies by comparing results obtained with an FDA-approved clinical oxygenation probe. Skin flap, bowel, and liver vascular occlusion experiments were performed on Yorkshire pigs and demonstrated that over the course of the experiment, relative changes in oxygen saturation measured using SFDI had an accuracy within 10% of those made using the FDA-approved device. Finally, the new SFDI system was translated to the clinic in a first-in-human pilot study that imaged skin flap oxygenation during reconstructive breast surgery. Overall, this study lays the foundation for clinical translation of endogenous contrast imaging using SFDI.
氧合测量在患者护理中得到广泛应用。然而，目前大多数临床可用的仪器都由接触式探头组成，这些探头只能提供患者的全局监测（例如，脉搏血氧饱和度探头）或对小区域的局部监测（例如，基于光谱的探头）。在没有预先了解缺陷位置的情况下，对大面积组织的氧合情况进行可视化，有可能改善许多手术和重症监护应用中的患者管理。在这项研究中，我们提出了一种经过临床优化的多光谱空间频域成像 (SFDI) 系统，用于手术氧合成像。该系统用于对大面积（16×12cm）的组织氧合进行成像，并在临床前研究中通过与经 FDA 批准的临床氧合探头的结果进行比较得到了验证。在约克夏猪上进行了皮瓣、肠和肝血管阻塞实验，结果表明，在实验过程中，使用 SFDI 测量的氧饱和度相对变化与经 FDA 批准的设备测量的结果的准确性在 10%以内。最后，该新的 SFDI 系统在首例人体初步研究中被转化为临床应用，对重建乳房手术中的皮瓣氧合进行了成像。总的来说，这项研究为使用 SFDI 进行内源性对比成像的临床转化奠定了基础。
