Section of Rheumatology, Allergy & Immunology, Department of Medicine, Yale School of Medicine, 300 Cedar Street, The Anlyan Center PO Box 208031, New Haven, CT, 06520, USA.
Clinical and Translational Research Accelerator, Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
Arthritis Res Ther. 2023 Jan 20;25(1):10. doi: 10.1186/s13075-023-02990-3.
BACKGROUND/PURPOSE: Lack of robust, feasible, and quantitative outcomes impedes Raynaud phenomenon (RP) clinical trials in systemic sclerosis (SSc) patients. Hyperspectral imaging (HSI) non-invasively measures oxygenated and deoxygenated hemoglobin (oxyHb and deoxyHb) concentrations and oxygen saturation (O sat) in the skin and depicts data as oxygenation heatmaps. This study explored the potential role of HSI in quantifying SSc-RP disease severity and activity.
Patients with SSc-RP (n = 13) and healthy control participants (HC; n = 12) were prospectively recruited in the clinic setting. Using a hand-held camera, bilateral hand HSI (HyperMed™, Waltham, MA) was performed in a temperature-controlled room (22 °C). OxyHb, deoxyHb, and O sat values were calculated for 78-mm regions of interest for the ventral fingertips and palm (for normalization). Subjects underwent a cold provocation challenge (gloved hand submersion in 15 °C water bath for 1 min), and repeated HSI was performed at 0, 10, and 20 min. Patients completed two patient-reported outcome (PRO) instruments: the Raynaud Condition Score (RCS) and the Cochin Hand Function Scale (CHFS) for symptom burden assessment. Statistical analyses were performed using the Mann-Whitney U test and a mixed effects model (Stata, College Station, TX).
Ninety-two percent of participants were women in their 40s. For SSc-RP patients, 69% had limited cutaneous SSc, the mean ± SD SSc duration was 11 ± 5 years, and 38% had prior digital ulcers-none currently. Baseline deoxyHb was higher, and O sat was lower, in SSc patients versus HC (p < 0.05). SSc patients had a greater decline in oxyHb and O sat from baseline to time 0 (after cold challenge) with distinct rewarming oxyHb, O sat, and deoxyHb trajectories versus HCs (p < 0.01). There were no significant correlations between oxyHb, deoxyHb, and O sat level changes following cold challenge and RCS or CHFS scores.
Hyperspectral imaging is a feasible approach for SSc-RP quantification in the clinic setting. The RCS and CHFS values did not correlate with HSI parameters. Our data suggest that HSI technology for the assessment of SSc-RP at baseline and in response to cold provocation is a potential quantitative measure for SSc-RP severity and activity, though longitudinal studies that assess sensitivity to change are needed.
背景/目的：缺乏稳健、可行和定量的结果阻碍了系统性硬化症 (SSc) 患者雷诺现象 (RP) 的临床试验。高光谱成像 (HSI) 无创测量皮肤中的氧合和去氧血红蛋白 (oxyHb 和 deoxyHb) 浓度和氧饱和度 (O sat)，并将数据描绘为氧合热图。本研究探讨了 HSI 量化 SSc-RP 疾病严重程度和活动的潜在作用。
前瞻性招募了 13 名 SSc-RP 患者 (n = 13) 和 12 名健康对照参与者 (HC; n = 12)。使用手持式相机，在温度控制的房间 (22°C) 中对双侧手部进行 HSI (HyperMed™，Waltham，MA)。为了归一化，计算了 78-mm 感兴趣区域的指尖和手掌的 oxyHb、deoxyHb 和 O sat 值。受检者接受冷诱发挑战(手套手浸入 15°C 水浴中 1 分钟)，并在 0、10 和 20 分钟时重复 HSI。患者完成了两项患者报告的结果 (PRO) 工具：雷诺状况评分 (RCS) 和科钦手部功能量表 (CHFS)，用于评估症状负担。使用曼-惠特尼 U 检验和混合效应模型 (Stata，College Station，TX) 进行统计分析。
92%的参与者为 40 多岁的女性。对于 SSc-RP 患者，69%为局限性皮肤 SSc，平均±标准差 SSc 病程为 11±5 年，38%无既往指端溃疡-目前无。与 HC 相比，SSc 患者的基线去氧 Hb 更高，O sat 更低 (p < 0.05)。与 HC 相比，SSc 患者在基线至冷刺激后即刻 (0 分钟) 时 oxyHb 和 O sat 的下降幅度更大，并且存在明显的再升温 oxyHb、O sat 和 deoxyHb 轨迹 (p < 0.01)。冷刺激后 oxyHb、deoxyHb 和 O sat 水平变化与 RCS 或 CHFS 评分之间无显著相关性。
高光谱成像 (HSI) 是一种可行的 SSc-RP 临床量化方法。RCS 和 CHFS 值与 HSI 参数无关。我们的数据表明，HSI 技术用于评估 SSc-RP 的基线和对冷刺激的反应是 SSc-RP 严重程度和活动的潜在定量测量方法，但需要进行评估敏感性变化的纵向研究。
