Breath-Hold Paradigm to Assess Variations in Oxygen Flow in Diabetic Foot Ulcers Using a Noncontact Near-Infrared Optical Scanner

Leiva, Kevin; Mahadevan, Jagadeesh; Kaile, Kacie; Schutzman, Richard; Robledo, Edwin; Narayanan, Sivakumar; Muthukrishnan, Varalakshmi; Mohan, Viswanathan; Wu, Wensong; Godavarty, Anuradha

doi:10.1089/wound.2018.0922

Cited by 15 publications

(6 citation statements)

References 21 publications

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“…Tissue oxygenation flow changes are measured by utilizing an innovative breath-hold (BH) stimulus that induces vasoconstriction and determines the differences in the flow patterns in and around the tissues. 70 The BH-induced oxygenation changes can be used as a stimulus to assess the ability of peripheral vasculature to respond to an oxygenation demand in diseased tissue models such as DFUs. 70 Thus, the measurement of tissue oxygenation using our approach is like that of TCOM which also assesses how the vasculature responds in DFUs.…”

Section: An Oxygenation Flow-based Imaging Approach Using Nirsmentioning

confidence: 99%

“…70 The BH-induced oxygenation changes can be used as a stimulus to assess the ability of peripheral vasculature to respond to an oxygenation demand in diseased tissue models such as DFUs. 70 Thus, the measurement of tissue oxygenation using our approach is like that of TCOM which also assesses how the vasculature responds in DFUs. The added advantage of our NIRS technique (using NIROS) is its ability to image the entire wound region, unlike discrete point measurements by TCOM.…”

Section: An Oxygenation Flow-based Imaging Approach Using Nirsmentioning

confidence: 99%

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Diabetic Foot Ulcer Imaging: An Overview and Future Directions

Godavarty,

Leiva,

Amadi

et al. 2023

J Diabetes Sci Technol

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Diabetic foot ulcers (DFUs) affect one in every three people with diabetes. Imaging plays a vital role in objectively complementing the gold-standard visual yet subjective clinical assessments of DFUs during the wound treatment process. Herein, an overview of the various imaging techniques used to image DFUs is summarized. Conventional imaging modalities (e.g., computed tomography, magnetic resonance imaging, positron emission tomography, single-photon emitted computed tomography, and ultrasound) are used to diagnose infections, impact on the bones, foot deformities, and blood flow in patients with DFUs. Transcutaneous oximetry is a gold standard to assess perfusion in DFU cases with vascular issues. For a wound to heal, an adequate oxygen supply is needed to facilitate reparative processes. Several optical imaging modalities can assess tissue oxygenation changes in and around the wounds apart from perfusion measurements. These include hyperspectral imaging, multispectral imaging, diffuse reflectance spectroscopy, near-infrared (NIR) spectroscopy, laser Doppler flowmetry or imaging, and spatial frequency domain imaging. While perfusion measurements are dynamically monitored at point locations, tissue oxygenation measurements are static two-dimensional spatial maps. Recently, we developed a spatio-temporal NIR-based tissue oxygenation imaging approach to map for the extent of asynchrony in the oxygenation flow patterns in and around DFUs. Researchers also measure other parameters such as thermal maps, bacterial infections (from fluorescence maps), pH, collagen, and trans-epidermal water loss to assess DFUs. A future direction for DFU imaging would ideally be a low-cost, portable, multi-modal imaging platform that can provide a visual and physiological assessment of wounds for comprehensive wound care intervention and management.

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Section: An Oxygenation Flow-based Imaging Approach Using Nirsmentioning

confidence: 99%

Section: An Oxygenation Flow-based Imaging Approach Using Nirsmentioning

confidence: 99%

Diabetic Foot Ulcer Imaging: An Overview and Future Directions

Godavarty,

Leiva,

Amadi

et al. 2023

J Diabetes Sci Technol

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“…37 A hand-held Near-InfraRed Optical Scanner (or NIROS) was developed in our lab recently. [38][39][40][41][42] The device measures effective (or relative) changes in TO in terms of 4 parameters: oxy-hemoglobin (∆HbO), deoxy-hemoglobin (∆HbR), total hemoglobin (∆HbT), and oxygen saturation (∆StO 2 ). NIROS imaging studies were performed on DFU subjects across weeks of treatment to study changes in the four TO parameters.…”

Section: Near-infrared Imaging Of Diabetic Foot Ulcersmentioning

confidence: 99%

Tissue Oxygenation Measurements to Aid Scalpel Debridement Removal in Patients With Diabetes

Kaile

Mahadevan

Leiva

et al. 2021

J Diabetes Sci Technol

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Background: Callus formation in the diabetic foot increases the risk of ulcer onset. It is standard procedure to remove these dead tissue layers to reduce rising pressures. In a surgical procedure known as scalpel debridement, or chiropody the callus tissue is removed up to the epidermal layer. Factors may influence the outcome of this surgical process such as clinician inexperience. In an effort to standardize the debridement process, tissue oxygenation (TO) measurements are obtained before and after to study the effect of debridement on callus tissue. Methods: Fifteen debridement cases were analyzed using near infrared (NIR) imaging to study changes in TO. The NIR-based device used in this study estimates effective changes in TO in terms of oxy-, deoxy-, total hemoglobin, and oxygen saturation. Weber contrasts between callus tissue and the surrounding normal tissue were compared following debridement for all TO parameters. In a secondary analysis, callus tissue was segmented into quadrants and a percent of significance (in terms of total TO change) was calculated using a t-test. Results: Results show majority of cases displayed greater than 80% as the significant change in TO following debridement, except in cases with the presence of blood clot (a common precursor for ulceration). In cases where incomplete debridement was suspected, a significant change in TO was still observed. Conclusions: With extensive systematic studies in the future, NIR imaging technique to measure changes in TO may be implemented as a low-cost hand-held imaging device useful for objectively assessing the effectiveness of the scalpel debridement process.

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“…NIRS uses discrete NIR wavelengths to obtain these tissue oxygenation measurements at discrete point locations via contact in and around the wound [6,7]. More recently an NIR-based optical scanner (NIROS) light was developed [8,9,10,11] to obtain tissue oxygenation maps of the wound region via non-contact imaging (as in HSI and MSI) [10,11,12]. NIROS uses discrete NIR wavelengths unlike HSI and MSI technologies and the device is handheld, low cost, and portable.…”

Section: Introductionmentioning

confidence: 99%

“…NIR optical imaging technology has been used in various applications such as cancer diagnostics, functional brain mapping, and more recently in the area of wound imaging. In the area of wound imaging, both spectroscopic point-based NIR imaging [6,7] and area-based imaging approaches [8,9,10,11,12] have been developed.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Smartphone-Based Near-Infrared Optical Imaging Device to Measure Physiological Changes In-Vivo

Kaile

Godavarty

2019

Micromachines

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Smartphone-based technologies for medical imaging purposes are limited, especially when it involves the measurement of physiological information of the tissues. Herein, a smartphone-based near-infrared (NIR) imaging device was developed to measure physiological changes in tissues across a wide area and without contact. A custom attachment containing multiple multi-wavelength LED light sources (690, 800, and 840 nm; and <4 mW of optical power per LED), source driver, and optical filters and lenses was clipped onto a smartphone that served as the detector during data acquisition. The ability of the device to measure physiological changes was validated via occlusion studies on control subjects. Noise removal techniques using singular value decomposition algorithms effectively removed surface noise and distinctly differentiated the physiological changes in response to occlusion. In the long term, the developed smartphone-based NIR imaging device with capabilities to capture physiological changes will be a great low-cost alternative for clinicians and eventually for patients with chronic ulcers and bed sores, and/or in pre-screening for potential ulcers in diabetic subjects.

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Breath-Hold Paradigm to Assess Variations in Oxygen Flow in Diabetic Foot Ulcers Using a Noncontact Near-Infrared Optical Scanner

Cited by 15 publications

References 21 publications

Diabetic Foot Ulcer Imaging: An Overview and Future Directions

Diabetic Foot Ulcer Imaging: An Overview and Future Directions

Tissue Oxygenation Measurements to Aid Scalpel Debridement Removal in Patients With Diabetes

Development and Validation of a Smartphone-Based Near-Infrared Optical Imaging Device to Measure Physiological Changes In-Vivo

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