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Wu J, Ma Q, Zhou X, Wei Y, Liu Z, Kang H. Segmentation and quantitative analysis of optical coherence tomography (OCT) images of laser burned skin based on deep learning. Biomed Phys Eng Express 2024; 10:045026. [PMID: 38718764 DOI: 10.1088/2057-1976/ad488f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
Evaluation of skin recovery is an important step in the treatment of burns. However, conventional methods only observe the surface of the skin and cannot quantify the injury volume. Optical coherence tomography (OCT) is a non-invasive, non-contact, real-time technique. Swept source OCT uses near infrared light and analyzes the intensity of light echo at different depths to generate images from optical interference signals. To quantify the dynamic recovery of skin burns over time, laser induced skin burns in mice were evaluated using deep learning of Swept source OCT images. A laser-induced mouse skin thermal injury model was established in thirty Kunming mice, and OCT images of normal and burned areas of mouse skin were acquired at day 0, day 1, day 3, day 7, and day 14 after laser irradiation. This resulted in 7000 normal and 1400 burn B-scan images which were divided into training, validation, and test sets at 8:1.5:0.5 ratio for the normal data and 8:1:1 for the burn data. Normal images were manually annotated, and the deep learning U-Net model (verified with PSPNe and HRNet models) was used to segment the skin into three layers: the dermal epidermal layer, subcutaneous fat layer, and muscle layer. For the burn images, the models were trained to segment just the damaged area. Three-dimensional reconstruction technology was then used to reconstruct the damaged tissue and calculate the damaged tissue volume. The average IoU value and f-score of the normal tissue layer U-Net segmentation model were 0.876 and 0.934 respectively. The IoU value of the burn area segmentation model reached 0.907 and f-score value reached 0.951. Compared with manual labeling, the U-Net model was faster with higher accuracy for skin stratification. OCT and U-Net segmentation can provide rapid and accurate analysis of tissue changes and clinical guidance in the treatment of burns.
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Affiliation(s)
- Jingyuan Wu
- Beijing Institute of Radiation Medicine, Beijing 100850, People's Republic of China
- College of Life Sciences, Hebei University, Baoding, Hebei 071002, People's Republic of China
| | - Qiong Ma
- Beijing Institute of Radiation Medicine, Beijing 100850, People's Republic of China
| | - Xun Zhou
- Beijing Institute of Radiation Medicine, Beijing 100850, People's Republic of China
| | - Yu Wei
- Beijing Institute of Radiation Medicine, Beijing 100850, People's Republic of China
- College of Life Sciences, Hebei University, Baoding, Hebei 071002, People's Republic of China
| | - Zhibo Liu
- Beijing Institute of Radiation Medicine, Beijing 100850, People's Republic of China
| | - Hongxiang Kang
- Beijing Institute of Radiation Medicine, Beijing 100850, People's Republic of China
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Li H, Bu Q, Shi X, Xu X, Li J. Non-invasive medical imaging technology for the diagnosis of burn depth. Int Wound J 2024; 21:e14681. [PMID: 38272799 PMCID: PMC10805628 DOI: 10.1111/iwj.14681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024] Open
Abstract
Currently, the clinical diagnosis of burn depth primarily relies on physicians' judgements based on patients' symptoms and physical signs, particularly the morphological characteristics of the wound. This method highly depends on individual doctors' clinical experience, proving challenging for less experienced or primary care physicians, with results often varying from one practitioner to another. Therefore, scholars have been exploring an objective and quantitative auxiliary examination technique to enhance the accuracy and consistency of burn depth diagnosis. Non-invasive medical imaging technology, with its significant advantages in examining tissue surface morphology, blood flow in deep and changes in structure and composition, has become a hot topic in burn diagnostic technology research in recent years. This paper reviews various non-invasive medical imaging technologies that have shown potential in burn depth diagnosis. These technologies are summarized and synthesized in terms of imaging principles, current research status, advantages and limitations, aiming to provide a reference for clinical application or research for burn specialists.
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Affiliation(s)
- Hang Li
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Medical UniversityXi'anP.R. China
| | - Qilong Bu
- Bioinspired Engineering and Biomechanics CenterXi'an Jiaotong UniversityXi'anP.R. China
| | - Xufeng Shi
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Medical UniversityXi'anP.R. China
| | - Xiayu Xu
- Bioinspired Engineering and Biomechanics CenterXi'an Jiaotong UniversityXi'anP.R. China
| | - Jing Li
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Medical UniversityXi'anP.R. China
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Xu J, Yuan X, Huang Y, Qin J, Lan G, Qiu H, Yu B, Jia H, Tan H, Zhao S, Feng Z, An L, Wei X. Deep-learning visualization enhancement method for optical coherence tomography angiography in dermatology. JOURNAL OF BIOPHOTONICS 2023; 16:e202200366. [PMID: 37289020 DOI: 10.1002/jbio.202200366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/20/2023] [Accepted: 05/21/2023] [Indexed: 06/09/2023]
Abstract
Optical coherence tomography angiography (OCTA) in dermatology usually suffers from low image quality due to the highly scattering property of the skin, the complexity of cutaneous vasculature, and limited acquisition time. Deep-learning methods have achieved great success in many applications. However, the deep learning approach to improve dermatological OCTA images has not been investigated due to the requirement of high-performance OCTA systems and difficulty of obtaining high-quality images as ground truth. This study aims to generate proper datasets and develop a robust deep learning method to enhance the skin OCTA images. A swept-source skin OCTA system was employed to create low-quality and high-quality OCTA images with different scanning protocols. We propose a model named vascular visualization enhancement generative adversarial network and adopt an optimized data augmentation strategy and perceptual content loss function to achieve better image enhancement effect with small amount of training data. We demonstrate the superiority of the proposed method in skin OCTA image enhancement by quantitative and qualitative comparisons.
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Affiliation(s)
- Jingjiang Xu
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
| | - Xing Yuan
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, Guangdong, China
| | - Yanping Huang
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
| | - Jia Qin
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
- Department of Ophthalmology, Clinical Medical Institute, Affiliated Hospital, Weifang Medical University, Weifang, Shandong, China
| | - Gongpu Lan
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
| | - Haixia Qiu
- Department of Laser Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Bo Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Haibo Jia
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Haishu Tan
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
| | - Shiyong Zhao
- Tianjin Hengyu Medical Technology Co., Ltd., Tianjin, China
| | - Zhongwu Feng
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, Guangdong, China
| | - Lin An
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
- Department of Ophthalmology, Clinical Medical Institute, Affiliated Hospital, Weifang Medical University, Weifang, Shandong, China
| | - Xunbin Wei
- Biomedical Engineering Department, Peking University, Beijing, China
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Zou Y, Yu C, Huang Q, Tan X, Tan X, Zhu X, Yi D, Mao J. Investigating the active chemical constituents and pharmacology of Nanocnide lobata in the treatment of burn and scald injuries. PLoS One 2023; 18:e0287147. [PMID: 37310979 DOI: 10.1371/journal.pone.0287147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE To identify the most effective fraction of Nanocnide lobata in the treatment of burn and scald injuries and determine its bioactive constituents. METHODS Chemical identification methods were used to analyze solutions extracted from Nanocnide lobata using petroleum ether, ethyl acetate, n-butanol using a variety of color reactions. The chemical constituents of the extracts were identified by ultra-performance liquid chromatography (UPLC)-mass spectrometry (MS). A total of 60 female mice were randomly divided into the following 6 groups: the petroleum ether extract-treated group; the ethyl acetate extract-treated group; the n-butanol extract-treated group; the model group; the control group; and the positive drug group. The burn/scald model was established using Stevenson's method. At 24 hours after modeling, 0.1 g of the corresponding ointment was evenly applied to the wound in each group. Mice in the model group did not undergo treatment, while those in the control group received 0.1 g of Vaseline. Wound characteristics, including color, secretions, hardness, and swelling, were observed and recorded. Photos were taken and the wound area calculated on the 1st, 5th, 8th, 12th, 15th, 18th and 21st days. Hematoxylin-eosin (HE) staining was utilized to observe the wound tissue of mice on the 7th, 14th, and 21st days. An enzyme-linked immunosorbent assay (ELISA) kit was used to measure the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-10, vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-β1. RESULTS The chemical constituents of Nanocnide lobata mainly include volatile oils, coumarins, and lactones. UPLC-MS analysis revealed 39 main compounds in the Nanocnide lobata extract. Among them, ferulic acid, kaempferitrin, caffeic acid, and salicylic acid have been confirmed to exhibit anti-inflammatory and antioxidant activity related to the treatment of burns and scalds. HE staining revealed a gradual decrease in the number of inflammatory cells and healing of the wounds with increasing time after Nanocnide lobata extract administration. Compared with the model group, the petroleum ether extract-treated group showed significant differences in the levels of TNF-α (161.67±4.93, 106.33±3.21, 77.67±4.04 pg/mL) and IL-10 (291.77±4.93, 185.09±9.54, 141.33±1.53 pg/mL) on the 7th, 14th, and 21st days; a significant difference in the content of TGF-β1 (75.68±3.06 pg/mL) on the 21st day; and a significant difference in the level of VEGF (266.67±4.73, 311.33±10.50 pg/mL) on the 7th and 14th days respectively. CONCLUSION Petroleum ether Nanocnide lobata extract and the volatile oil compounds of Nanocnide lobata might be effective drugs in the treatment of burn and scald injuries, as they exhibited a protective effect on burns and scalds by reducing the expression of TNF-α, IL-10 and TGF-β1 and increasing the expression of VEGF. In addition, these compounds may also exert pharmacological effects that promote wound tissue repair, accelerate wound healing, and reduce scar tissue proliferation, inflammation and pain.
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Affiliation(s)
- Yanlin Zou
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- School of Pharmacy, Chongqing Medical and Pharmaceutical College, 401331, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Cao Yu
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Qian Huang
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Xiaorong Tan
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Xiaoyan Tan
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Xiaolong Zhu
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Dongyang Yi
- School of Pharmacy, Three Gorges Medical College, 404120, Chongqing, China
- Chongqing Anti-tumor Natural Drug Engineering Technology Research Center, Three Gorges Medical College, 404120, Chongqing, China
| | - Jingxin Mao
- School of Pharmacy, Chongqing Medical and Pharmaceutical College, 401331, Chongqing, China
- College of Pharmaceutical Sciences, Southwest University, 400715, Chongqing, China
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Shupp JW, Holmes JH, Moffatt LT, Phelan HA, Sousse L, Romanowski KS, Jeschke M, Kowalske KJ, Badger K, Allely R, Cartotto R, Burmeister DM, Kubasiak JC, Wolf SE, Wallace KF, Gillenwater J, Schneider DM, Hultman CS, Wiechman SA, Bailey JK, Powell HM, Travis TE, Supp DM, Carney BC, Johnson LS, Johnson LS, Chung KK, Chung KK, Kahn SA, Gibson ALF, Christy RJ, Carter JE, Carson JS, Palmieri TL, Kopari NM, Blome-Eberwein SA, Hickerson WL, Parry I, Cancio JM, Suman O, Schulman CI, Lamendella R, Hill DM, Wibbenmeyer LA, Nygaard RM, Wagner AL, Carter ADW, Greenhalgh DG, Lawless MB, Carlson DL, Harrington DT. Proceedings of the 2021 American Burn Association State and Future of Burn Science Meeting. J Burn Care Res 2022; 43:1241-1259. [PMID: 35988021 DOI: 10.1093/jbcr/irac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Periodically, the American Burn Association (ABA) has convened a State of the Science meeting on various topics representing multiple disciplines within burn care and research. In 2021 at the request of the ABA President, meeting development was guided by the ABA's Burn Science Advisory Panel (BSAP) and a subgroup of meeting chairs. The goal of the meeting was to produce both an evaluation of the current literature and ongoing studies, and to produce a research agenda and/or define subject matter-relevant next steps to advance the field(s). Members of the BSAP defined the topics to be addressed and subsequently solicited for nominations of expert speakers and topic leaders from the ABA's Research Committee. Current background literature for each topic was compiled by the meeting chairs and the library then enhanced by the invited topic and breakout discussion leaders. The meeting was held in New Orleans, LA on November 2nd and 3rd and was formatted to allow for 12 different topics, each with two subtopics, to be addressed. Topic leaders provided a brief overview of each topic to approximately 100 attendees, followed by expert-lead breakout sessions for each topic that allowed for focused discussion among subject matter experts and interested participants. The breakout and topic group leaders worked with the participants to determine research needs and associated next steps including white papers, reviews and in some cases collaborative grant proposals. Here, summaries from each topic area will be presented to highlight the main foci of discussion and associated conclusions.
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6
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Weigelt MA, Lev-Tov HA, Tomic-Canic M, Lee WD, Williams R, Strasfeld D, Kirsner RS, Herman IM. Advanced Wound Diagnostics: Toward Transforming Wound Care into Precision Medicine. Adv Wound Care (New Rochelle) 2022; 11:330-359. [PMID: 34128387 DOI: 10.1089/wound.2020.1319] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Significance: Nonhealing wounds are an ever-growing global pandemic, with mortality rates and management costs exceeding many common cancers. Although our understanding of the molecular and cellular factors driving wound healing continues to grow, standards for diagnosing and evaluating wounds remain largely subjective and experiential, whereas therapeutic strategies fail to consistently achieve closure and clinicians are challenged to deliver individualized care protocols. There is a need to apply precision medicine practices to wound care by developing evidence-based approaches, which are predictive, prescriptive, and personalized. Recent Advances: Recent developments in "advanced" wound diagnostics, namely biomarkers (proteases, acute phase reactants, volatile emissions, and more) and imaging systems (ultrasound, autofluorescence, spectral imaging, and optical coherence tomography), have begun to revolutionize our understanding of the molecular wound landscape and usher in a modern age of therapeutic strategies. Herein, biomarkers and imaging systems with the greatest evidence to support their potential clinical utility are reviewed. Critical Issues: Although many potential biomarkers have been identified and several imaging systems have been or are being developed, more high-quality randomized controlled trials are necessary to elucidate the currently questionable role that these tools are playing in altering healing dynamics or predicting wound closure within the clinical setting. Future Directions: The literature supports the need for the development of effective point-of-care wound assessment tools, such as a platform diagnostic array that is capable of measuring multiple biomarkers at once. These, along with advances in telemedicine, synthetic biology, and "smart" wearables, will pave the way for the transformation of wound care into a precision medicine. Clinical Trial Registration number: NCT03148977.
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Affiliation(s)
- Maximillian A. Weigelt
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Hadar A. Lev-Tov
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Marjana Tomic-Canic
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - W. David Lee
- Precision Healing, Inc., Newton, Massachusetts, USA
| | | | | | - Robert S. Kirsner
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ira M. Herman
- Precision Healing, Inc., Newton, Massachusetts, USA
- Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
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Lu J, Deegan AJ, Cheng Y, Liu T, Zheng Y, Mandell SP, Wang RK. Application of OCT-Derived Attenuation Coefficient in Acute Burn-Damaged Skin. Lasers Surg Med 2021; 53:1192-1200. [PMID: 33998012 DOI: 10.1002/lsm.23415] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/18/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES There remains a need to objectively monitor burn wound healing within a clinical setting, and optical coherence tomography (OCT) is proving itself one of the ideal modalities for just such a use. The aim of this study is to utilize the noninvasive and multipurpose capabilities of OCT, along with its cellular-level resolution, to demonstrate the application of optical attenuation coefficient (OAC), as derived from OCT data, to facilitate the automatic digital segmentation of the epidermis from scan images and to work as an objective indicator for burn wound healing assessment. STUDY DESIGN/MATERIALS AND METHODS A simple, yet efficient, method was used to estimate OAC from OCT images taken over multiple time points following acute burn injury. This method enhanced dermal-epidermal junction (DEJ) contrast, which facilitated the automatic segmentation of the epidermis for subsequent thickness measurements. In addition, we also measured and compared the average OAC of the dermis within said burns for correlative purposes. RESULTS Compared with unaltered OCT maps, enhanced DEJ contrast was shown in OAC maps, both from single A-lines and completed B-frames. En face epidermal thickness and dermal OAC maps both demonstrated significant changes between imaging sessions following burn injury, such as a loss of epidermal texture and decreased OAC. Quantitative analysis also showed that OAC of acute burned skin decreased below that of healthy skin following injury. CONCLUSIONS Our study has demonstrated that the OAC estimated from OCT data can be used to enhance imaging contrast to facilitate the automatic segmentation of the epidermal layer, as well as help elucidate our understanding of the pathological changes that occur in human skin when exposed to acute burn injury, which could serve as an objective indicator of skin injury and healing.
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Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Teng Liu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yujiao Zheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Samuel P Mandell
- Department of Surgery, Division of Trauma, Critical Care, and Burn, School of Medicine, University of Washington, Seattle, Washington, 98104
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195.,Department of Ophthalmology, School of Medicine, University of Washington, Seattle, Washington, 98104
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Lu J, Deegan AJ, Cheng Y, Mandell SP, Wang RK. OCT-Based Angiography and Surface Topography in Burn-Damaged Skin. Lasers Surg Med 2020; 53:849-860. [PMID: 33305835 DOI: 10.1002/lsm.23367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND OBJECTIVES There is a clinical need for an accurate, non-invasive imaging tool that can provide the objective assessment of burn wounds. The aims of this study are to demonstrate the potential of optical coherence tomography (OCT) in evaluating burn wound healing, as well as exploring the physiological basis of human wound healing. STUDY DESIGN/MATERIALS AND METHODS This was a retrospective study. Seven patients with severe burn wounds who were admitted to Harborview Medical Center were imaged using an in-house-built, clinical-prototype OCT system. OCT imaging was carried out at multiple scan sites on the burned skin across two time points (imaging session #1 and #2) with a field of view of ~9 × 9 mm. Due to pathological differences among burn zones, scan sites were classified into red sites (zone of hyperemia), white sites (zone of coagulation), and mixed sites. In addition to obtaining qualitative en face vascular and surface topography maps, we quantified vascular area density and surface roughness for comparative purposes. RESULTS En face vascular and surface topography maps demonstrated numerous morphological changes over both imaging sessions associated with burn injury, such as altered blood flow and loss of regular texture. Quantitative analyses revealed that during imaging session #1, vascular area density was significantly increased within the red sites compared with that of a healthy control (P = 0.0130), while vascular area density was significantly decreased within the white sites compared with that of a healthy control (P < 0.0001). During imaging session #2, vascular area density was significantly reduced to a more normal range within the red sites compared with imaging session #1 (P = 0.0215); however, vascular area density was still significantly lower within the white sites compared with that of a healthy control (P < 0.0001). Furthermore, vascular area density and surface roughness were significantly increased within the white sites during imaging session #2 compared with imaging session #1 (both P < 0.0001). CONCLUSIONS OCT is clinically feasible to monitor vascular changes and alterations in skin surface roughness during the process of burn wound healing. Variations in vascular area density and roughness measurements within the burn wounds revealed by OCT offer some key insights into the underlying pathophysiological mechanisms responsible for wound healing, which may become critical biological indicators in future clinical evaluation and monitoring of wound healing. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Samuel P Mandell
- Department of Surgery, Division of Trauma, Critical Care, and Burn, School of Medicine, University of Washington, Seattle, Washington, 98104
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195.,Department of Ophthalmology, School of Medicine, University of Washington, Seattle, Washington, 98104
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9
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Wan B, Ganier C, Du-Harpur X, Harun N, Watt FM, Patalay R, Lynch MD. Applications and future directions for optical coherence tomography in dermatology. Br J Dermatol 2020; 184:1014-1022. [PMID: 32974943 DOI: 10.1111/bjd.19553] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/24/2022]
Abstract
Optical coherence tomography (OCT) is a noninvasive optical imaging method that can generate high-resolution en face and cross-sectional images of the skin in vivo to a maximum depth of 2 mm. While OCT holds considerable potential for noninvasive diagnosis and disease monitoring, it is poorly understood by many dermatologists. Here we aim to equip the practising dermatologist with an understanding of the principles of skin OCT and the potential clinical indications. We begin with an introduction to the technology and discuss the different modalities of OCT including angiographic (dynamic) OCT, which can image cutaneous blood vessels at high resolution. Next we review clinical applications. OCT has been most extensively investigated in the diagnosis of keratinocyte carcinomas, particularly basal cell carcinoma. To date, OCT has not proven sufficiently accurate for the robust diagnosis of malignant melanoma; however, the evaluation of abnormal vasculature with angiographic OCT is an area of active investigation. OCT, and in particular angiographic OCT, also shows promise in monitoring the response to therapy of inflammatory dermatoses, such as psoriasis and connective tissues disease. We additionally discuss a potential role for artificial intelligence in improving the accuracy of interpretation of OCT imaging data.
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Affiliation(s)
- B Wan
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - C Ganier
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - X Du-Harpur
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK.,The Francis Crick Institute, 1 Midland Road, London, UK
| | - N Harun
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - F M Watt
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - R Patalay
- St John's Institute of Dermatology, King's College London, London, UK
| | - M D Lynch
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK.,St John's Institute of Dermatology, King's College London, London, UK
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