Projects / Programmes
Combined multispectral and thermographic imaging for screening and monitoring of small joint arthritis
| Code |
Science |
Field |
Subfield |
| 2.06.09 |
Engineering sciences and technologies |
Systems and cybernetics |
Medical physics |
| Code |
Science |
Field |
| T115 |
Technological sciences |
Medical technology |
| Code |
Science |
Field |
| 2.06 |
Engineering and Technology |
Medical engineering
|
arthritis, biomedical optics, thermography, 3D scanning, clinical trial
Researchers (16)
Organisations (3)
Abstract
Rheumatoid arthritis (RA) is the most common chronic inflammatory arthritis. The prevalence in Europe is between 0.5 and 1% and the incidence rate increases with age, peaking at age of around 60 years. RA typically affects small and medium sized joints in a symmetric fashion and has a progressive, destructive course. Another inflammatory arthritis is psoriatic arthiritis (PsA), which is chronic erosive arthritis affecting joints, entheses and certain extra-articular sites. The prevalence of PsA is around 0.5%.
RA and PsA are both associated with significant pain and joint destruction and deformation, resulting in the progressive loss of function, mobility and the ability to care for oneself. High level of disability, including work disability, has a negative impact on social and psychological functioning of the patient.
The functional outcome and subsequently the indirect costs are strongly dependent on the time lag between the onset of the disease and the beginning of the treatment. Several studies have shown that a window of opportunity for alteration or even reversal of the disease exists in the first year and especially in the first 3 months. First few months therefore represent an important therapeutic window. Early diagnosis and early therapeutic intervention should be therefore a priority/goal. Tools for cost-effective and reliable diagnosis of early inflammatory signs in finger joints are therefore of highest importance to ensure a successful therapy and to reduce the loss of quality of life for the patient as well as the amount of disease related indirect costs.
Currently, x-ray, ultrasound (US) and magnetic resonance (MRI) are used as imaging modalities for diagnosis of arthritis. All these techniques have drawbacks therefore a novel imaging modality for diagnosis of arthritis addressing all these drawbacks is thus critically needed.
Several reports have indicated that optical techniques can be useful for imaging of inflamed joints. Specifically for an inflamed joint, the features, which can significantly alter the optical measurements, include vessel proliferation, relative hypoxia and change of synovial fluid.
We recently demonstrated that hyperspectral imaging (HSI) could serve as an imaging modality for the diagnostics and follow-up monitoring of arthritis in small joints. HSI is a non-contact and non-invasive optical technique which provides both spectral and spatial information in one measurement. However, HSI is relatively expensive and the data analysis is rather complex. Therefore a simplified multispectral imaging approach would be more appropriate. It was recently demonstrated that a combination of multispectral LED illumination and an RGB camera can fulfil these requirements.
Another imaging modality applicable to arthritis detection is thermography due to increased temperatures in the inflamed joints. Thermography provides temperature distribution maps of an object.
The overall objective of the proposed research is to develop and clinically evaluate a multimodal imaging modality combining multispectral and thermographic imaging for detection of early stage arthritis in small human joints. Namely, the specific aims of the study are: (1) TO DESIGN THE SYSTEM, (2) TO BUILD THE SYSTEM, (3) TO EVALUATE THE SYSTEM. The last part will include a clinical pilot study, where performance of the multimodal imaging system will be compared to the standard of care approaches.
It is expected that such imaging modality would significantly simplify and accelerate screening and therapy monitoring procedures for patients with joint inflammation, and also increase sensitivity and accuracy of the diagnostic imaging. Such system could be available in GP offices or as a home use monitoring device. Nevertheless, the proposed research could guide development of other diagnostic and monitoring procedures based on optical and thermographic compact imaging systems.
Significance for science
A successful competition of the project will result in a novel multimodal imaging system. The most important outcomes of the project relevant for the development of science or a scientific field will be:
· Promoting optical and thermographic imaging in rheumatology: The device performance at the detection of joint inflammation will be compared to other reported optical and SoC (Standard of Care) approaches. Due to the particular sensitivity of the optical and thermographic methods to the changes in inflammed joints, a superior sensitivity and specificity are expected, which will promote both the multispectral, thermographic and combined imaging in the rheumatology field.
· Individual therapy monitoring: The compact system will provide possibility for individual therapy monitoring, therefore studying the continuous response to the therapy will become possible. Moreover, dynamic therapy protocols could be developed, where the therapy will be regulated by the monitoring findings (feedback). The dynamically regulated therapy would offer a personalized medicine approach with optimal treatment and minimal side-effects.
· Novel algorithms: Custom developed algorithms for each of the modality and their combination will be developed. The algorithms and their evaluation will be published in suitable scientific journals. The developed algorithms could be utilized in other applications in the biomedical engineering and medical physics field.
· RGB channels and LED’s for mapping chromophores: A detailed numerical and experimental study of utilization of RGB snapshot imaging in combination with the multispectral illumination for determination of chromophores and scattering amplitudes. The results of these studies will offer optimal combinations of RGB channels and LEDs for mapping of specific chromophores and scattering. The findings could be used for optical screening and monitoring of other pathologies, i.e. arterial diseases, diabetic vascular diseases, chronic wounds, burns, monitoring dermatologic therapies.
Significance for the country
The broad relevance of the project proposal is well documented in the priority of one of the Horizon 2020 calls, which states: "Clinical trial(s) supporting proof of concept in humans to assess the potential clinical efficacy of the novel therapeutic concept(s) and/or optimization of available therapies (e.g., drug repurposing)." Socioeconomic impact of this work is remarkable, since the developed world population is ageing and the joint diseases, impairing functionality and life quality of the affected population, are becoming very common.
Specific impact of the project for a patient and a physician are:
· Fast screening of the suspected joints.
· Monitoring of the therapy allowing personalized therapy
· Reduced or eliminated inter-operator variability.
· Could be used by a general practitioner and even by patient
· Reduced waiting times
Specific impact of the project for the economy is:
Realistic opportunity to commercialize a novel device for screening and monitoring of small joints inflammation exists. The production costs of the compact device could be reduced to approx. 200-300 EUR and the device could be thus potentially available to the patients for home use, while the screening device could be produced for approx. 1000-2000 EUR, which could prove affordable for community health centres. If estimated that approx. 1-2% of the population suffers because of the arthritic diseases, and 50% of the patients would buy the device, the income from selling the compact device would be several million EUR just in Slovenia. The financial impact if the device will be available in other countries would be markedly larger.
Most important scientific results
Final report
Most important socioeconomically and culturally relevant results
Interim report,
final report
