Using multimodal imaging techniques to monitor limb ischemia: a rapid noninvasive method for assessing extremity wounds

Luthra, Rajiv; Caruso, Joseph D.; Radowsky, Jason S.; Rodriguez, Maricela; Forsberg, Jonathan A.; Elster, Eric A.; Crane, Nicole J.

doi:10.1117/12.2000467

Cited by 2 publications

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“…Preliminary investigations of the 3CCD imagery suggest that the relationship between the red and blue channels, indicative of oxygenation, is related to the ischemia event/ [18] For the 3CCD frames, differences in the red and blue channels correlate to tissue oxygenation. [16,[20][21][22][23] In the infrared frames, a mean intensity value for the region of interest indicates limb perfusion.…”

Section: Image Acquisitionmentioning

confidence: 98%

Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

et al. 2014

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Ischemia and reperfusion injuries present major challenges for both military and civilian medicine. Improved methods for assessing the effects and predicting outcome could guide treatment decisions. Specific issues related to ischemia and reperfusion injury can include complications arising from tourniquet use, such as microvascular leakage in the limb, loss of muscle strength and systemic failures leading to hypotension and cardiac failure. Better methods for assessing the viability of limbs/tissues during ischemia and reducing complications arising from reperfusion are critical to improving clinical outcomes for at-risk patients. The purpose of this research is to develop and assess possible prediction models of outcome for acute limb ischemia using a pre-clinical model. Our model relies only on non-invasive imaging data acquired from an animal study. Outcome is measured by pathology and functional scores. We explore color, texture, and temporal features derived from both color and thermal motion imagery acquired during ischemia and reperfusion. The imagery features form the explanatory variables in a model for predicting outcome. Comparing model performance to outcome prediction based on direct observation of blood chemistry, blood gas, urinalysis, and physiological measurements provides a reference standard. Initial results show excellent performance for the imagery-base model, compared to predictions based direct measurements. This paper will present the models and supporting analysis, followed by recommendations for future investigations.

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Section: Image Acquisitionmentioning

confidence: 98%

Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

et al. 2014

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Preclosure spectroscopic differences between healed and dehisced traumatic wounds

et al. 2018

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BackgroundThe complexity and severity of traumatic wounds in military and civilian trauma demands improved wound assessment, before, during, and after treatment. Here, we explore the potential of 3 charge-coupled device (3CCD) imaging values to distinguish between traumatic wounds that heal following closure and those that fail. Previous studies demonstrate that normalized 3CCD imaging values exhibit a high correlation with oxygen saturation and allow for comparison of values between diverse clinical settings, including utilizing different equipment and lighting.MethodsWe screened 119 patients at Walter Reed National Military Medical Center and at Grady Memorial Hospital with at least one traumatic extremity wound of ≥ 75 cm2. We collected images of each wound during each débridement surgery for a total of 66 patients. An in-house written computer application selected a region of interest in the images, separated the pixel color values, calculated relative values, and normalized them. We followed patients until the enrolled wounds were surgically closed, quantifying the number of wounds that dehisced (defined as wound failure or infection requiring return to the operating room after closure) or healed.ResultsWound failure occurred in 20% (19 of 96) of traumatic wounds. Normalized intensity values for patients with wounds that healed successfully were, on average, significantly different from values for patients with wounds that failed (p ≤ 0.05). Simple thresholding models and partial least squares discriminant analysis models performed poorly. However, a hierarchical cluster analysis model created with 17 variables including 3CCD data, wound surface area, and time from injury predicts wound failure with 76.9% sensitivity, 76.5% specificity, 76.6% accuracy, and a diagnostic odds ratio of 10.8 (95% confidence interval: 2.6–45.9).ConclusionsImaging using 3CCD technology may provide a non-invasive and cost-effective method of aiding surgeons in deciding if wounds are ready for closure and could potentially decrease the number of required débridements and hospital days. The process may be automated to provide real-time feedback in the operating room and clinic. The low cost and small size of the cameras makes this technology attractive for austere and shipboard environments where space and weight are at a premium.

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Using multimodal imaging techniques to monitor limb ischemia: a rapid noninvasive method for assessing extremity wounds

Cited by 2 publications

References 0 publications

Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

Preclosure spectroscopic differences between healed and dehisced traumatic wounds

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