Diseases diagnosed with assessment of blood flow account for 29% of deaths in the US and are leading causes of premature morbidity, including visual disorders which carry an economic burden of $35 bil- lion per year. The heart disease with the most impact on public health is coronary artery disease (CAD); more than one million percutaneous coronary interventions (PCI) are performed in the US ev- ery year. Among visual disorders diabetic retinopathy, macular degeneration and glaucoma are lead- ing causes of blindness in the US and affect 9% of the population over 40. All of these diseases are di- agnosed based on the qualitative assessment of blood flow using invasive dye contrast techniques. Extensive clinical trials have shown that guiding PCI based on quantitative blood flow assessment greatly improves the clinical outcome, but blood flow assessment requires catheters which are not in- tegrated with imaging catheters, increasing the intervention duration and therefore risk and cost. In- travascular optical coherence tomography (IV-OCT) has enabled high-resolution structural imaging of coronary arteries and can evaluate the response to PCI. Enabling blood flow quantification, flowmetry, with IV-OCT would provide functional information, critical to guide treatment and improve clinical outcomes. Similarly, OCT has been established as the standard of care in retinal diseases, providing critical structural imaging for diagnosis. It is known that early diagnosis of DR-MD-G requires func- tional information in the form of flowmetry, detecting changes in blood flow rate before the disease af- fects the vascular network structure and reducing associated vision loss. This project develops an OCT flowmetry technological platform, OCT-Flow, which relies on the analy- sis of the stochastic fluctuations of the OCT signal and its relation to the scatterers' velocity field. OCT- Flow will provide accurate flowmetry in complex-amplitude- and intensity-based modes. Upon com- pletion, OCT-Flow will be fully validated and will enable CAD treatment guidance and early eye-dis- ease diagnosis. The long-term impact of OCT-Flow will further include a wide range of clinical and preclinical applications, meeting the large demand for accurate flowmetry for treatment guidance and diagnosis in healthcare.

Public Health Relevance

Coronary artery disease (CAD) and visual disorders like diabetic retinopathy, macular degeneration and glaucoma are among the leading causes of mortality and morbidity in the US, and are diagnosed using the qualitative assessment of blood flow using invasive dye contrast techniques. This project de- velops a fully validated flowmetry technique to guide CAD treatment and to provide early eye disease diagnosis, with the potential to extend into a wide range of clinical applications, meeting the large de- mand for accurate blood flowmetry in healthcare.

National Institute of Health (NIH)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Mentored Quantitative Research Career Development Award (K25)
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Special Emphasis Panel (ZEB1)
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King, Randy Lee
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Massachusetts General Hospital
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Cuartas-Vélez, Carlos; Restrepo, René; Bouma, Brett E et al. (2018) Volumetric non-local-means based speckle reduction for optical coherence tomography. Biomed Opt Express 9:3354-3372