More than 10% of the 15 million Americans who experience skeletal fractures each year suffer from impaired healing. The large incidence of impaired healing results in poor quality of life and high total cost of care for pa- tients. To enhance fracture healing, various regenerative medicine based approaches are being developed, but their development rates are slow due to the limitations of current imaging techniques. For example, vasculariza- tion, a key step in bone healing, is assessed using endpoint methods requiring sacri?ce/destruction of animals, leading to high inter-subject variability, time and cost. Our objective is to establish diffuse optical tomography (DOT) and correlation tomography (DCT) as non-invasive, longitudinal research tools to monitor vascularization and predict bone fracture healing. DOT and DCT, 3D deep-tissue hemodynamic imaging techniques, are ideal for frequent longitudinal monitoring due to low cost and the use of non-ionizing light. In addition, DOT and DCT are easily scalable between preclinical and clinical applications. Together, these methods report multiple microvas- cular parameters: total hemoglobin concentration and oxygen saturation with DOT and blood ?ow with DCT. We hypothesize that DOT and DCT provide accurate quanti?cation of regional blood volume, oxygenation and ?ow in bone and surrounding soft tissues, which can serve as surrogate markers for the quality of bone healing. Three speci?c aims are designed to test the hypotheses:
Aim 1 : Construct a prediction model for bone fracture treatment ef?cacy using an animal bone fracture model, Aim 2: Directly compare DOT and DCT with histomorphometry, ?uorescent microsphere technique and dynamic-contrast-enhanced magnetic resonance imaging in a murine fracture model, Aim 3: Construct clinical prediction model for nonunions in proximal ?fth metatarsal fractures based on DOT and DCT measurements. Successful completion of these aims will result in great advances in regenerative medicine and musculoskeletal research by providing a comprehensive and innovative non-invasive longitudinal monitoring tool. In addition, the proposed work lays the foundation for clinical translation of DOT and DCT for bone vascular monitoring by direct comparison with traditional vascularization assessment techniques and by constructing a clinical prediction model for impaired healing in fractures.

Public Health Relevance

Vascularization is a key step in bone fracture healing, but is often measured only once or not at all due to technical limitations or cost. We propose to develop and validate optical instruments for non-invasive, longitudinal monitoring of blood ?ow, volume and oxygenation in bone fractures and surrounding tissues to predict bone healing. This approach will signi?cantly expedite the development of new bone fracture treatments based on regenerative medicine and the diagnosis of impaired healing, which currently takes at least 3 months.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR071363-03
Application #
9686474
Study Section
Biomedical Imaging Technology Study Section (BMIT)
Program Officer
Wang, Fei
Project Start
2017-04-01
Project End
2022-03-31
Budget Start
2019-04-01
Budget End
2020-03-31
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of Rochester
Department
Biomedical Engineering
Type
School of Medicine & Dentistry
DUNS #
041294109
City
Rochester
State
NY
Country
United States
Zip Code
14627