Quantitative skin assessment using spatial frequency domain imaging (SFDI) in patients with or at high risk for pressure ulcers

• Published in: Lasers in surgery and medicine 2017-11, Vol.49 (9), p.827-834
• Main Authors: Yafi, Amr, Muakkassa, Fuad K., Pasupneti, Tejasvi, Fulton, Judy, Cuccia, David J., Mazhar, Amaan, Blasiole, Kimberly N., Mostow, Eliot N.
• Format: Article
• Language: English
• Subjects: Aged; Blood; Blood volume; camera; Case studies; Constituents; Erythema; Exanthema; Feasibility Studies; Female; Frequency dependence; Hemoglobin; Humans; I.R. radiation; Imaging; Infrared imagery; Infrared imaging; Lasers; light; Male; Middle Aged; near‐infrared; Optical Imaging - instrumentation; Optical Imaging - methods; Optical properties; optics; Oxygen; Oxygen content; Patients; photography; Pressure; Pressure Ulcer - diagnostic imaging; Pressure Ulcer - etiology; Pressure Ulcer - pathology; Pressure ulcers; Prospective Studies; Reproducibility of Results; Risk assessment; Saturation; Scattering; SFDI; Skin; Technology assessment; Ulcers; wound; Wounds
• ISSN: 0196-8092; 1096-9101
• DOI: 10.1002/lsm.22692

Background and Objective Pressure ulcers (PU) are a significant problem facing the health system in the United States. Here, we present preliminary case studies demonstrating feasibility of Spatial Frequency Domain Imaging (SFDI) to assess skin status in high‐risk populations and pre‐existing wounds. SFDI is a wide‐field non‐contact optical imaging technology that uses structured light to obtain tissue optical properties and of tissue constituents. This study aims to determine the fit of SFDI for PU care and determine the next steps. Study Design/Materials and Methods Patients at risk for pressure ulcers were imaged using a near‐infrared SFDI system. SFDI‐derived images of tissue function (tissue hemoglobin, tissue oxygen saturation) and structure (tissue scattering) were then compared to each other as well as a blinded dermatologist's clinical impressions. Results Four case series were chosen to demonstrate the imaging capability of this technology. The first scenario demonstrates normal skin of three patients without skin breakdown with spatially uniform measures of tissue oxygen saturation, scattering, and blood volume. The second scenario demonstrates a stage II PU; the third case shows non‐blanchable erythema of an unstageable PU; a fourth scenario is a clinically indistinguishable skin rash versus early stages of a PU. In all these cases, we observe spatial changes in tissue constituents (decrease in tissue oxygen saturation, increased blood pooling, decreased scattering). Conclusion We have presented the first use of SFDI for pressure ulcer imaging and staging. This preliminary study demonstrates the feasibility of this optical technology to assess tissue oxygen saturation and blood volume status in a quantitative manner. With the proposed improvements in modeling and hardware, SFDI has potential to provide a means for pressure ulcer risk stratification, healing and staging. Lasers Surg. Med. 49:827–834, 2017 © 2017 Wiley Periodicals, Inc.