Toward a Miniaturized Terahertz Spectroscopic Scanner for Triage and Determination of Burn Depth Under PFC Scenarios
Abstract
Objectives and Rationale: Burns represent 5%-20% of all combat-related injuries, 20% of which are considered severe or involve more than 20% of total body surface area, resulting in significant recovery and rehabilitation, cost of care, and long-term complications including functional impairment and disfigurement. A subgroup of these severe burns will spontaneously heal, while others will develop to a full thickness state and eventually will require surgical intervention. However, the accuracy of clinical burn diagnosis has remained below 70%. In a realistic scenario, a burn patient would undergo multiple excision and reconstructive surgeries, partly due to inaccuracies in estimating the wound-healing boundaries, resulting in extended periods of hospitalization and higher recovery costs. According to the American Burn Association, each year in the United States, 40,000 cases require hospitalization with an estimated annual expenditure of more than $2 billion direct costs of care and much greater rehabilitation costs (American Burn Association Incidence Fact Sheet 2016). We propose to develop a compact field-deployable diagnostic imaging device that can be operated by either non-medical first responders or military medics in a pre-hospital setting with telehealth capability to allow for objective determination of the course of treatment during and beyond the Golden Hour, when the access to medical resources or evacuations are limited. The new diagnostic imaging modality is based on tissue spectroscopy using terahertz electromagnetic waves. The terahertz (THz) part of the electromagnetic spectrum is usually defined by the frequencies between 100 GHz and 10 THz. THz waves have very low photon energies, less than infrared light, and therefore are non-ionizing and safe for in vivo imaging applications. Noninvasive THz spectral imaging has shown new promise in diagnosing different burns. We have shown in several preclinical studies that THz spectral reflectivity between 0.1 and 1 THz varies systematically with the severity of the burn wounds, as assessed independently by histology. Recently, we have also shown that THz hyperspectral imaging can predict the course of treatment and healing outcome of partial thickness burns. The objectives of our study are to implement a rapid, portable, and highly accurate THz spectral imager for diagnosis of burn wounds. We will compare the accuracy of burn diagnosis and the ultimate healing outcome based on the THz scans obtained immediately after presentation to an emergency department. Moreover, we will compare the utility of the new THz hyperspectral images in increasing the accuracy of burn diagnosis between burn care providers who had access to THz images as compared to those who did not (diagnosis based on naked eye examination). Applicability and Impact: This project seeks to develop a non-invasive imaging modality to be used in prolonged field-care scenarios, where access to burn surgeons is not available or medical evacuations are logistically not possible. This device can be used by non-medical first responders and military medics in a pre-hospital setting. Therefore, this project is directly responsive to both Focus Areas of the FY20 Military Burn Research Program. The project is designed to be conducted at the Stony Brook University Burn Center using civilian patient populations, who provide informed consent. The study will not impact the routine course of treatment of these patients. Results of this project will benefit both military and civilian populations in the future by improving the accuracy of burn triage to more than 95% and by guiding burn treatment in the field. We expect that our study will require complete Food and Drug Administration (FDA) approval through an Investigational Device Exemption process. Upon the successful completion of this project, a multi-center double-blind next-phase clinical trial may be needed to show intervention efficacy a
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110258
Entities
People
- Mohammad Arbab
Organizations
- Stony Brook University
- United States Army