529 Evaluating Clinical Observation, Spatial Frequency Domain Imaging (SFDI) and Laser Speckle Imaging (LSI) for the Assessment of Burns

Abstract

The current standard for diagnosis of burn severity and subsequent wound healing is through clinical examination, which is highly subjective. Several new technologies focus on burn care in an attempt to help clinicians quantify burn severity earlier and more accurately. Laser Speckle Imaging (LSI) is a technique that quantifies perfusion to assess burn wounds while Spatial Frequency Domain Imaging (SFDI) can quantify the structural damage caused by burns. Here we test each system’s ability to categorize burn wounds and compare their performance. Clinical assessment of a Yorkshire pig (n=3) graded burn model was performed at 24 hours after burn injury. A commercial LSI (Periscan PIM 3, Perimed Inc.) and SFDI (OxImager RS, MI Inc.) device were used to measure hemodynamic (blood flow) and structural (reduced scattering coefficient) properties of the burn wounds. Burn severity was confirmed by histology. Additionally, both devices were used to collect preliminary data on clinical patients. Clinical assessments in the swine model were 83% percent accurate, while the LSI and SFDI systems were 81% and 85% percent accurate respectively. In addition to being more accurate than LSI in this study, SFDI data suggests that it can spatially resolve the heterogeneity of burn severity within a burn wound. This was not observed using the commercial LSI device. Preliminary results on clinical patients also showed both devices were capable of non-invasively predicting burn regions that would eventually require grafting. The testing of these different imaging modalities in a controlled environment allows a direct comparison. Here we show that SFDI is capable of categorizing burn wounds in a swine model of histologically confirmed graded burn severity more accurately than clinical assessment or LSI. SFDI is also able to resolve spatial heterogeneity of burn severity within a wound. SFDI has the potential to improve clinical care with additional information related to tissue structure and function, thus aiding clinicians to make decisions on how to treat burn wounds accurately at earlier time points. Additionally, these noninvasive imaging technologies have the potential to enhance tracking of wound progression and treatment efficacy. By improving diagnostic accuracy of which burn areas will require grafting, these devices may aid clinicians make appropriate treatment decisions sooner.