1. 1. Andrea Murray Shedding light on scleroderma
2. 2. Aim and drive for developing technologies To develop better, more sensitive and robust imaging techniques to measure disease severity, progression & treatment response Better targeting and monitoring of treatments Improved disease management
3. 3. Light based - techniques Advancement of nailfold capillaroscopy Laser Doppler imaging Multispectral imaging
4. 4. Light based - techniques Advancement of nailfold capillaroscopy Laser Doppler imaging Multispectral imaging
5. 5. Capillaroscopy equipment
6. 6. Nailfold capillaroscopy in action
7. 7. Nailfold capillary architecture
8. 8. Nailfold capillaroscopy Developed software for automated capillary recognition Capable of measuring individual and average capillary width, density, tortuosity Berks et al. Med Image Comput Comput Assist Interv. 2014;17(Pt 1):658-65.
9. 9. Comparison of capillary measures between subject groups
10. 10. Blood flow in nailfold capillaroscopy Tresadern et al. Conf Proc IEEE Eng Med Biol Soc. 2013;2013
11. 11. Light based - techniques Advancement of nailfold capillaroscopy Laser Doppler imaging Multispectral imaging
12. 12. Laser Doppler imaging
13. 13. Measuring blood flow in digital ulcers LDI can image ischaemia/hyperaemia in ulceration 61 DU imaged; 60% ulcers were ischaemic Murray A, et al. Arthritis and Rheumatism 2011; 63: s574
14. 14. Measurement of healing in digital ulcers LDI can measure healing of ulcers with respect to blood flow increase in ulcer blood flow and decrease in adjacent blood flow Baseline At healing (as clinically assessed ) Murray A, et al. Arthritis and Rheumatism 2011; 63: s574
15. 15. Pilot iontophoresis - perfusion increase with time Good local method of delivery (no side effects) we need a longer lasting drug
16. 16. Light based - techniques Advancement of nailfold capillaroscopy Laser Doppler imaging Multispectral imaging
17. 17. Hyperspectral or Multispectral imaging Spectroscopy spectrometer White light
18. 18. Hyperspectral or Multispectral imaging Spectroscopy spectrometer White light
19. 19. Hyperspectral or Multispectral imaging Spectroscopy spectrometer
20. 20. Hyperspectral or Multispectral imaging Spectroscopy spectrometer
21. 21. Hyperspectral or Multispectral imaging Spectroscopy spectrometer
22. 22. 10 HC, 10 LcSSc, 7 DcSSc Digital occlusion; 200 mmHg, 2 mins Imaged baseline, during, upon release and after 1 minute, after 5 mins Oxygenation Pilot study of multispectral imaging in patients with systemic sclerosis and healthy controls Poxon I et al. Rheumatology (2015) 54 : i161.
23. 23. Pilot study of multispectral imaging in patients with systemic sclerosis and healthy controls oxygenation Oxygenation
24. 24. Pilot study of multispectral imaging in patients with systemic sclerosis and healthy controls oxygenation Oxygenation Possible to differentiate between controls and patients with SSc using changes in oxygenation Poxon I et al. Rheumatology (2015) 54 : i161.
25. 25. Summary Light based imaging techniques help us to learn more about Raynauds phenomenon and scleroderma non-invasively Some techniques remain in the research arena, others move towards clinical diagnostic status Aim is to validate techniques in order to measure disease severity, progression & treatment response Improve disease management
26. 26. Ariane Herrick Tonia Moore Joanne Manning Paul New Sarah Leggett Christopher Griffiths Mark Dickinson Chris Taylor Danny Allen Phil Tresadern Mike Berks Graham Dinsdale Donna Arthur Ian Poxon Mike Hughes Elizabeth Evans I am grateful to: All our volunteers who make it possible! Our funders