Scleroderma, or systemic sclerosis (SSc) is a chronic, autoimmune disorder that manifests in the fibrosis of skin and internal organs. The clinical gold standard used to track SSc disease progression is the modified Rodnan skin score (mRSS), which is based on clinical palpation. Spatial Frequency Domain Imaging (SFDI), a widefield, non-contact diffuse optical imaging technology may provide an alternate quantitative and objective method to track progression of SSc by measuring tissue reflectance and optical properties. To investigate this, SFDI measurements were conducted on 10 SSc patients and 8 healthy controls, with 6 patients and 2 controls also being measured longitudinally. We found that there were proportional changes in SFDI metrics (μs' at 851 nm and Rd at 851 nm and 0.2 mm-1) corresponding to SSc progression (measured by mRSS scores and with histopathological metrics), suggesting SFDI could provide an improved method to track SSc progression.
Our prior work has established that SFDI metrics can be used to assess skin involvement in scleroderma. To ease clinical translation of SFDI for SSc disease assessment, a preliminary design for a handheld SFDI system optimized for measurement of sclerodermatous skin is proposed. An LED is used as an illumination source, light is modulated using a printed transparency, and Rd is extracted using single snapshot demodulation methods. Additionally, the imager can measure scattering orientation using a rotating pattern. The performance of the imager was assessed using phantoms, and its inter- and intra-observer reliabilities were assessed.
The extend of skin fibrosis in scleroderma patients is currently assessed using the semi-quantitative modified Rodnan skin score (mRSS) which is an assessment of skin thickness. We investigated the use of spatial frequency domain imaging (SFDI) for more quantitative and reliable assessment of skin fibrosis. SFDI measurements were conducted at 6 body locations of 10 control subjects and 10 patients with scleroderma. SFDI results, especially reduced scattering coefficient, show strong correlation with the mRSS score measured by the physician at the same body locations suggesting that SFDI is a reliable tool to quantify skin fibrosis in scleroderma patients.
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