Mr. Rajiv Luthra Profile

Rajiv Luthra

at Naval Medical Research Ctr

SPIE Involvement:

Author

Publications (2)

Proceedings Article | 11 March 2014 Paper

Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

John Irvine, John Regan, Tammy Spain, Joseph Caruso, Maricela Rodriquez, Rajiv Luthra, Jonathon Forsberg, Nicole Crane, Eric Elster

Proceedings Volume 9037, 90371F (2014) https://doi.org/10.1117/12.2043958

KEYWORDS: Ischemia, Pathology, Blood, Motion models, Tissues, Animal model studies, Image sensors, Injuries, Data modeling, Composites

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Proceedings Article | 13 March 2013 Paper

Using multimodal imaging techniques to monitor limb ischemia: a rapid noninvasive method for assessing extremity wounds

Rajiv Luthra, Joseph Caruso, Jason Radowsky, Maricela Rodriguez, Jonathan Forsberg, Eric Elster, Nicole Crane

Proceedings Volume 8574, 85740C (2013) https://doi.org/10.1117/12.2000467

KEYWORDS: Tissues, Ischemia, Image sensors, Infrared imaging, Injuries, Surgery, Infrared cameras, Multimodal imaging, Cameras, Infrared radiation

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Over 70% of military casualties resulting from the current conflicts sustain major extremity injuries. Of these the majority are caused by blasts from improvised explosive devices. The resulting injuries include traumatic amputations, open fractures, crush injuries, and acute vascular disruption. Critical tissue ischemia—the point at which ischemic tissues lose the capacity to recover—is therefore a major concern, as lack of blood flow to tissues rapidly leads to tissue deoxygenation and necrosis. If left undetected or unaddressed, a potentially salvageable limb may require more extensive debridement or, more commonly, amputation. Predicting wound outcome during the initial management of blast wounds remains a significant challenge, as wounds continue to “evolve” during the debridement process and our ability to assess wound viability remains subjectively based. Better means of identifying critical ischemia are needed. We developed a swine limb ischemia model in which two imaging modalities were combined to produce an objective and quantitative assessment of wound perfusion and tissue viability. By using 3 Charge-Coupled Device (3CCD) and Infrared (IR) cameras, both surface tissue oxygenation as well as overall limb perfusion could be depicted. We observed a change in mean 3CCD and IR values at peak ischemia and during reperfusion correlate well with clinically observed indicators for limb function and vitality. After correcting for baseline mean R-B values, the 3CCD values correlate with surface tissue oxygenation and the IR values with changes in perfusion. This study aims to not only increase fundamental understanding of the processes involved with limb ischemia and reperfusion, but also to develop tools to monitor overall limb perfusion and tissue oxygenation in a clinical setting. A rapid and objective diagnostic for extent of ischemic damage and overall limb viability could provide surgeons with a more accurate indication of tissue viability. This may help reducing the number of surgical interventions required, by aiding surgeons in identifying and demarcating areas of critical tissue ischemia, so that a more adequate debridement may be performed. This would have obvious benefits of reducing patient distress and decreasing both the overall recovery time and cost of rehabilitation.

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