Hyperspectral imaging in systemic sclerosis-associated Raynaud phenomenon

• Published in: Arthritis research & therapy Vol. 25; no. 1; pp. 10 - 9
• Main Authors: Teaw, Shannon, Gupta, Akash, Williams, Alyssa, Wilson, F. Perry, Sumpio, Brandon J., Sumpio, Bauer E., Hinchcliff, Monique
• Format: Journal Article
• Language: English
• Published: London BioMed Central 20.01.2023; BioMed Central Ltd; BMC
• Subjects: Arthritis; Clinical outcomes; Clinical trials; Cold; Diagnosis; Diagnostic imaging; Evaluation; Female; Hands; Humans; Hyperspectral Imaging; Imaging; Likert scale; Male; Medicine; Medicine & Public Health; Orthopedics; Patient-reported outcome instruments; Patients; Raynaud disease; Raynaud Disease - diagnostic imaging; Raynaud phenomenon; Raynaud's disease; Rheumatology; Scleroderma; Scleroderma (Disease); Scleroderma, Localized; Scleroderma, Systemic - complications; Scleroderma, Systemic - diagnostic imaging; Scleroderma, Systemic - drug therapy; Spectrum analysis; Systemic scleroderma; Systemic sclerosis; Ulcers; United States; Digital ulcers; Systemic sclerosis; Patient-reported outcome instruments; Imaging; Raynaud phenomenon; Raynaud condition score; Cochin hand function scale; Scleroderma; Outcomes; Hyperspectral imaging
• ISSN: 1478-6362; 1478-6354; 1478-6362
• DOI: 10.1186/s13075-023-02990-3

Background/purpose Lack of robust, feasible, and quantitative outcomes impedes Raynaud phenomenon (RP) clinical trials in systemic sclerosis (SSc) patients. Hyperspectral imaging (HSI) non-invasively measures oxygenated and deoxygenated hemoglobin (oxyHb and deoxyHb) concentrations and oxygen saturation (O 2 sat) in the skin and depicts data as oxygenation heatmaps. This study explored the potential role of HSI in quantifying SSc-RP disease severity and activity. Methods Patients with SSc-RP ( n = 13) and healthy control participants (HC; n = 12) were prospectively recruited in the clinic setting. Using a hand-held camera, bilateral hand HSI (HyperMed™, Waltham, MA) was performed in a temperature-controlled room (22 °C). OxyHb, deoxyHb, and O 2 sat values were calculated for 78-mm 2 regions of interest for the ventral fingertips and palm (for normalization). Subjects underwent a cold provocation challenge (gloved hand submersion in 15 °C water bath for 1 min), and repeated HSI was performed at 0, 10, and 20 min. Patients completed two patient-reported outcome (PRO) instruments: the Raynaud Condition Score (RCS) and the Cochin Hand Function Scale (CHFS) for symptom burden assessment. Statistical analyses were performed using the Mann-Whitney U test and a mixed effects model (Stata, College Station, TX). Results Ninety-two percent of participants were women in their 40s. For SSc-RP patients, 69% had limited cutaneous SSc, the mean ± SD SSc duration was 11 ± 5 years, and 38% had prior digital ulcers—none currently. Baseline deoxyHb was higher, and O 2 sat was lower, in SSc patients versus HC ( p < 0.05). SSc patients had a greater decline in oxyHb and O 2 sat from baseline to time 0 (after cold challenge) with distinct rewarming oxyHb, O 2 sat, and deoxyHb trajectories versus HCs ( p < 0.01). There were no significant correlations between oxyHb, deoxyHb, and O 2 sat level changes following cold challenge and RCS or CHFS scores. Conclusion Hyperspectral imaging is a feasible approach for SSc-RP quantification in the clinic setting. The RCS and CHFS values did not correlate with HSI parameters. Our data suggest that HSI technology for the assessment of SSc-RP at baseline and in response to cold provocation is a potential quantitative measure for SSc-RP severity and activity, though longitudinal studies that assess sensitivity to change are needed.