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A novel arthritis in vivo fluorescence optical imaging technology pushed to the limits

机译：一种新型的关节炎体内荧光光学成像技术推向了极限

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Sir, Fluorescence optical imaging (FOI) is a novel method that is increasingly utilized for visualizing arthritides by detecting local hyperperfusion. We report on a 57-year-old man of Indian heritage, suffering from an ACR criteria-positive FiA. At the first visit to our clinic the patient complained of painful and swollen finger joints of several weeks duration. Clinical examination (CE) showed signs of a highly active polyarthritis involving both wrists and multiple small finger joints, which was reflected by a DAS28 score of 6.28. Laboratory evaluation revealed an elevated ESR of 53 mm/h (0-29 mm/h) and elevated CRP of 23mg/J (<=5.0 mg/l). In addition, the following abnormal laboratory parameters were observed: haemoglobin 12.7 g/l, RF 127 U/ml, anti-CCP 250 U/ml and anti-modified citrullinated vimentin antibodies (anti-MCV) 669 U/ml. Musculoskeletal US (MUS) demonstrated highly active polysynovitis, with a US7 score of 17 [1]. Conventional radiographic examinations revealed no erosions. After obtaining the patient's consent, a novel in vivo FCI technique was applied that uses the US Food and Drug Administration-approved fluorescence dye indocyanine green (ICG) to determine microperfusion. The FOI examination follows a standardized protocol by placing both hands on a preformed hand rest, followed by injection of an ICG bolus (0.1 mg/kg/body weight i.v.) and subsequent imaging with one image every second for a total of 6 min. Alterations of fluorophore concentration are depicted as alterations in signal intensity. As we observed highly active polysynovitis both clinically and sonographi-cally, we expected to see similar changes in the FOI examination. However, the results did not correlate with the MUS findings or the CE (Fig. 1).
机译：主席先生，荧光光学成像（FOI）是一种新颖的方法，通过检测局部过度灌注，越来越多地用于可视化关节炎。我们报告了一位57岁的印度裔男子，患有ACR标准阳性的FiA。初次到我们诊所就诊时，患者抱怨持续数周的手指关节疼痛和肿胀。临床检查（CE）显示出手腕和多个小指关节均活跃的多关节炎的迹象，DAS28评分为6.28反映了这一点。实验室评估显示，ESR升高至53 mm / h（0-29 mm / h），CRP升高至23mg / J（<= 5.0 mg / l）。此外，观察到以下异常实验室参数：血红蛋白12.7 g / l，RF 127 U / ml，抗CCP 250 U / ml和抗修饰的瓜氨酸波形蛋白抗体（抗MCV）669 U / ml。肌肉骨骼US（MUS）表现为高度活跃的多发性滑膜炎，US7评分为17 [1]。常规放射线检查未发现糜烂。获得患者同意后，应用了一种新的体内FCI技术，该技术使用了美国食品药品监督管理局批准的荧光染料吲哚菁绿（ICG）来测定微灌流。 FOI检查遵循标准化方案，将双手放在预先形成的扶手上，然后注射ICG推注（0.1 mg / kg /体重，静脉内注射），随后每秒以一幅图像进行成像，总共6分钟。荧光团浓度的变化表示为信号强度的变化。当我们在临床和超声检查中观察到高度活跃的多发性滑膜炎时，我们期望在FOI检查中看到类似的变化。但是，结果与MUS结果或CE无关（图1）。

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