(PI-003) Multimodal imaging device for real-time bacterial load and thermal imaging: a study of synergy in clinical wound assessment workflow

Danielle Dunham, MHSc; Ashley Jacob, BNS, RN; Katherine McLeod, RN – Madigan Army Medical Center; Monique Rennie, PhD; Rowena Stefan, RN – Madigan Army Medical Center; Liis Teene, MSc

Introduction:

Fluorescence (FL) imaging* of bacterial load/location has proven its impact on wound management and healing outcomes, underscoring the role of high bacterial loads in non-healing wounds. However, the pathogenesis and perpetuation of these wounds are multifactorial with impairments in blood flow and oxygenation playing a major part. Thermal image mapping serves as a proxy measure for various pathophysiologies. Higher temperatures indicate potential inflammation or infection; low temperatures suggest healing impairment possibly linked to decreased localized oxygen delivery. This pilot study evaluated the potential of a novel multi-modal imaging platform enabling a more comprehensive wound assessment with real-time thermal and FL-imaging* in a single handheld device.

Methods:

Patients presenting for routine outpatient wound care (n=25) with various wound types (DFU, VLU, SSI, PI, post-traumatic) were imaged with the multi-modal imaging platform* during their visit. The handheld device enabled: (1) real-time bacterial load/location mapping (FL-imaging), (2) real-time quantitative temperature information (thermal imaging), (3) co-registered standard images, and (4) digital wound measurement. The impact of multi-modal imaging on diagnosis, treatment planning, and workflow was recorded.

Results: 25 patients were imaged with both modalities. A third (32%, 8/25) had an isolated FL-positive finding, 16% (4/25) had an isolated abnormal thermal finding, and 8% (2/25) had both FL and thermal positive findings. Results from multimodal imaging were used for diagnosis and to guide treatment. In one case, thermal imaging alerted to regional pressure, enabling proactive intervention, and in another case identified tunneling. In two cases thermal images led to infection diagnosis, one of which was cellulitis. FL-imaging enabled local, targeted debridements and other hygiene for proactive bacterial-infection management.

Discussion: Multi-modal imaging findings were found to be both complimentary and synergistic, without hindering clinical workflow. Point-of-care physiological imaging modalities for more proactive management of chronic wounds have great potential to identify pressure and prevent infection and its complications.

Trademarked Items: *MolecuLight DX

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