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Session: Poster session II
Session starts: Thursday 24 January, 16:00

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Khalid Daoudi (Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine radboud university medical center)
Brigit E. Kersten (Department of Rheumatology, Radboud University Medical Center)
Madelon C, Vonk (Department of Rheumatology, Radboud University Medical Center, )
Chris L. de Korte (Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine radboud university medical center)

Abstract:
Systemic Sclerosis (SSc) is an autoimmune disease characterized by a triad of inflammation, vasculopathy, and fibrosis of the skin and internal organs such as gastrointestinal tract, heart, lungs, renal and kidneys. SSc can lead to premature death especially when there is pulmonary involvement. At early stages, alterations of blood vessel networks in the fingertip may occur in patients with SSc, leading to hypoxia as well as subtle skin thickening. Imaging these parameters could lead to early diagnosis of SSc patients and monitoring of early therapy responses. Currently, there is a need for a real-time and non-invasive imaging modality that combines morphological and functional imaging with the possibility to monitor the oxygen status of the blood vessel network. In this study, we investigated the feasibility to detect and diagnose systemic sclerosis by imaging microcirculation and oxygen saturation of blood vessels in nail-bed using photoacoustic imaging (PA) and estimating skin thickening using high-frequency ultrasound (HFUS). Thirty two subjects (both adult man and women) participated in this study: 12 patients with advanced systemic sclerosis, 5 patients with early systemic sclerosis, 5 primary Raynaud’s, and 10 healthy subjects as a control group. Nail bed oxygen saturation of patient with SSc whether it is in advanced or early stage showed a significant lower oxygenation (78.09 ±10.68 vs. 95.3 ±2.7, p < 0.0001) and a skin thickness difference (0.51 ±0.17 mm vs. 0.33 ±0.04 mm, p<0.005) compared to primary Raynaud’s and healthy volunteers. The PA and HFUS data was supported by conventional capillaroscopy imaging performed on all participants. This pilot study demonstrates the possibility to use photoacoustics and high-frequency ultrasound as a diagnostic tool for early detection of systemic sclerosis by imaging parameters not accessible with other imaging tool and might be used to non-invasively monitor early therapy response.