A newly developed tissue scanner allows looking under the skin of psoriasis patients. This provides clinically relevant information, such as the structure of skin layers and blood vessels, without the need for contrast agents or radiation exposure. A team of researchers from Helmholtz Zentrum München and the Technical University of Munich (TUM) recently introduced the technology in ‘Nature Biomedical Engineering’.
Psoriasis (Psoriasis vulgaris) is an inflammatory skin disease that is characterized by small to palm-sized patches of severely scaling skin. The disease is estimated to affect between ten and fifteen million people in the European Union.
Currently, physicians evaluate the severity of the disease based on visual assessment of features of the skin surface, such as redness or thickness of the flaking skin. “Unfortunately, these standards miss all parameters that lie below the surface of the skin, and may be subjective,” Dr. Juan Aguirre points out. “Knowing the structure of the skin and vessels before treatment can provide the physician with useful information,” explains the group leader at the Institute of Biological and Medical Imaging (IBMI) at the Helmholtz Zentrum München.*
A look under the skin
In order to provide clinicians with this information, Aguirre and his team developed a new technique that gets under the skin. It bears the name RSOM** and works as follows: A weak laser pulse excites the tissue of interest, which then absorbs energy and heats up minimally. This causes momentary tissue expansion, which generates ultrasound waves. The scientists measure these ultrasound signals and use this information to reconstruct a high resolution image of what lies under the skin.
High tech that fits in the hand
While developing the method, the scientists were able to reduce the size of the scanner to a handheld device. “This technology, which is easy to use and does not involve any radiation exposure or contrast agent, is allowing us to acquire the first new insights into the disease mechanisms. It also facilitates treatment decisions for the physicians,” explains Prof. Dr. Vasilis Ntziachristos, Director of the IBMI at the Helmholtz Zentrum München and Chair of Biological Imaging at the Technical University of Munich.
In the recently published study, the scientists demonstrated RSOM’s performance by examining cutaneous and subcutaneous tissue from psoriasis patients. RSOM allowed them to determine several characteristics of psoriasis and inflammation, including skin thickness, capillary density, number of vessels, and total blood volume in the skin. They compiled these to define a novel clinical index*** for assessing psoriasis severity that may be superior to the current clinical standard because the new index also takes into account characteristics below the skin surface.
The researchers plan to use the same imaging method to assess other diseases such as skin cancer or diabetes in the future. Patients with diabetes often suffer from damaged blood vessels that, if detected early enough, may allow earlier treatment and therefore greater efficacy.
*Psoriasis treatment depends on the severity of the disease and possible organ involvement, which the new technique can help assess in a non-invasive way, obtaining information that before could only be retrieved with painful, invasive biopsy.
**RSOM stands for raster-scan optoacoustic mesoscopy.
*** In medicine, an index is a value that includes several diagnostic parameters allowing to estimate the severity of a disease.
Aguirre, J. et al. (2017): Precision assessment of label-free psoriasis biomarkers with ultra-broadband optoacoustic mesoscopy. Nature Biomedical Engineering, DOI: 10.1038/s41551-017-0068
The Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München is headquartered in Neuherberg in the north of Munich and has about 2,300 staff members. It is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members.
The Institute for Biological and Medical Imaging (IBMI) conducts research into in vivo imaging technologies for the biosciences. It develops systems, theories and methods of imaging and image reconstruction as well as animal models to test new technologies at the biological, preclinical and clinical level. The aim is to provide innovative tools for biomedical laboratories, for diagnosis and for the therapeutic monitoring of human diseases.
The Center of Allergy & Environment (ZAUM) in Munich is a joint undertaking by the Helmholtz Zentrum München and the Technical University of Munich (TUM). This cooperation, which is the only one of its kind in the German research landscape, is dedicated to interdisciplinary basic research and forms a link between clinicians at the hospital and clinical research staff at the university. Thanks to this approach, findings about the mechanisms that lie behind allergies are translated into preventive and therapeutic measures. The development of effective, individually tailored treatments enables better care to be provided for allergy-sufferers.
Technical University of Munich (TUM) is one of Europe’s leading research universities, with more than 500 professors, around 10,000 academic and non-academic staff, and 39,000 students. Its focus areas are the engineering sciences, natural sciences, life sciences and medicine, reinforced by schools of management and education. TUM acts as an entrepreneurial university that promotes talents and creates value for society. In that it profits from having strong partners in science and industry. It is represented worldwide with a campus in Singapore as well as offices in Beijing, Brussels, Cairo, Mumbai, San Francisco, and São Paulo. Nobel Prize winners and inventors such as Rudolf Diesel, Carl von Linde, and Rudolf Mößbauer have done research at TUM. In 2006 and 2012 it won recognition as a German “Excellence University.” In international rankings, TUM regularly places among the best universities in Germany.