FIRST CLINICAL TRIALS OF NEW HANDHELD AUTOFLUORESCENCE IMAGING PLATFORM FOR INVESTIGATION OF CHRONIC WOUNDS ­ PRODIGI

Canadian molecular imaging Scientist Dr. Ralph S. DaCosta, and colleagues at the Princess Margaret Cancer Center and Techna Institute for the Advancement of Technology for Health, University Health Network (Toronto), have developed a novel handheld autofluorescence imaging platform, named PRODIGI (Portable Real­time Optical Detection Identification and Guide for Intervention), which is intended for non­invasive detection and tracking of bacterial infections in wounds. It facilitates real­time, non­contact, high­resolution imaging of pathogenic bacteria by using their endogenous autofluorescence.  The published clinical trials describe PRODIGI’s use for point­of­care investigation and treatment options of bioburden in chronic wounds.

According to Dr. DaCosta, “The device shows promise for image­guided wound sampling, cleaning, debridement, and quantitative monitoring of treatment response.  The novelty of the method and the positive initial clinical findings should also have wider interest to clinicians and scientists beyond chronic wounds: for example infection in surgical sites, radiation skin damage and skin grafts for burn treatments. This in vivo platform can also serve as a new tool in wound care research, by providing an objective way to assess emerging wound treatments based on antimicrobial strategies.”

Chronic wounds present a problem for healthcare professionals as their treatment can be limited my lack of information. In routine clinical practice, chronic wounds are diagnosed by visual inspection under white light and microbiological sampling, which are not the most accurate methods (the former is subjective and the latter samples only the center of the wound). This unmet need for concrete diagnostic information prompted the scientists to create PRODIGI to address the issues encountered by clinicians. 

The trials, which assessed the use of PRODIGI for real­time imaging of bacteria in chronic wounds, showed that the novel imaging platform can accurately detect the concentration and distribution of bacterial pathogens in the wound bed, periphery and off­site. This gives physicians the opportunity to provide guided wound sampling and treatment, accelerate wound closure (compared with standard methods) and track bacterial load over time.

Because the current methods of diagnosing chronic wounds are not very effective, the empiric use of antibiotics increases, which exacerbates the steady emergence of drug­resistant bacteria. The novel device, PRODIGI, fills a major hole in addressing early identification, assessment of bioburden and wound management, improving healing rates of chronic wounds.

DaCosta RS, Kulbatski I, Lindvere­Teene L, Starr D, Blackmore K, Silver JI, Opoku J, Wu YC, Medeiros PJ, Xu W, et al. Point­of­Care Autofluorescence Imaging for Real­Time Sampling and Treatment Guidance of Bioburden in Chronic Wounds: First­in­Human Results. PLoS One. 2015 Mar 19;10(3):e0116623. doi: 10.1371/journal.pone.0116623. eCollection 2015. PubMed PMID: 25790480; PubMed Central PMCID: PMC4366392.