Neoplasms

All Conditions

Skin and Connective Tissue Diseases

Nevus, Pigmented

Nevus

Melanoma

Nevi and Melanomas

Neoplasms by Histologic Type

Subjects with Nevi who will as part of their standard of care, will undergo biopsy.

Application of reagents, then imaging and scoring

Skin Fluorescent Imaging

BRANDI DUNN

Cathy Shachaf

Anchal Dhawan

Sunil Dhawan, MD

Lawrence Osman, MD

Serena Mraz, MD

Doug Grossman, MD

Douglas Grossman, MD

Cathy Shachaf, PhD

The Sponsor has developed the Skin Fluorescent Imaging (SFI) system, an in vivo imaging modality, for the purpose of providing physicians with insight into the biological changes occurring during tissue remodeling in a nevus.

The SFI system, a non-invasive point-of-care imaging system, is able to detect markers associated with tissue remodeling and thus provide real-time information about biological and structural changes occurring in nevi indicative of dysplastic transition.

If the Site specific pathology lab will not allow the sponsor to make a digital image of the original slide, then the Sponsor is asking that a duplicate slide be provided for digital scanning. Once scanning is complete these additional slides may not be returned to the site.

Skin Fluorescent Imaging (SFI) System in Patients With Nevi

Establish the performance (sensitivity and specificity) for SFI in comparison to dysplasia.

Comparison of the SFI score ( 0 to 10) to the clinical diagnosis of the physician assessing and the pathologist

Adverse events will be collected to ensure overall safety of reagents and imaging

Orlucent, Inc

Diseases and Abnormalities at or Before Birth

Hemangioma

Hemangioma, Capillary

Port-Wine Stain

Neoplasms, Vascular Tissue

Congenital Abnormalities

Skin Abnormalities

Skin Diseases

Anti-Arrhythmia Agents

Antihypertensive Agents

Vasodilator Agents

All Drugs and Chemicals

Propranolol

Timolol

Maleic acid

Dosage of 1 mg/kg per day divided 2 times daily. Blood pressure, heart rate and oxygen saturation are monitored after propranolol initiation. Treatment is continued with a gradual increase to 2 mg/kg per day divided 2 times daily. Treatment is continued until the hemangioma no longer changes in the characteristics judged by the physicians, including, color, size, temperature and deformability.

One drop of of timolol maleate 0.5% gel is topically applied and massaged into the hemangioma twice per day . This dosage provides an estimated 0.5 mg of timolol per day. The treatment is continued until it is considered to be no longer effective as judged by the physicians.

No oral or topical treatment will be given as recommended by the treating physicians and elected by the parents. Patients will be evaluated periodically to determine what changes in treatment are warranted. If this occurs, the patients will be included in the appropriate study group.

Marty O Visscher, PhD

Denise Adams, MD

Adrienne Hammill, MD, PhD

A combined set of quantitative skin imaging methods will quantitatively describe the natural ontogeny and the response to standard treatments over time in patients with infantile hemangiomas.

Infantile hemangiomas (IH) are relatively common benign vascular neoplasms, which appear shortly after birth and grow rapidly in the following weeks and months. The proliferative phase involves a rapidly dividing endothelial cell proliferation. The tumors generally stabilize and then involute over time. They are usually clinically insignificant; however, a small percentage of them can be life threatening secondary to location, associated syndrome, and physical findings such as ulceration. Treatment options have included steroids, interferon, vincristine and more recently propranolol. There are few published prospective research studies on the effectiveness of these treatment options. Because of several factors, it has been difficult to objectively measure response of these lesions. The purpose is to determine (1) whether multiple quantitative skin imaging modalities can quantitatively describe the clinically relevant features of infantile hemangiomas, including color (red, blue), lightness, size (height, volume), biomechanical properties, temperature and perfusion and (2) the natural ontogeny and response to treatment over time. The treatments are oral propranolol, topical timolol and untreated (observation).

Ontogeny of Infantile Hemangiomas With Skin Imaging Modalities

Ontogeny and Quantitative Multimodal Skin Imaging of Infantile Hemangiomas

IH height and volume will be obtained from surface scans with the Artec scanner with a 0.5 mm resolution, 0.1 mm accuracy, at 60 cm. Three dimensional scans will be created with the Artec Studio software and features quantified with the three dimensional software. Soft tissue landmarks will create the region of interest for all evaluations. Height and volume will be calculated for the infantile hemangioma versus the control.

Temperature information will be acquired with a thermal imaging camera with analysis software. The thermal features of the surrounding uninvolved control skin are removed by applying thresholds. Static infrared thermography captures the steady-state condition and spatial distribution. Dynamic infrared thermography applies a stress (cooling) to stimulate the thermal response within the tissue.

High resolution color Images will be taken taken with a digital camera, Micro 60 mm lens with a wireless close up flash system at 30cm and perpendicular to the site. The images are color corrected and processed into three distinct images : red color, blue-yellow color, and lightness (white - back).

Color and thermal images are co-registered and analyzed with customized software. The system creates quantitative outputs and maps for visualization of IH regions of thermal and color activity. Threshold values for the lightness, red color, blue color and thermal images are selected based upon histogram distributions of the uninvolved skin as the values above the mean and multiple standard deviations The pixels beyond the thresholds are used to quantify and map the features due to the hemangioma itself.

Tissue mechanical properties (i.e., elasticity, elastic deformation, laxity, stiffness, etc.) will be measured to assess tissue deformability. The instrument measures biomechanical properties of the skin by applying a negative pressure, in the range between 20 and 500 mbar. These properies are compared to an uninvolved contralateral control site.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Skin Fluorescent Imaging (SFI) System in Patients With Nevi	NCT04368247	Nevus Dysplasia; Epit...	Skin Fluorescen...	18 Years -	Orlucent, Inc
Ontogeny of Infantile Hemangiomas With Skin Imaging Modalities	NCT02061735	Infantile Heman...		1 Month - 5 Years	Children's Hospital Medical Center, Cincinnati
Ontogeny of Infantile Hemangiomas With Skin Imaging Modalities	NCT02061735	Infantile Heman...		1 Month - 5 Years	Children's Hospital Medical Center, Cincinnati

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