Facial plethora: modern technology for quantifying an ancient clinical sign and its use in Cushing syndrome

Authors

• A Afshari
• Y Ardeshirpour
• MB Lodish
• E Gourgari
• M Keil
• F Chowdhry
• E Belyavskaya
• C Lyssikatos
• V Chernomordik
• C Stratakis
• AH Gandjbakhche

Abstract

Currently, the most important criteria that applies to identify the remission and cure for Cushing’ syndrome (CS), is based on how much and fast serum cortisol level drops after the transsphenodial surgery. However, this drop in serum cortisol level does not guarantee of a lifetime cure, and long-term follow-up is necessary Therefore better criteria are necessary to asses and interpret the surgery as cured, in remission or nonresponsive. In this pilot study, non-invasive multi-spectral near infrared imaging and a two-layer skin analytical model were used to study the facial plethora in patients with Cushing’s syndrome. We quantitatively examined the changes in patients’ facial blood volume and blood oxygenation before, after surgery and three to twelve months follow up compared these parameters with the treatment outcome, determined by clinicians . Thirty four patients were imaged before surgery and a few days after surgery. Two of the patients had two transsphenoidal surgeries (TSSs) within 10–28 days; thus, 36 surgeries were included in the analysis. Our results show that a decrease in cheek’s blood volume concentration after surgery correlates with the clinical assessment in patients who considered clinically as cured. To sum up, evaluation of blood volume in the cheek by multispectral imaging is a promising tool to assess Cushing disease response to surgical treatment.

Scientific Focus Area: Biomedical Engineering and Biophysics

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