Systemic sclerosis (SSc) is a rare, chronic autoimmune disease characterized by fibrosis and vascular abnormalities in multiple organs, including skin, lungs, and gastrointestinal tract. Early and accurate diagnosis of SSc is essential for timely intervention and improved patient outcomes. More than 90% of patients with SSc have fibrosis in the skin that manifests as mechanical changes in the skin. The modified Rodnan Skin Score (mRSS) is the gold standard for assessing skin involvement in SSc but has high inter-observer variability. The other widely used method is ultrasound imaging. Ultrasound elastography is emerging as a useful technique for assessing SSc, but its accuracy is still under investigation. Even though the results from these studies provide a quantitative assessment of SSc, ultrasound elastography has many limits, such as the lack of high-resolution performance to detect SSc-affected skin structural and elastic characteristics simultaneously. Optical coherence elastography (OCE) is an established technique to assess the mechanical properties of tissues noninvasively and quantitatively with high resolution. We measured the mechanical properties of skin in 45 patients (36 SSc and 9 matched controls) using a home-built swept source OCE setup that uses air-coupled acoustic radiation force for tissue excitation. The measurements were performed at three locations on each arm: the proximal phalanx of the third finger, the second intermetacarpal space, and the dorsal forearm midline. The OCE results were compared to mRSS and clinical ultrasound elastography, which a trained physician performed. Our results show that OCE outperformed ultrasound elastography with a higher correlation with mRSS.
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