Technology Overview


NOCISCAN ™ is an investigational technology platform being developed with the hopes to provide, in the future, a non-invasive, pain-free, objective diagnostic test that may assist in the diagnosis of lumbar disc pain based on a derivative of Magnetic Resonant Imaging (MRI) called Magnetic Resonance Spectroscopy (MRS).

MRS uses pulsed magnetic fields generated by an MR Scanner that cause chemical bonds in body tissues to vibrate, which generates signals that are detected by "antennae" detector coils placed along the spine. Certain chemicals vibrate at unique "signature" frequencies along a frequency "spectrum." The level of detected signal at a given signature frequency for a chemical can be processed to measure the amount of that chemical in the tissue being examined.

NOCISCAN™ is being developed as an investigational software suite to work in the future with existing high field MR systems and MRS pulse sequence packages via a new protocol to conduct MRS exams of lumbar discs.  The software suite is being designed to post-process this data to measure spectroscopic signals at regions along the MRS frequency spectrum associated with certain chemicals that may change with degeneration and pain.

The investigational Nociscan application exam includes two primary modules. A first module – the Nociscan MRS Pulse Sequence - is a software upgrade installation to standard 3T MRI systems with MRS capabilities. This instructs the MR system to run the uniquely directed MRS examination of the lumbar discs.  The Nociscan application is being developed for use with existing MR systems and MRS pulse sequences already provided by the respective MR companies with clearance for use in assessing tissue chemistry, although operated under a new proprietary investigational protocol developed by Nocimed and specifically directed to MRS of discs.  A second module – the Nociscan MRS Post-Processor - is being developed as an investigational software engine that receives information acquired during the Nociscan Pulse Sequence exam and processes that information through various algorithms to provide optimally robust MRS spectra, spectral measurements, and diagnostic results. The Nociscan MRS Post-Processor is currently housed and operated under an external server/computer with connectivity to the MR acquisition system via a picture archival communications system (PACS) network and internet.

Nociscan is being developed to ultimately generate a NOCIGRAM™ report that will indicate the Nociscan MRS results associated with each disc examined.  This iscurrently planned as overlay to a standard MRI image of the spine itself for a patient subject examined.  This report may provide the respective MRS spectra for each disc studied, chemical-related measurements associated with those spectral signals, and/or algorithmic results applying such measurements for correlation to degree of disc degeneration and/or pain.  The information provided in the Nocigram report is expected to be limited to use only by trained professional physicians, and only to assist them in using their own professional judgment, in context of all available information they may have, in performing their own ultimate diagnosis.



Potential Future Advantages of Nociscan™ May Include:

  • Augment results of MR-based exams with additional information, adding chemistry-related MRS information to structural/hydration-related MRI information, to potentially assist in diagnosing degree of disc degeneration and/or pain in chronic, severe discogenic pain patients
  • Totally non-invasive, non-painful, objective, cost efficient test
  • Results to be provided may correlate to invasive, painful, subjective, and risky needle-based Provocative Discography (PD) that often follows MRI today for this purpose
  • Identifies chemical indicators of discogenic pain vs. structural defects (e.g. herniations compressing nerves causing sciatica, etc.)
  • Merely extends a standard clinical MRI test conducted today by about 5-10 minutes per disc level being examined
  • Does not require ionizing radiation (e.g. as required for provocative discography)
  • Permits multiple sessions over time to assess disease progression or clinical treatment results, without significant risks


Nocigram™

  A unique synergy of phenotype and chemistry for potentially assisting in the clinical assessment of discogenic pain.


Based on on-going study of chemical indicators in discs and correlations being evaluated as biomarkers for pain, and through the use of advanced signal processing and diagnostic algorithm development, Nociscan™ is being investigated to hopefully provide clinicians in the future with additional diagnostic information and context to assist doctors, together with other available information, in patient diagnosis and selection for appropriate patient treatment and care regimens.



How Nociscan™ Works



MRI uses the magnetic properties of water, bone, and fat to create an image based on the difference in these properties. MRS uses the magnetic properties of other chemicals in tissues to assess the chemical make-up of those tissues.  Nociscan is being investigated to use MRS data from within the nucleus of an intervertebral disc to generate a chemical signature for the disc, and to make related measurements that may provide information to hopefully assist doctors in the future, together with other available information, in diagnosing whether a disc is painful or not.

A three-dimensional volume is defined in the disc nucleus and "vibrated" by the MR scanner using existing MRS pulse sequences via proprietary Nociscan™ protocol specific to discs.



Signals acquired from the nucleus are processed by Nociscan ™ post-processing software to create MRS spectra. Spectral signatures are then measured as inputs to a diagnostic algorithm to generate a “Nociscore” correlated in clinical investigation studies to pain (as indicated by discography)..



Nocigram™ Report

(Example 1 – LBP Patient)




Nocigram™ Report

(Example 2 – Pain-Free Volunteer)




Above:  Two examples of Nocimed’s existing investigational clinical research data, shown via T2-weighted MRI images for a low back pain patient (left), and an asymptomatic control volunteer (right). Provocative discography performed at L4-S1 discs in the pain patient tested negative for the L4L5 disc, and positive at L5S1 for concordant pain (with subsequent relief observed via anesthetic discography also at L5S1).  Nociscan MRS spectral results are also shown for the respective lower two L4-S1 lumbar discs in each subject, and correlate with the positive discogram disc as distinguished from the other non-painful discs in the examples. 

CAUTION:  Nociscan™ is restricted by Federal Law to investigational use.  Nociscan™ is investigational only and not available for sale or use within or outside of the United States.
Nocimed™ and Nociscan™ are both proprietary trademarks of Nocimed, LLC (all rights reserved).  Nocimed’s technologies and products are considered proprietary and the subject of multiple patents pending within and outside of the United States.
Physicians interested in possibly becoming an investigator in Nocimed’s investigational research are encouraged to contact the company directly via the contact information provided via link on the company’s website home page.
Copyright © 2012



Technology

Technology Overview
Market Overview