Standard in vitro lab tests can help elucidate a patientÂ’s health and diagnose several possible medical conditions to be monitored. Cost, patient and lab time, and patient discomfort, mean that these tests are done infrequently, and are limited to suspected morbidities. The invasive nature of most tests (requiring blood draws, urine samples, etc.) limits what is measured, and how often. In the field, such tests can be difficult to execute, require trained medics and samples can become contaminated or damaged in transport. The analytical equipment itself can also require calibration, decontamination, resupply of reagents, etc. all of which can be a bridge too far in austere environments. By avoiding the need for samples, in vivo tests avoid many of the challenges faced by traditional lab tests. No device exists that enables low cost, non-invasive in vivo testing. No service exists that translates repeated metabolomic measurements into dynamic health status reports. We are working to change that. We propose to develop a system for the detection of metabolites capable of automated field use by non-experts. Unlike existing efforts at Point Of Care (POC) devices, our approach is based on in vivo magnetic resonance spectroscopy (MRS). While our approach has reduced sensitivity compared to state-of-the-art mass spec (MS) on in vitro samples, we assert that the benefits of avoiding sample extraction, handling and preparation, especially in austere environments, offsets the reduced sensitivity of MRS and the reduced sample volume of in vivo measurements. Indeed, the ability, which we are proposing, to simultaneously detect spectra from a variety of tissue types (e.g. blood, bone, fat, muscle, etc.) means that additional diagnostic information is available that would otherwise require biopsy and multiple complex tests. This multi-tissue and multi-metabolite scan capability is the functional equivalent of multiplexed in vitro tests. Our Non-Invasive Military Metabolite Analyzer (NIMMA) will offer many of the benefits of traditional laboratory tests without the pain of a blood draw and the waiting times associated with wet laboratory tests. Our test results can be obtained several times per day per patient to offer a dynamic timeline (longitudinal) and predict healthcare status changes on an individual and fighting force population basis. This allows for more rapid and continuous testing to quicken diagnoses. NIMMA tests provide data for the individual patient, and healthcare provider, to maintain and control a health status. Additionally, trauma specialists, GPs, clinicians, and other health workers can analyze diagnostic indicators of disease. Most importantly, our proposed scanner can be operated in the field by non-experts, quickly, pain-free and without the need for chemical reagents.
