Optical coherence tomography: an emerging technology for biomedical imaging and optical biopsy

Place et intérêt de la tomographie par cohérence optique en gynécologie

Optical coherence tomography is one of the most important technological progress of the last ten years in the field of medical imaging. It is similar to ultrasound imaging except that it uses properties of light instead of ultrasound. Optical coherence tomography provides images of tissue structure, and at a cellular level, in situ, in real time, with much better spatial resolution than ultrasound and without removal of tissue (optical biopsy). Using optical coherence tomography in combination with catheters or endoscopes may enable the imaging of internal organs as the cervix, the uterine tissue and the ovary. The use of optical coherence tomography in the gynecological field is still experimental and is mainly about the in vitro and in vivo diagnosis of cervical dysplasia, cervical cancer, ovary cancer, endometrial cancer and endometriosis. We aim to present the principles of optical coherence tomography and to expose the main ways of research and the future and potential clinical applications of this technique in gynecology.

Diagnosis of nonmelanoma skin cancer/keratinocyte carcinoma: a review of diagnostic accuracy of nonmelanoma skin cancer diagnostic tests and technologies

BACKGROUND

Nonmelanoma skin cancer (NMSC) is the most prevalent cancer in the light-skinned population. Noninvasive treatment is increasingly used for NMSC patients with superficial lesions, making the development of noninvasive diagnostic technologies highly relevant.

OBJECTIVE

The scope of this review is to present data on the current state-of-the-art diagnostic methods for keratinocyte carcinoma: basal cell carcinoma, squamous cell carcinoma, and actinic keratosis.

METHODS AND MATERIALS

MEDLINE, BIOSIS, and EMBASE searches on NMSC and physical and clinical examination, biopsy, molecular marker, ultrasonography, Doppler, optical coherence tomography, dermoscopy, spectroscopy, fluorescence imaging, confocal microscopy, positron emission tomography, computed tomography, magnetic resonance imaging, terahertz imaging, electrical impedance and sensitivity, specificity, and diagnostic accuracy.

RESULTS

State-of-the-art diagnostic research has been limited in this field, but encouraging results from the reviewed diagnostic trials have suggested a high diagnostic accuracy for many of the technologies. Most of the studies, however, were pilot or small studies and the results would need to be validated in larger trials.

CONCLUSIONS

Some of these new imaging technologies have the capability of providing new, three-dimensional in vivo, in situ understanding of NMSC development over time. Some of the new technologies described here have the potential to make it from the bench to the clinic.

Characterization of benign and malignant melanocytic skin lesions using optical coherence tomography in vivo

BACKGROUND

Although optical coherence tomography (OCT) is a promising noninvasive imaging technique for the micromorphology of the skin, OCT has not been studied systematically in skin cancer such as malignant melanoma (MM).

OBJECTIVE

We sought to visualize and characterize melanocytic skin lesions (MSL) by using OCT in vivo, compare OCT features of benign nevi (BN) and MM, and histologically validate the OCT findings.

METHODS

In all, 75 patients with 92 MSL, including 52 BN and 40 MM, were included in this study. MSL were investigated by OCT in vivo and consecutive histology. We compared the OCT images with the corresponding histologic slices of BN and MM. To ascertain accuracy of correlation between OCT images and histologic sections, the excised lesions were tattooed according to the level of OCT scanning. For every MSL, serial histologic slices were prepared.

RESULTS

MM often showed a marked architectural disarray (P = .036) and rarely displayed a clear dermoepidermal border (P = .0031) when compared with BN. OCT of MM infrequently demonstrated a dermoepidermal junction zone with finger-shaped elongated rete ridges as typically seen in BN (P = .011). Compared with BN, the papillary and superficial reticular dermis in MM frequently displayed a more diffuse or patchy reflectivity with loss of the typical bright horizontal linear structures (P = .022). However, more or less large vertical, icicle-shaped structures were the most striking OCT feature of MM, which were not observed in BN (P < .001).

LIMITATIONS

The diagnostic performance of OCT in the diagnosis of MSL could not be fully determined. Sensitivity and specificity studies also including other skin tumors have not been performed.

CONCLUSION

In this study, distinct OCT features of MSL could be correlated to histopathologic findings. With regard to the micromorphologic features visualized by OCT, we detected significant differences between BN and MM. These OCT features might serve as useful discriminating parameters of MSL.

Illuminating the metastatic process

Until recently most studies of metastasis only measured the end point of the process--macroscopic metastases. Although these studies have provided much useful information, the details of the metastatic process remain somewhat mysterious owing to difficulties in studying cell behaviour with high spatial and temporal resolution in vivo. The use of luminescent and fluorescent proteins and developments in optical imaging technology have enabled the direct observation of cancer cells spreading from their site of origin and arriving at secondary sites. This Review will describe recent advances in our understanding of the different steps of metastasis gained from cellular resolution imaging, and how these techniques can be used in preclinical drug evaluation.

Intraoperative techniques and tumor margin status--room for improvement for cervical cancer patients of childbearing age

OBJECTIVE

Inadequate tumor margin status in cervical cancer and pre-cancer patients is associated with repeat procedures and an increased risk of recurrence and progression. This review will outline information regarding the current treatment options for women who wish to maintain fertility, the methods currently used in practice to evaluate tumor margin involvement, and a look at potential solutions to this critical issue.

METHOD

We performed a PUBMED literature search of relevant research articles pertaining to tumor margin evaluation for multiple cancers, current treatment options for patients of cervical dysplasia and the effects of those treatments on fertility.

RESULTS

Previous studies have correlated cancer recurrence and progression to obtaining clear margins upon resection. The most common need to obtain clear margins with respect to conservative treatment in patients with cervical neoplasia occurs with women who wish to preserve fertility. However, current detection methods are limited and current treatments present additional fertility concerns.

CONCLUSION

In order to provide the best care for patients wishing to retain fertility post-treatment for cervical dysplasia, a superior option for detecting tumor margins accurately at the microscopic scale must be further explored.

Laser Scanning Imaging for Macular Disease

OBJECTIVE

To evaluate currently available data in the published literature to answer the question of whether laser scanning imaging is a sensitive and specific tool for detecting macular disease when compared with the current standard technique of slit-lamp biomicroscopy or stereoscopic fundus photography.

METHODS

Literature searches conducted in December 2004 and in August 2006 retrieved 370 citations. The Retina Panel members selected 65 articles for the panel methodologist to review and rate according to the strength of the evidence. Of the 65 articles reviewed, 6 provided level I evidence, 9 provided level II evidence, and 50 provided level III evidence. A level I rating was assigned to studies that reported an independent masked comparison of an appropriate spectrum of consecutive patients, all of whom had undergone both the diagnostic test and the reference standard. A level II rating was assigned to an independent masked or objective comparison; a study performed in a set of nonconsecutive patients or confined to a narrow spectrum of study individuals (or both), all of whom had undergone both the diagnostic test and the reference standard; or an independent masked comparison of an appropriate spectrum, but the reference standard had not been applied to all study patients. A level III rating was assigned when the reference standard was unobjective, unmasked, or not independent; positive and negative tests were verified using separate reference standards; or the study was performed in an inappropriate spectrum of patients.

RESULTS

There are high-level studies of the use of laser scanning imaging to quantify macular thickness and, thereby, macular edema in patients with diabetic retinopathy and to examine patients with a macular hole. There is lower-quality evidence on the use of laser scanning imaging for other diseases of the macula. There is insufficient evidence to compare the different instruments.

CONCLUSIONS

There is level I evidence that laser scanning imaging can accurately and reliably quantify macular thickness in patients with diabetic retinopathy. There is level I evidence that optical coherence tomography provides additional information to clinical examination when used in patients with a macular hole. Laser scanning imaging provides important information that is helpful in patient management by allowing objective serial quantitative measurements. Although further studies are needed to develop an optimal testing strategy using these imaging modalities, laser scanning imaging is a sensitive, specific, reproducible tool for diagnosing macular edema and, therefore, is likely to be useful for managing diseases that result in macular edema.

Light scattering from collagen fiber networks: micro-optical properties of normal and neoplastic stroma

Development of epithelial precancer and cancer leads to well-documented molecular and structural changes in the epithelium. Recently, it has been recognized that stromal biology is also altered significantly with preinvasive disease. We used the finite-difference time-domain method, a popular technique in computational electromagnetics, to model light scattering from heterogeneous collagen fiber networks and to analyze how neoplastic changes alter stromal scattering properties. Three-dimensional optical images from the stroma of fresh normal and neoplastic oral-cavity biopsies were acquired using fluorescence confocal microscopy. These optical sections were then processed to create realistic three-dimensional collagen networks as model input. Image analysis revealed that the volume fraction of collagen fibers in the stroma decreases with precancer and cancer progression, and fibers tend to be shorter and more disconnected in neoplastic stroma. The finite-difference time-domain modeling results showed that neoplastic fiber networks have smaller scattering cross sections compared to normal networks. Computed scattering-phase functions indicate that high-angle scattering probabilities tend to be higher for neoplastic networks. These results provide valuable insight into the micro-optical properties of normal and neoplastic stroma. Characterization of optical signals obtained from epithelial tissues can aid in development of optical spectroscopic and imaging techniques for noninvasive monitoring of early neoplastic changes.

Molecular imaging using visible light to reveal biological changes in the brain

Advances in imaging have enabled the study of cellular and molecular processes in the context of the living body that include cell migration patterns, location and extent of gene expression, degree of protein-protein interaction, and levels of enzyme activity. These tools, which operate over a range of scales, resolutions, and sensitivities, have opened up broad new areas of investigation where the influence of organ systems and functional circulation is intact. There are a myriad of imaging modalities available, each with its own advantages and disadvantages, depending on the specific application. Among these modalities, optical imaging techniques, including in vivo bioluminescence imaging and fluorescence imaging, use visible light to interrogate biology in the living body. Optimal imaging with these modalities require that the appropriate marker be used to tag the process of interest to make it uniquely visible using a particular imaging technology. For each optical modality, there are various labels to choose from that range from dyes that permit tissue contrast and dyes that can be activated by enzymatic activity, to gene-encoding proteins with optical signatures that can be engineered into specific biological processes. This article provides and overview of optical imaging technologies and commonly used labels, focusing on bioluminescence and fluorescence, and describes several examples of how these tools are applied to biological questions relating to the central nervous system.

Validation of optical coherence tomographyin vivousing cryostat histology

We aimed to validate for the first time optical coherence tomography (OCT) measurements of epidermal thickness (ET) using cryopreparation for histology. OCT assessments of ET were performed on healthy skin using the algorithms as follows: first, peak-to-valley analysis of the A-scan (ET-OCT-V), second, line-traced image analysis of the B-scan (ET-OCT-IA). Histology was performed using cryostat sections which were also evaluated using the image analysis (ET-Histo). We selected 114 samples, including B-scans and corresponding histology, for method comparison between ET-OCT-IA and ET-Histo. Forty-two A-scans were available for method comparison between ET-OCT-V and ET-Histo. Bland and Altman plots revealed a marked bias with wide 95% limits of agreement for ET-OCT-V versus ET-Histo. Comparison of ET-OCT-IA versus ET-Histo revealed only a slight bias and narrow 95% limits of agreement. A-scan analysis for ET determination is linked to significant limitations and lacks agreement with histology. By contrast, we observed satisfactory agreement between ET-OCT-IA and ET-Histo indicating that both methods can be utilized interchangeably. OCT using the line-traced image analysis of the B-scan appears to be a valid and relatively practicable method for the determination of ET in vivo. Furthermore, the comparisons with the in vivo OCT profiles demonstrate that cryostat sectioning provides a better preservation of relative and absolute dimensions of skin layers than paraffin embedding.

In vivo optical coherence tomography of basal cell carcinoma

BACKGROUND

Optical coherence tomography (OCT) is a promising non-invasive imaging technique that has not systematically been studied in skin cancer such as basal cell carcinoma (BCC).

OBJECTIVE

We aimed, first, to describe the in vivo histologic features of BCC by using OCT, and second, to find out whether it is possible to differentiate BCC subtypes by means of OCT.

METHODS

Prior to the excision, the BCCs (n=43) as well as adjacent non-lesional skin sites were assessed by OCT in vivo. The lesional area of interest was marked prior to OCT and tattooed after excision, respectively, in order to enable topographical concordance between the cross-sectional OCT images and the histologic sections.

RESULTS

Compared to non-lesional skin, a loss of normal skin architecture and disarrangement of the epidermis and upper dermis was observed in the OCT images of BCCs. Features that were frequently identified by OCT and correlated with histology included large plug-like signal-intense structures, honeycomb-like signal-free structures, and prominent signal free cavities in the upper dermis. With regard to the aforementioned OCT features, no statistically significant (P<0.05) difference was found between nodular, multifocal superficial, and infiltrative BCCs, respectively.

CONCLUSIONS

OCT is capable to visualize altered skin architecture and histopathological correlates of BCC. However, there is not at this time sufficient data supporting the clinical use of OCT for the differentiation of BCC subtypes.

Structural and functional MRI reveals multiple retinal layers

MRI is a noninvasive diagnostic modality that reveals anatomy, physiology, and function in vivo without depth limitation or optical interference. MRI application to the retina, however, remains challenging. We improved spatial resolution to resolve layer-specific structure and functional responses in the retina and confirmed the laminar resolution in an established animal model of retinal degeneration. Structural MRI of normal rat retinas revealed three bands corresponding histologically to (i) the combined ganglion cell layer/inner nuclear layer plus the embedded retinal vessels, (ii) the avascular outer nuclear (photoreceptor) layer and its photoreceptor segments, and (iii) the choroidal vascular layer. Imaging with an intravascular contrast agent (gadolinium-diethylene-tri-amine-pentaacetic acid) enhanced the retinal and choroidal vascular layers bounding the retina, but not the avascular outer nuclear layer and the vitreous. Similarly, blood-oxygen-level-dependent (BOLD) functional MRI revealed layer-specific responses to hyperoxia and hypercapnia. Importantly, layer-specific BOLD responses in the two vascular layers were divergent, suggesting the two vasculatures are differentially regulated. To corroborate sensitivity and specificity, we applied layer-specific MRI to document photoreceptor degeneration in Royal College of Surgeons rats. Consistent with histology, layer-specific MRI detected degeneration of the outer nuclear layer. Surprisingly, MRI revealed increased thickness in the choroidal vascular layer and diminished BOLD responses to hyperoxia and hypercapnia in the Royal College of Surgeons rat retinas, suggesting perturbation of vascular reactivity secondary to photoreceptor loss. We conclude that MRI is a powerful investigative tool capable of resolving lamina-specific structures and functional responses in the retina as well as probing lamina-specific changes in retinal diseases.

Imaging stem cells implanted in infarcted myocardium

Stem cell-based cellular cardiomyoplasty represents a promising therapy for myocardial infarction. Noninvasive imaging techniques would allow the evaluation of survival, migration, and differentiation status of implanted stem cells in the same subject over time. This review describes methods for cell visualization using several corresponding noninvasive imaging modalities, including magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, and bioluminescent imaging. Reporter-based cell visualization is compared with direct cell labeling for short- and long-term cell tracking.

Feasibility of three-dimensional optical coherence tomography and optical Doppler tomography of malignancy in hamster cheek pouches

OBJECTIVE

Hamster cheek pouches (HCP) with various degrees of 9,10-dimethyl-1,2-benzanthracene (DMBA)-induced dysplasia and malignancies were imaged with OCT/ODT in vivo and in vitro to assess the potential for three-dimensional high-resolution optical localization of airway malignancy.

BACKGROUND DATA

Optical coherence tomography (OCT)/optical doppler tomography (ODT) provide potential capability for real-time in vivo high-resolution (2-20 microm) cross-sectional imaging of tissues and spatially resolved blood flow in microvasculature for pathology diagnostics.

METHODS

DMBA was applied to the right side of the cheek pouch (HCP), and mineral oil (control) to the left side three times weekly for 10-18 weeks in Syrian Golden Hamsters using a standard protocol for malignancy induction. HCP were imaged in vivo with OCT/ODT as well as in vitro post-excision, using a prototype 1310-nm broadband superluminescent diode-based OCT/ODT device constructed in our laboratory. Three-dimensional images were constructed, and compared to standard and three-dimensional histology hematoxylin and eosin staining.

RESULTS AND CONCLUSION

OCT imaging offered exceptional resolution of the HCP to depths of 1-2 mm and confirmed ability to detect dysplasia and malignancy. Three-dimensional OCT images were readily constructed, allowing visualization of extent and localization of tumor margins. ODT demonstrated increased vascularity in the area of neoplasia. OCT/ODT is a promising new technology for oral airway diagnostics.

Optical coherence tomography as a diagnostic aid to visual inspection and colposcopy for preinvasive and invasive cancer of the uterine cervix

The purpose of this study was to determine the sensitivity and specificity of optical coherence tomography (OCT) under two well-defined clinical settings. First, as an aid to cervical cancer screening, using visual inspection with acetic acid (VIA) in low-resource settings, and the second, as an adjunct to the traditional management of abnormal cervical cytology with colposcopy and biopsy. Patients referred for colposcopy with > or = atypical squamous cells of undetermined significance were accrued for the study. Each subject underwent VIA and colposcopy. OCT was performed in all VIA- and colposcopy-positive areas and at the squamocolumnar junction in all four quadrants. The sensitivity of VIA for > or = cervical intraepithelial neoplasia 2 was 76% (95% CI 58-88). When OCT was applied to VIA as a secondary screen, the specificity improved from 34% (95% CI 27-41) to 61% (95% CI 60-74). With liberal diagnostic criteria for the majority of the colposcopy examinations, OCT showed an even greater relative improvement in specificity. OCT proved to be a fair diagnostic modality (receiver operating characteristic curve 0.73) adjunctive to VIA and colposcopy. On the basis of the above findings, we believe that this technology could potentially show greatest utility in the management of cervical dysplasia in low-resource settings where a single episode of care is most desirable.

Magnetic resonance imaging of tissue and vascular layers in the cat retina

PURPOSE

To report the visual resolution of multiple cell and vascular "layers" in the cat retina using MRI.

MATERIALS AND METHODS

T2- and diffusion-weighted MRI at 4.7 Tesla was performed. Layer-specific thickness, T2, spin density, apparent diffusion coefficient perpendicular (ADC(perpendicular)) and parallel (ADC(parallel)) to the retinal surface were tabulated. T1-weighted MRI was acquired before and after intravenous administration of Gd-DTPA and subtraction images were obtained. Histology was performed for validation.

RESULTS

Three distinct "layers" were observed. The inner strip nearest to the vitreous (exhibiting large T2, ADC, spin density with Gd-DTPA enhancement) overlapped the ganglion cell layer, bipolar cell layer, and the embedded retinal vascular layer. The middle strip (exhibiting small T2, ADC, spin density without Gd-DTPA enhancement) overlapped the photoreceptor cell layer and the inner and outer segments. The outer strip (exhibiting large T2, ADC, spin density with Gd-DTPA enhancement) overlapped the tapetum and choroidal vascular layer. T2, spin density, ADC(perpendicular) and ADC(parallel) of different "layers" were tabulated. The inner strip was slightly thicker than the other two strips. The total thickness, including neural and nonneural retina, was 358 +/- 13 microm (N = 6) by MRI and 319 +/- 77 microm (N = 5) by histology.

CONCLUSION

MRI provides a noninvasive tool to study the retina with laminar specificity without depth limitation.

Review of tissue simulating phantoms for optical spectroscopy, imaging and dosimetry

Optical spectroscopy, imaging, and therapy tissue phantoms must have the scattering and absorption properties that are characteristic of human tissues, and over the past few decades, many useful models have been created. In this work, an overview of their composition and properties is outlined, by separating matrix, scattering, and absorbing materials, and discussing the benefits and weaknesses in each category. Matrix materials typically are water, gelatin, agar, polyester or epoxy and polyurethane resin, room-temperature vulcanizing (RTV) silicone, or polyvinyl alcohol gels. The water and hydrogel materials provide a soft medium that is biologically and biochemically compatible with addition of organic molecules, and are optimal for scientific laboratory studies. Polyester, polyurethane, and silicone phantoms are essentially permanent matrix compositions that are suitable for routine calibration and testing of established systems. The most common three choices for scatters have been: (1.) lipid based emulsions, (2.) titanium or aluminum oxide powders, and (3.) polymer microspheres. The choice of absorbers varies widely from hemoglobin and cells for biological simulation, to molecular dyes and ink as less biological but more stable absorbers. This review is an attempt to indicate which sets of phantoms are optimal for specific applications, and provide links to studies that characterize main phantom material properties and recipes.

Evaluation of the atrophogenic potential of different glucocorticoids using optical coherence tomography, 20-MHz ultrasound and profilometry; a double-blind, placebo-controlled trial

BACKGROUND

Skin atrophy is one of the main side-effects of topical corticosteroid therapy. Although the use of high-frequency ultrasound is an established method that has been studied previously, it allows measurements of the slow-reacting dermal thickness only.

OBJECTIVES

To investigate the decreasing epidermal thickness, which occurs earlier, we used optical coherence tomography (OCT), a high-resolution noninvasive imaging technique, and compared it with 20-MHz ultrasound and profilometry.

PATIENTS/METHODS

In this double-blind placebo-controlled trial 20 healthy volunteers applied four different corticosteroids and the cream base formulation as placebo to the volar part of both arms once a day over a 4-week period. The epidermal thickness, the dermal thickness and the skin surface roughness were assessed using OCT, high-frequency ultrasound and profilometry.

RESULTS

Each of the three methods allowed the detection and monitoring of significant corticosteroid-induced skin atrophy and its reversibility. The changes correlated with the potency of the steroids. The epidermal thickness decreased significantly in all test areas, even in the placebo and the untreated fields. As expected, the reduction in epidermal thickness was more pronounced and could be detected earlier by OCT than the reduction of dermal thickness using ultrasound. The epidermal surface roughness investigated using profilometry showed a slight smoothing.

CONCLUSIONS

OCT allows a simple, fast and noninvasive in vivo measurement of the epidermal thickness. To evaluate the atrophogenic potential of corticosteroids it is more suitable than high-frequency ultrasound as epidermal thickness decreases earlier. In addition, epidermal thickness is a more sensitive indicator of steroid atrophy as the degree of thinning is much higher compared with the dermal atrophy. Profilometry might give further information; however, it would not be suitable for clinical use as the results were generally less pronounced. In the future, OCT might be useful to detect corticosteroid-induced side-effects at the beginning for monitoring the therapy.

Optical coherence tomography in the diagnosis of bronchial lesions

PURPOSE

Optical coherence tomography (OCT) can obtain high-resolution, cross-sectional microscopic images of tissue, potentially enabling optical biopsy to substitute for conventional excisional biopsy. We sought to investigate the capability of OCT to image the microstructure of normal and abnormal bronchial tissue.

MATERIALS AND METHODS

EQUIPMENT

The OCT system was produced by Light Lab Imaging (Boston, U.S.A.) and Pentax. (Tokyo, Japan). Preliminary examination: the OCT system was used to image-resected lung specimens from patients who had given written informed consent for this study. We inserted the OCT catheter via the working channel of the bronchoscope to evaluate the bronchial lumen. The catheter delivers a radial OCT beam and scans circumferentially to generate a transluminal image. We collected OCT images of normal bronchus, primary tumors and alveoli. All images were saved and labeled according to the patient and type of tissue imaged for later correlation with histologic studies. Clinical examination: five other patients, all of whom had given written informed consent, were examined with the OCT system under local anesthesia. The OCT catheter was inserted into the working channel of the bronchoscope for evaluation of the bronchial lumen. We collected OCT images of the normal bronchus and tumors in vivo.

RESULTS

(1) Normal bronchus: the bronchial mucosal and submucosal layers appear homogeneous in OCT images. The submucosal layer is relatively reflective due to the presence of an extracellular matrix. A membrane can be seen between the submucosal and the smooth muscle layer, and areas of cartilage show high levels of scattering. (2) Alveoli: OCT images show the uniform appearance of the bronchial wall and the structure of air-containing alveoli. (3) Central type lung cancers: in preliminary and clinical examinations, the tumors showed unevenly distributed high backscattering areas and resultant loss of the normal layer structure.

CONCLUSIONS

This study was the first report of the endobronchial OCT for lung cancer in clinical practice. Layers of the bronchial wall were distinctly observed in the normal bronchus on the OCT images, as opposed to bronchial tumors which lacked a layered structure. The ability of OCT to identify abnormal areas may well revise present methods for early diagnosis endoscopically.

COMMENTARY ON THE PLEASURES OF SOLVING IMPOSSIBLE PROBLEMS OF EXPERIMENTAL PHYSIOLOGY

This commentary presents a series of examples of "impossible experimental problems" that we have encountered over the years in addressing various challenging questions in physiology. We aim to show how stimulating the challenges of physiology can be and demonstrate how our naive invocation of methods from disparate fields of science and engineering has led to delightful resolutions of physiological challenges that were utterly new to this intrepid interdisciplinary researcher.

Measurement of dye diffusion in scattering tissue phantoms using dual-wavelength low-coherence interferometry

We demonstrate low-coherence interferometry (LCI) for dye diffusion measurements in scattering tissue phantoms. The diffusion coefficient of a phthalocyanine dye in 1.5% agar gel containing scattering Intralipid was measured using a dual-wavelength interfero-meter. One wavelength was matched to the absorption peak of the dye at 675 nm. The other, 805 nm, was not affected by the dye, and was used to correct for varying sample scattering as a function of depth, assuming a constant ratio between scattering at the two wavelengths. The same wavelength dependence of scattering is assumed for the entire sample, but no a priori knowledge about the amount of scattering is needed. The dye diffusion coefficient was estimated by fitting a mathematical model of the interferometer signal to the measured LCI envelope. We compare results obtained using both a constant-scattering and a depth-resolved-scattering approach to determine the sample scattering. The presented method provides robust estimation of the diffusion coefficient when spatial resolution in determining the depth-resolved scattering is varied. Results indicate that the method is valid for samples having continuous spatial variations in the scattering coefficient over lengths as short as the coherence length of the probing light. The method allows in situ characterization of diffusion in scattering media.

Fluorescent nanocrystals for use in early cervical cancer detection

BACKGROUND

Quantum dots (qdots) are a promising alternative to organic fluorophores for biological imaging. Advantages of quantum dots over organic fluorophores include broad excitation coupled with narrow, tunable emission, high resistance to chemical and metabolic degradation, a higher photobleaching threshold and finally the ability to be modified with a targeting ligand. These many properties allow quantum dots to be used in conjunction with optical detection methods for imaging.

METHODS

We are investigating the use of quantum dots to detect precancerous biomarkers. We have directly targeted epidermal growth factor receptors with quantum dots conjugated to anti-EGFR antibodies.

RESULTS

Compared to appropriate controls, we do see specific labeling of EGF receptors.

CONCLUSIONS

Quantum dots provide a promising alternative to conventional organic dyes for biological imaging. Combined with optical imaging technologies, quantum dots can help visualize changes in cervical cancer at the molecular level. This ability may alert health care providers to the need for intervention before a cancer can metastasize.

Novel algorithm of processing optical coherence tomography images for differentiation of biological tissue pathologies

A numerical algorithm based on a small-angle approximation of the radiative transfer equation (RTE) is developed to reconstruct scattering characteristics of biological tissues from optical coherence tomography (OCT) images. According to the algorithm, biological tissue is considered to be a layered random medium with a set of scattering parameters in each layer: total scattering coefficient, variance of a small-angle scattering phase function, and probability of backscattering, which fully describe the OCT signal behavior versus probing depth. The reconstruction of the scattering parameters is performed by their variation to fit the experimental OCT signal by the theoretical one using a time-saving genetic algorithm. The proposed reconstruction procedure is tested on model media with known scattering parameters. The possibility to estimate scattering parameters from OCT images is studied for various regimes of OCT signal decay. The developed algorithm is applied to reconstruct optical characteristics of epithelium and stroma for normal cervical tissue and its pathologies, and the potential to distinguish between the types of pathological changes in epithelial tissue by its OCT images is demonstrated.

In vivo optical coherence tomography for the diagnosis of oral malignancy

BACKGROUND AND OBJECTIVE

Oral cancer results in 10,000 U.S. deaths annually. Improved highly sensitive diagnostics allowing early detection of oral cancer would benefit patient survival and quality of life. Objective was to investigate in vivo non-invasive optical coherence tomography (OCT) techniques for imaging and diagnosing neoplasia-related epithelial, sub-epithelial changes throughout carcinogenesis.

STUDY DESIGN/MATERIALS AND METHODS

In the standard hamster cheek pouch model for oral carcinogenesis (n = 36), in vivo OCT was used to image epithelial and sub-epithelial change. OCT- and histopathology-based diagnoses on a scale of 0 (healthy) to 6 (squamous cell carcinoma, SCC) were performed at all stages throughout carcinogenesis by two blinded investigators.

RESULTS

Epithelial, sub-epithelial structures were clearly discernible using OCT. OCT diagnosis agreed with the histopathological gold standard in 80% of readings.

CONCLUSION

In vivo OCT demonstrates excellent potential as a diagnostic tool in the oral cavity.

Doppler optical coherence tomography for measuring flow in engineered tissue

The engineering of human tissue represents a major paradigm shift in clinical medicine. Early embodiments of tissue engineering are currently being taken forward to the clinic by production methods that are essentially extensions of laboratory manual procedures. However, to achieve the status of routine large-scale clinical practice, automation and scale-out processes are required. This in turn will require the development of reliable on-line monitoring and control systems. This paper examines one demand of crucial importance, namely the real time in vitro monitoring of the flow characteristics through growing tissue since this has a complex interrelationship. Doppler optical coherence tomography (DOCT) is a recently developed imaging technique for studying the rheological properties of tissues in vivo. Capable of non-invasive imaging in real time with high resolution, it is potentially ideal for the continuous monitoring of engineered tissues in vitro. As a base line, the current status of DOCT in vivo is therefore reviewed. This paper also reports the first preliminary use of DOCT in tissue engineering. The application described involves the imaging of a fully developed laminar flow through a combined tissue fabrication/bioreactor with a tissue-engineered construct (substitute blood vessel) in situ.

The scanning laser ophthalmoscope--a review of its role in bioscience and medicine

The scanning laser ophthalmoscope (SLO) offers the potential for retinal imaging that is complementary both to that of the fundus camera and also the newly developing technique of optical coherence tomography (OCT). It has the ability to produce rapid images at low light levels using light of specific wavelengths. This permits temporal studies of fluorescent-labelled cells which offer a unique insight into inflammatory processes in the eye. The facility to image with several different wavelengths simultaneously offers the potential for spectral imaging of retinal tissue with the aim of revealing those early changes in tissue perfusion that indicate the onset of retinal disease, so increasing the probability of successful therapy.

Non-resonant multiphoton photoacoustic spectroscopy for noninvasive subsurface chemical diagnostics

This paper describes the development and validation of a novel noninvasive spectroscopic subsurface chemical detection technique, non-resonant multiphoton photoacoustic spectroscopy (NMPPAS). In this technique, non-resonant multiphoton excitation is used to provide subsurface excitation of chemical constituents in a sample followed by the subsequent detection of an acoustic signal using a piezoelectric transducer. Because NMPPAS relies on non-radiative relaxation of the absorbing species, it is capable of monitoring both fluorescent and non-fluorescent species. Moreover, since the majority of the energy imparted to most molecules upon the absorption of light is released through non-radiative pathways, sensitive measurements of even fluorescent molecules can be performed. In this paper, demonstration of proof-of-principle of this novel technique has been shown using test samples of common fluorescent dyes and biomarkers including rhodamine 6G, tryptophan, and NADH in solution and gelatin tissue phantoms. From these studies, it was found that detection limits of these chromophores are in the subnanomolar concentration regime. In addition, preliminary results on excised tumor and healthy tissue samples have demonstrated significant differences between the tumorous and non-tumorous tissues at 740 nm and 950 nm wavelengths. From this work, it was found that NMPPAS has a great deal of potential for subsurface chemical diagnostics in the field of biomedical research.

High-resolution imaging of the thyroid gland using optical coherence tomography

BACKGROUND

Current diagnostic imaging modalities of the thyroid gland cannot reliably distinguish benign from malignant lesions, primarily because of their inability to visualize microscopic structure. A high-resolution imaging technique capable of examining thyroid tissue architectural morphology in real time is needed. Optical coherence tomography (OCT) has been shown to achieve high resolutions approaching the cellular range (1-15 microm). The feasibility of optical coherence tomography for imaging thyroid tissue was explored ex vivo on the human thyroid gland.

METHODS

High-resolution OCT was performed in real time at 2 to 4 frames per second on three postmortem and 15 surgically excised thyroid glands containing normal, hyperplastic, and neoplastic tissue. OCT images acquired were compared with those obtained using standard histopathologic methods.

RESULTS

The microstructure of the normal thyroid gland, including colloid-filled follicles as small as 15 microm and their supporting stroma, was clearly identified. OCT images of degenerative, hyperplastic, adenomatous, and malignant change within the thyroid gland were shown to correlate well with corresponding histopathologic findings.

CONCLUSIONS

The ability of OCT to image thyroid tissue microarchitecture makes it a potentially powerful technology that can be used to assess the thyroid gland at a resolution greater than currently available clinical imaging modalities.

Optical coherence tomography for ultrahigh resolution in vivo imaging

Optical coherence tomography (OCT) is an emerging biomedical optical imaging technique that performs high-resolution, cross-sectional tomographic imaging of microstructure in biological systems. OCT can achieve image resolutions of 1-15 microm, one to two orders of magnitude finer than standard ultrasound. The image penetration depth of OCT is determined by the optical scattering and is up to 2-3 mm in tissue. OCT functions as a type of 'optical biopsy' to provide cross-sectional images of tissue structure on the micron scale. It is a promising imaging technology because it can provide images of tissue in situ and in real time, without the need for excision and processing of specimens.

Arthroscopic microscopy of articular cartilage using optical coherence tomography

BACKGROUND

Optical coherence tomography is an echograph of infrared light that can yield microscopic cross-sectional images of articular cartilage without removing or damaging the tissue.

HYPOTHESIS

To determine whether optical coherence tomography images of human cartilage can be acquired arthroscopically and whether the resulting images have high correlation with histopathology.

METHODS

Optical coherence tomography was configured into an arthroscope and used to image 2 human cadaver knees and 45 cores harvested from 9 osteoarthritic knees. The imaged cartilage was then processed for histological analysis. Optical coherence tomography images and histology were graded using a modified Mankin structural score. Agreement was determined using weighted kappa statistics. Morphometric analysis performed on optical coherence tomography images was correlated with histomorphometric analysis using linear regression.

RESULTS

Imaging of the medial and lateral femoral condyles and trochlea was readily accomplished using the optical coherence tomography arthroscope. Modified Mankin surface scores for specimens with the earliest structural changes (grades 0-3) had high agreement with scores assigned to histology (kappa= 0.87). Fibrillation indices calculated from optical coherence tomography had near-perfect correlation to that of histology (R = 0.98)

CLINICAL RELEVANCE

Arthroscopic optical coherence tomography may be clinically useful for early detection of articular cartilage injury and nondestructive assessment of articular cartilage repair.

The potential of optical coherence tomography in the engineering of living tissue

The better repair of human tissue is an urgent medical goal and in order to achieve a safe outcome there is a parallel need for sensitive, non-invasive methods of assessing the quality of the engineered tissues and organs prior to surgical implantation. Optical coherence tomography (OCT) can potentially fulfil this role. The current status of OCT as an advanced imaging tool in clinical medicine, developmental biology and material science is reviewed and the parallels to the engineering of living tissue and organs are discussed. Preliminary data are also presented for a tissue engineering bioreactor with in situ OCT imaging. The data suggest that OCT can be utilized as a real time, non-destructive, non-invasive tool to critically monitor the morphology of tissue-engineered constructs during their fabrication and growth.

Use of optical coherence tomography to monitor biological tissue freezing during cryosurgery

The use of optical coherence tomography (OCT) for imaging skin during cryosurgery is evaluated. OCT provides high spatial resolution (5-10 microm) images of optical backscattering due to local variations in refractive index, such as the boundary between liquid and frozen water in tissue. Time resolved OCT images were acquired during freezing of water, Intralipid trade mark, and in vivo hamster skin. Subsurface morphological changes were evident only during freezing of Intralipid and skin. A simple thermal model was applied which predicted freezing times on the same order of magnitude as those observed in OCT images. OCT can be used as a feedback tool during cryosurgical procedures to monitor progression of the freezing front.

Characterization of age-related effects in human skin: A comparative study that applies confocal laser scanning microscopy and optical coherence tomography

Skin structure and age-related changes in human skin were characterized in vivo by applying confocal laser scanning microscopy (CLSM) and optical coherence tomography (OCT). The overall effect of aging skin, derived from studies of volunteers belonging to two age groups, was found to be a significant decrease in the maximum thickness of the epidermis and flattening of the dermo-epidermal junction. At a certain depth in the dermis, well below the basal layer, a reflecting layer of fibrous structure is observed in CLSM images. The location of this layer strongly depends on age and is situated much deeper below the skin surface in younger than in older skin. In addition, large structural changes were observed with age. The OCT images show two bright reflecting layers. The first one is due to scattering at the skin surface. The second band appears to be caused by a layer of fibrous structure in the dermis. Direct comparison of CLSM and OCT suggests that the same fibrous layer is imaged by the two techniques. This layer might be due to the transition between the papillary and reticular dermis. A comparison of CLSM and OCT enables a better understanding of the images.

Analysis of low-coherence interference fringes by the Kalman filtering method

Interferometers with low-coherence illumination allow noncontact measurement of rough-surface relief with a wide range of measurement definition by locating the visibility maxima of interference fringes. The problem is light scattering by the surface to be measured, which can cause distortion of low-coherence interferometric signals. We propose to use a stochastic fringe model and a Kalman filtering method for processing noisy low-coherence fringes dynamically. Prediction of the fringe's signal value at each discretization step is based on all the information available before this step; the prediction error is used for dynamic correction of the estimates of the fringe envelope and phase. The advantages of the Kalman filtering method consist in its immunity to noise, optimal fringe evaluation, and data-processing speed.

Real-Time Digital Signal Processing-Based Optical Coherence Tomography and Doppler Optical Coherence Tomography

We present the development and use of a real-time digital signal processing (DSP)-based optical coherence tomography (OCT) and Doppler OCT system. Images of microstructure and transient fluid-flow profiles are acquired using the DSP architecture for real-time processing of computationally intensive calculations. This acquisition system is readily configurable for a wide range of real-time signal processing and image processing applications in OCT.

Ultrahigh-resolution optical coherence tomography

In the past two decades, optical coherence tomography (OCT) has been established as an adjunct diagnostic technique for noninvasive, high-resolution, cross-sectional imaging in a variety of medical fields. The rapid development of ultrabroad bandwidth light sources has recently enabled a significant improvement in OCT imaging resolution, demonstrating the potential of OCT to accomplish its original goal of performing noninvasive optical biopsies, i.e., the in vivo visualization of microstructural morphology in situ, which had previously only been possible with histopathology. In addition, these novel light sources might also enable the use of spectroscopic OCT, an extension of ultrahigh-resolution OCT, for enhancing image contrast as well as detecting spatially resolved functional, biochemical tissue information. State-of-the-art-light sources that now permit ultrahigh-resolution OCT covering the whole wavelength region from 500 to 1600 nm are reviewed and fundamental limitations of OCT image resolution are discussed. Ex vivo ultrahigh-resolution OCT tomograms are compared with histological results; first clinical in vivo ultrahigh-resolution OCT and preliminary spectroscopic OCT results are presented and their impact for future clinical and research applications is discussed.

Optical imaging of the cervix

Recent advances in fiber optics, sources and detectors, imaging, and computer-controlled instrumentation have stimulated a period of unprecedented growth in the development of photonics technologies for a wide variety of diagnostic and therapeutic clinical applications. These include the application of quantitative optical spectroscopy and imaging for the detection of precancerous lesions in the uterine cervix, a topic of interest at the Second International Conference on Cervical Cancer, which was held April 11-14, 2002. Investigators have applied the Littenberg method of emerging technology assessment to new optical methods used to detect cervical neoplasia. Currently, such technologies as fluorescence spectroscopy (the combination of fluorescence and diffuse reflectance spectroscopy), tri-modal spectroscopy, and light-scattering spectroscopy that probe the spectral characteristics of tissue are being investigated. Optical technologies that create images of subcellular structure without biopsy subsequent to pathology that currently are under investigation include in vivo confocal imaging and optical coherence tomography. Numerous small studies have demonstrated the potential of these optical technologies. What remains to be elucidated are the fundamental biophysical origins of variations in remitted optical signals between normal and dysplastic tissue. Large multicenter randomized controlled trials are needed to confirm the detection and imaging capabilities of optical technology. Furthermore, the development of contrast agents that could boost detection with these technologies is needed, and basic biologic characterization of signals should be pursued. Applying the Littenberg assessment will help ensure that superior, not simply alternative, technologies are implemented.

The prospects for high resolution optical brain imaging: the magnetic resonance perspective

Various analogs of NMR and MRI are now technically possible in optics; specifically, high-resolution laser-pulse shaping and complex pulse sequence generation with well-defined phase shifts has been demonstrated. Here we summarize this technology and discuss the potential for these methods to enhance optical functional imaging, competing with (and surpassing?) what is possible by functional MRI.

Shedding light on bioscience. Symposium on Optical Imaging: Applications to Biology and Medicine

This dynamic symposium, held on 11-16 February 2003 in Taos, New Mexico, was the first Keystone meeting to focus on optical techniques and their use in biology and medicine. It was organized by D. Becker, D. Farkas and S. Fraser and attracted almost 100 participants from both academia and industry. Fluorescence imaging and its applications, ranging from nano-bioscience to small-animal imaging and imaging of disease progression in humans, were the main topics, with opportunities for further discussion in the cantinas of the town and on the ski slopes of Taos mountain.

Measurement of dye diffusion in agar gel by use of low-coherence interferometry

We demonstrate low-coherence interferometry for diffusion measurements. We have measured the diffusion coefficient of a phthalocyanine dye in 1.5% agar gel with a two-wavelength interferometer; one wavelength was matched to the absorption peak of the dye at 675 nm, while the other, 805 nm, was not affected by the dye. The diffusion coefficient of the dye was found by fitting a mathematical model for the interferometer signal to the measured low-coherence interferometry amplitude. A 95% confidence interval for the diffusion coefficient was found to be D = (2.5 +/- 0.2) x 10(-10) m2/s. The influence of speckle averaging and experiment time on the determination of the diffusion coefficient has been studied. The presented technique allows in situ characterization of diffusion in semitransparent media.

Retinal thickness decreases with age: an OCT study

BACKGROUND/AIM

In three dimensional optic disc tomography a reference plane is required to calculate optic disc rim or cup values. The position of the reference plane often depends on the retinal thickness at the temporal disc margin. Originally it was assumed that the retinal thickness at the temporal disc margin is independent of age. The aim of the study was to check this hypothesis using optical coherence tomography, and additionally to determine the reproducibility of OCT measurements in this area.

METHODS

100 eyes of 100 healthy volunteers were included in this study. Three OCT scans were performed on each eye. The scans were aligned vertically and placed at the temporal edge of the optic disc. For each eye, the thickness of the whole retina as well as the thickness of the retinal nerve fibre layer were calculated together with their coefficients of variation. Thereafter retinal thickness and nerve fibre layer thickness were correlated with age.

RESULTS

The mean retinal thickness was 249 (SD 22) micro m. The mean nerve fibre layer thickness was 109 (22) micro m. The mean coefficients of variation were 3.5% (total retinal thickness) and 8.0% (nerve fibre layer thickness). Both the total retinal thickness and the nerve fibre layer thickness were significantly correlated with age (total retina: y = 269.5 - 0.53 x x; R(2) = 0.133; p = 0.0002, nerve fibre layer: y = 126.8 - 0.44 x x; R(2) = 0.094; p<0.0019.

CONCLUSIONS

Using OCT scans the total retinal thickness can be calculated with high reproducibility (coefficient of variation = 3.5%). The reproducibility of nerve fibre layer thickness measurements is clearly lower (coefficient of variation = 8.0%). Both the total retinal thickness and the nerve fibre layer thickness significantly decrease with age. This influence of the age related decrease in RNFL/retinal thickness on the reference plane, however, is negligible.

Optical coherence tomography: Technology and applications for neuroimaging

Optical coherence tomography (OCT) is an emerging imaging technology with applications in biology, medicine, and materials investigations. Attractive features include high cellular-level resolution, real-time acquisition rates, and spectroscopic feature extraction in a compact noninvasive instrument. OCT can perform "optical biopsies" of tissue, producing images approaching the resolution of histology without having to resect and histologically process tissue specimens for characterization and diagnosis. This article will review several of the current technological developments in OCT. To illustrate the potential of this technology for neuroimaging, applications for imaging neural development, the neural retina, tumors of the central nervous system, and the microsurgical repair of peripheral nerves will be presented. This technology offers a potential investigative tool for addressing many of the present challenges in neuroimaging.

Evaluation of (E)-2'-deoxy-2'-(fluoromethylene)cytidine on the 9L rat brain tumor model using MRI

(E)-2'-deoxy-2'-(fluoromethylene)cytidine (FMdC), was evaluated as a potential treatment for malignant gliomas using the rat 9L brain tumor model. FMdC was shown to be an effective inhibitor of cell proliferation in cultured 9L cells with an EC(50) of 40 ng/ml. In vitro studies also revealed that this compound significantly inhibited incorporation of [(3)H]thymidine in 9L cells. In vivo therapeutic efficacy of FMdC was evaluated in rats harboring intracerebral 9L tumors which were treated daily with 15 mg/kg, i.p. Treatment response was quantified from changes in tumor growth rates as assessed from sequential magnetic resonance imaging (MRI) tumor volume measurements. In vivo tumor cell kill in individual animals was calculated by fitting tumor volume data with an iterative computer routine. It was estimated that therapeutically responsive rats treated with FMdC daily produced a >/= 0.1 log kill per therapeutic dose which resulted in a significant reduction in tumor growth rate. In addition, localized (1)H-MRS of intracerebral 9L tumors revealed changes in metabolite levels which correlated with therapeutic response. These results provide evidence supporting the use of FMdC in clinical trials for the treatment of malignant gliomas and reveals that MR can play an important role in the pre-clinical evaluation of novel compounds using orthotopic tumor models.

Advancing Molecular Therapies through In Vivo Bioluminescent Imaging

Effective development of therapeutics that target the molecular basis of disease is dependent on testing new therapeutic moieties and delivery strategies in animal models of human disease. Accelerating the analyses of these models and improving their predictive value through whole animal imaging methods, which provide data in real time and are sensitive to the subtle changes, are crucial for rapid advancement of these approaches. Modalities based on optics are rapid, sensitive, and accessible methods for in vivo analyses with relatively low instrumentation costs. In vivo bioluminescent imaging (BLI) is one of these optically based imaging methods that enable rapid in vivo analyses of a variety of cellular and molecular events with extreme sensitivity. BLI is based on the use of light-emitting enzymes as internal biological light sources that can be detected externally as biological indicators. BLI has been used to test spatio-temporal expression patterns of both target and therapeutic genes in living laboratory animals where the contextual influences of whole biological systems are preserved. BLI has also been used to analyze gene delivery, immune cell therapies, and the in vivo efficacy of inhibitory RNAs. New tools for BLI are being developed that will offer greater flexibility in detection and analyses. BLI can be used to accelerate the evaluation of experimental therapeutic strategies and whole body imaging offers the opportunity of revealing the effects of novel approaches on key steps in disease processes.

Digital algorithm for dispersion correction in optical coherence tomography for homogeneous and stratified media

The resolution of optical coherence tomography (OCT) often suffers from blurring caused by material dispersion. We present a numerical algorithm for computationally correcting the effect of material dispersion on OCT reflectance data for homogeneous and stratified media. This is experimentally demonstrated by correcting the image of a polydimethyl siloxane microfludic structure and of glass slides. The algorithm can be implemented using the fast Fourier transform. With broad spectral bandwidths and highly dispersive media or thick objects, dispersion correction becomes increasingly important.

Noninvasive real-time imaging of apoptosis

Strict coordination of proliferation and programmed cell death (apoptosis) is essential for normal physiology. An imbalance in these two opposing processes results in various diseases including AIDS, neurodegenerative disorders, myelodysplastic syndromes, ischemiareperfusion injury, cancer, autoimmune disease, among others. Objective and quantitative noninvasive imaging of apoptosis would be a significant advance for rapid and dynamic screening as well as validation of experimental therapeutic agents. Here, we report the development of a recombinant luciferase reporter molecule that when expressed in mammalian cells has attenuated levels of reporter activity. In cells undergoing apoptosis, a caspase-3-specific cleavage of the recombinant product occurs, resulting in the restoration of luciferase activity that can be detected in living animals with bioluminescence imaging. The ability to image apoptosis noninvasively and dynamically over time provides an opportunity for high-throughput screening of proapoptotic and antiapoptotic compounds and for target validation in vivo in both cell lines and transgenic animals.

MRI of mouse models for gliomas shows similarities to humans and can be used to identify mice for preclinical trials

Magnetic resonance imaging (MRI) has been utilized for screening and detecting brain tumors in mice based upon their imaging characteristics appearance and their pattern of enhancement. Imaging of these tumors reveals many similarities to those observed in humans with identical pathology. Specifically, high-grade murine gliomas have histologic characteristics of glioblastoma multiforme (GBM) with contrast enhancement after intravenous administration of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), implying disruption of the blood-brain barrier in these tumors. In contrast, low-grade murine oligodendrogliomas do not reveal contrast enhancement, similar to human tumors. MRI can be used to identify mice with brain neoplasms as inclusion criteria in preclinical trials.

Magnetic resonance imaging in cancer research

Non-invasive assessment of antineoplastic response and correlation of the location, magnitude and duration of transgene expression in vivo would be particularly useful for evaluating cancer gene therapy protocols. This review presents selected examples of how magnetic resonance (MR) has been used to assess therapeutic efficacy by non-invasive quantitation of cell kill, to detect a therapeutic response prior to a change in tumour volume and to detect spatial heterogeneity of the tumour response and quantitate transgene expression. In addition, applications of the use of bioluminescence imaging (BLI) for the evaluation of treatment efficacy and in vivo transgene expression are also presented. These examples provide an overview of areas in which imaging of animal tumour models can contribute towards improving the evaluation of experimental therapeutic agents.