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Yu Y, Feng T, Qiu H, Gu Y, Chen Q, Zuo C, Ma H. Simultaneous photoacoustic and ultrasound imaging: A review. ULTRASONICS 2024; 139:107277. [PMID: 38460216 DOI: 10.1016/j.ultras.2024.107277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/09/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
Photoacoustic imaging (PAI) is an emerging biomedical imaging technique that combines the advantages of optical and ultrasound imaging, enabling the generation of images with both optical resolution and acoustic penetration depth. By leveraging similar signal acquisition and processing methods, the integration of photoacoustic and ultrasound imaging has introduced a novel hybrid imaging modality suitable for clinical applications. Photoacoustic-ultrasound imaging allows for non-invasive, high-resolution, and deep-penetrating imaging, providing a wealth of image information. In recent years, with the deepening research and the expanding biomedical application scenarios of photoacoustic-ultrasound bimodal systems, the immense potential of photoacoustic-ultrasound bimodal imaging in basic research and clinical applications has been demonstrated, with some research achievements already commercialized. In this review, we introduce the principles, technical advantages, and biomedical applications of photoacoustic-ultrasound bimodal imaging techniques, specifically focusing on tomographic, microscopic, and endoscopic imaging modalities. Furthermore, we discuss the future directions of photoacoustic-ultrasound bimodal imaging technology.
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Affiliation(s)
- Yinshi Yu
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China
| | - Ting Feng
- Academy for Engineering & Technology, Fudan University, Shanghai 200433,China.
| | - Haixia Qiu
- First Medical Center of PLA General Hospital, Beijing, China
| | - Ying Gu
- First Medical Center of PLA General Hospital, Beijing, China
| | - Qian Chen
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China
| | - Chao Zuo
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China.
| | - Haigang Ma
- Smart Computational Imaging Laboratory (SCILab), School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210094, China; Smart Computational Imaging Research Institute (SCIRI) of Nanjing University of Science and Technology, Nanjing, Jiangsu Province 210019, China; Jiangsu Key Laboratory of Spectral Imaging & Intelligent Sense, Nanjing, Jiangsu Province 210094, China.
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Tyberg A, Raijman I, Gaidhane M, Trindade AJ, Shahid H, Sarkar A, Samarasena J, Andalib I, Diehl DL, Pleskow DK, Woods KE, Gordon SR, Pannala R, Kedia P, Draganov PV, Tarnasky PR, Sejpal DV, Kumta NA, Parasher G, Adler DG, Patel K, Yang D, Siddiqui U, Kahaleh M, Joshi V. First interobserver agreement of optical coherence tomography in the bile duct: A multicenter collaborative study. Endosc Int Open 2022; 10:E1065-E1072. [PMID: 35979031 PMCID: PMC9377829 DOI: 10.1055/a-1779-5027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background and study aims Optical coherence tomography (OCT) is a new technology available for evaluation of indeterminate biliary strictures. It allows under-the-surface visualization and preliminary studies have confirmed standardized characteristics associated with malignancy. The aim of this study is to evaluate the first interobserver agreement in identifying previously agreed upon OCT criteria and diagnosing of malignant versus benign disease. Patients and methods Fourteen endoscopists were asked to review an atlas of reference clips and images of eight criteria derived from expert consensus A total of 35 de-identified video clips were then evaluated for presence of the eight criteria and for final diagnosis of malignant versus benign using the atlas as reference Intraclass correlation (ICC) analysis was done to evaluate interrater agreement. Results Clips of 23 malignant lesions and 12 benign lesions were scored. Excellent interobserver agreement was seen with dilated hypo-reflective structures (0.85) and layering effacement (0.89); hyper-glandular mucosa (0.76), intact layering (0.81), and onion-skin layering (0.77); fair agreement was seen with scalloping (0.58), and thickened epithelium (0.4); poor agreement was seen with hyper-reflective surface (0.36). The diagnostic ICC for both neoplastic (0.8) and non-neoplastic (0.8) was excellent interobserver agreement. The overall diagnostic accuracy was 51 %, ranging from 43 % to 60 %. Conclusions Biliary OCT is a promising new modality for evaluation of indeterminate biliary strictures. Interobserver agreement ranged from fair to almost perfect on eight previously identified criteria. Interobserver agreement for malignancy diagnosis was substantial (0.8). Further studies are needed to validate this data.
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Affiliation(s)
- Amy Tyberg
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
| | - Isaac Raijman
- Baylor St Lukes Medical Center, Houston, Texas, United States
| | - Monica Gaidhane
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
| | - Arvind J. Trindade
- Long Island Jewish Medical Center, New Hyde Park, New York, United States
| | - Haroon Shahid
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
| | - Avik Sarkar
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
| | - Jason Samarasena
- University of California Irvine, Irvine, California, United States
| | - Iman Andalib
- Mount Sinai South Nassau, Oceanside, New York, United States
| | - David L. Diehl
- Geisinger Medical Center, Danville, Pennsylvania, United States
| | - Douglas K. Pleskow
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Kevin E. Woods
- Southeastern Regional Medical Center, Lumberton, North Carolina, United States
| | - Stuart R. Gordon
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States
| | - Rahul Pannala
- Mayo Clinic Phoenix, Phoenix, Arizona, United States
| | - Prashant Kedia
- Methodist Dallas Medical Center, Dallas, Texas, United States
| | - Peter V. Draganov
- University of Florida, Gainesville, Gainesville, Florida, United States
| | | | | | | | - Gulshan Parasher
- University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
| | - Douglas G. Adler
- University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Kalpesh Patel
- Baylor College of Medicine, Houston, Texas, United States
| | - Dennis Yang
- University of Florida, Gainesville, Gainesville, Florida, United States
| | - Uzma Siddiqui
- University of Chicago, Chicago, Illinois, United States
| | - Michel Kahaleh
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
| | - Viren Joshi
- Ochsner Medical Center, New Orleans, Louisiana, United States
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Qi L, Zhuang Z, Zhang S, Huang S, Feng Q, Chen W. Automatic correction of the initial rotation angle error improves 3D reconstruction in endoscopic airway optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2021; 12:7616-7631. [PMID: 35003856 PMCID: PMC8713659 DOI: 10.1364/boe.439120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 10/27/2021] [Indexed: 05/11/2023]
Abstract
Endoscopic airway optical coherence tomography (OCT) is an advanced imaging modality capable of capturing the internal anatomy and geometry of the airway. Due to fiber-optic catheter bending and friction, the rotation speed of the endoscopic probe is usually non-uniform: at each B-scan image, the initial rotation angle of the probe is easily misaligned with that of the previous slices. During the pullback operation, this initial rotation angle error (IRAE) will be accumulated and will result in distortion and deformation of the reconstructed 3D airway structure. Previous attempts to correct this error were mainly manual corrections, which are time-consuming and suffered from observer variation. In this paper, we present a method to correct the IRAE for anatomically improved visualization of the airway. Our method derived the rotation angular difference of adjacent B-scans by measuring their contour similarity and then tracks the IRAE by formulating its continuous drift as a graph-based problem. The algorithm was tested on a simulated airway contour dataset, and also on experimental datasets acquired by two different long range endoscopic airway OCT platforms. Effective and smooth compensation of the frame-by-frame initial angle difference was achieved. Our method has real-time capability and thus has the potential to improve clinical imaging efficiency.
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Affiliation(s)
- Li Qi
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- These authors contributed equally to this work
| | - Zhijian Zhuang
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- These authors contributed equally to this work
| | - Shuangyang Zhang
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Shixian Huang
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Qianjin Feng
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Wufan Chen
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
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Jelly ET, Kwun J, Schmitz R, Farris AB, Steelman ZA, Sudan DL, Knechtle SJ, Wax A. Optical coherence tomography of small intestine allograft biopsies using a handheld surgical probe. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210108R. [PMID: 34561973 PMCID: PMC8461564 DOI: 10.1117/1.jbo.26.9.096008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE The current gold standard for monitoring small intestinal transplant (IT) rejection is endoscopic visual assessment and biopsy of suspicious lesions; however, these lesions are only superficially visualized by endoscopy. Invasive biopsies provide a coarse sampling of tissue health without depicting the true presence and extent of any pathology. Optical coherence tomography (OCT) presents a potential alternative approach with significant advantages over traditional white-light endoscopy. AIM The aim of our investigation was to evaluate OCT performance in distinguishing clinically relevant morphological features associated with IT graft failure. APPROACH OCT was applied to evaluate the small bowel tissues of two rhesus macaques that had undergone IT of the ileum. The traditional assessment from routine histological observation was compared with OCT captured using a handheld surgical probe during the days post-transplant and subsequently was compared with histophaology. RESULTS The reported OCT system was capable of identifying major biological landmarks in healthy intestinal tissue. Following IT, one nonhuman primate (NHP) model suffered a severe graft ischemia, and the second NHP graft failed due to acute cellular rejection. OCT images show visual evidence of correspondence with histological signs of IT rejection. CONCLUSIONS Results suggest that OCT imaging has significant potential to reveal morphological changes associated with IT rejection and to improve patient outcomes overall.
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Affiliation(s)
- Evan T. Jelly
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Jean Kwun
- Duke University Medical Center, Duke Transplant Center, Department of Surgery, Durham, United States
| | - Robin Schmitz
- Duke University Medical Center, Duke Transplant Center, Department of Surgery, Durham, United States
| | - Alton B. Farris
- Emory University, Department of Pathology, Atlanta, Georgia, United States
| | - Zachary A. Steelman
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Debra L. Sudan
- Duke University Medical Center, Duke Transplant Center, Department of Surgery, Durham, United States
| | - Stuart J. Knechtle
- Duke University Medical Center, Duke Transplant Center, Department of Surgery, Durham, United States
| | - Adam Wax
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
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Ding J, Li Q, Lin J, He S, Chen W, He Q, Zhang Q, Chen J, Wu T, Zhong S, Li D. Optical coherence tomography for the early detection of colorectal dysplasia and cancer: validation in a murine model. Quant Imaging Med Surg 2021; 11:371-379. [PMID: 33392036 PMCID: PMC7719940 DOI: 10.21037/qims-20-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 09/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND There is an urgent need to develop a non-invasive imaging technique for detecting colorectal dysplasia and cancer. Technology for early and real-time microscopic assessments to select the most representative biopsy sites would also be of clinical value. In this study, we explored the sensitivity of optical coherence tomography (OCT) in detecting local lesions to demonstrate its potential for the early detection of colorectal dysplasia and cancer. METHODS An azoxymethane/dextran sodium sulfate mouse model of colorectal carcinogenesis was utilized. Mice were imaged by OCT, and colorectal tissue sections were observed with hematoxylin and eosin staining. The results of the parallel analyses were compared to evaluate the performance of OCT in imaging and early screening of colorectal lesions. RESULTS Dysplasia and cancer could be distinguished from normal colon tissues based on the OCT images. However, simple morphological changes observed in the OCT images were not sufficient to distinguish different degrees of dysplasia or distinguish dysplasia from cancerous tissues. The Youden index and diagnostic efficiency of OCT for colorectal dysplasia and cancer were 62.50% and 82.14%, respectively, while the sensitivity and specificity were 87.50% and 75.00%, respectively. Further, the positive and negative predictive values were 82.35% and 81.82%, respectively. CONCLUSIONS Based on our findings, we predict that OCT is a promising non-invasive imaging technique that can offer excellent positive detection rates and diagnostic accuracy for early colorectal dysplasia and cancer. This technique is expected to be valuable in realizing real-time qualitative analysis and guided targeted biopsy.
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Affiliation(s)
- Jian Ding
- Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qiu Li
- Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jiewen Lin
- Laboratory of Optics, Terahertz and Non-Destructive Testing, School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Shanshan He
- Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Weiqiang Chen
- Laboratory of Optics, Terahertz and Non-Destructive Testing, School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Qiyong He
- Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qiukun Zhang
- Laboratory of Optics, Terahertz and Non-Destructive Testing, School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Jintong Chen
- Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ting Wu
- Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shuncong Zhong
- Laboratory of Optics, Terahertz and Non-Destructive Testing, School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Dan Li
- Department of Gastroenterology, Union Hospital, Fujian Medical University, Fuzhou, China
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Ellebrecht DB, Latus S, Schlaefer A, Keck T, Gessert N. Towards an Optical Biopsy during Visceral Surgical Interventions. Visc Med 2020; 36:70-79. [PMID: 32355663 DOI: 10.1159/000505938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background Cancer will replace cardiovascular diseases as the most frequent cause of death. Therefore, the goals of cancer treatment are prevention strategies and early detection by cancer screening and ideal stage therapy. From an oncological point of view, complete tumor resection is a significant prognostic factor. Optical coherence tomography (OCT) and confocal laser microscopy (CLM) are two techniques that have the potential to complement intraoperative frozen section analysis as in vivo and real-time optical biopsies. Summary In this review we present both procedures and review the progress of evaluation for intraoperative application in visceral surgery. For visceral surgery, there are promising studies evaluating OCT and CLM; however, application during routine visceral surgical interventions is still lacking. Key Message OCT and CLM are not competing but complementary approaches of tissue analysis to intraoperative frozen section analysis. Although intraoperative application of OCT and CLM is at an early stage, they are two promising techniques of intraoperative in vivo and real-time tissue examination. Additionally, deep learning strategies provide a significant supplement for automated tissue detection.
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Affiliation(s)
- David Benjamin Ellebrecht
- LungenClinic Grosshansdorf, Department of Thoracic Surgery, Grosshansdorf, Germany.,University Medical Center Schleswig-Holstein, Campus Lübeck, Department of Surgery, Lübeck, Germany
| | - Sarah Latus
- Hamburg University of Technology, Institute of Medical Technology, Hamburg, Germany
| | - Alexander Schlaefer
- Hamburg University of Technology, Institute of Medical Technology, Hamburg, Germany
| | - Tobias Keck
- University Medical Center Schleswig-Holstein, Campus Lübeck, Department of Surgery, Lübeck, Germany
| | - Nils Gessert
- Hamburg University of Technology, Institute of Medical Technology, Hamburg, Germany
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Gora MJ, Quénéhervé L, Carruth RW, Lu W, Rosenberg M, Sauk JS, Fasano A, Lauwers GY, Nishioka NS, Tearney GJ. Tethered capsule endomicroscopy for microscopic imaging of the esophagus, stomach, and duodenum without sedation in humans (with video). Gastrointest Endosc 2018; 88:830-840.e3. [PMID: 30031805 PMCID: PMC8176642 DOI: 10.1016/j.gie.2018.07.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 07/11/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Patients with many different digestive diseases undergo repeated EGDs throughout their lives. Tethered capsule endomicroscopy (TCE) is a less-invasive method for obtaining high-resolution images of the GI mucosa for diagnosis and treatment planning of GI tract diseases. In this article, we present our results from a single-center study aimed at testing the safety and feasibility of TCE for imaging the esophagus, stomach, and duodenum. METHODS After being swallowed by a participant without sedation, the tethered capsule obtains cross-sectional, 10 μm-resolution, optical coherence tomography images as the device traverses the alimentary tract. After imaging, the device is withdrawn through the mouth, disinfected, and reused. Safety and feasibility of TCE were tested, focusing on imaging the esophagus of healthy volunteers and patients with Barrett's esophagus (BE) and the duodenum of healthy volunteers. Images were compared with endoscopy and histopathology findings when available. RESULTS Thirty-eight patients were enrolled. No adverse effects were reported. The TCE device swallowing rate was 34 of 38 (89%). The appearance of a physiologic upper GI wall, including its microscopic pathology, was visualized with a tissue coverage of 85.4% ± 14.9% and 90.3% ± 6.8% in the esophagus of BE patients with and without endoscopic evidence of a hiatal hernia, respectively, as well as 84.8% ± 7.4% in the duodenum. A blinded comparison of TCE and endoscopic BE measurements showed a strong to very strong correlation (r = 0.7-0.83; P < .05) for circumferential extent and a strong correlation (r = 0.77-0.78; P < .01) for maximum extent (Prague classification). TCE interobserver correlation was very strong, at r = 0.92 and r = 0.84 (P < .01), for Prague classification circumferential (C) and maximal (M) length measurements, respectively. CONCLUSIONS TCE is a safe and feasible procedure for obtaining high-resolution microscopic images of the upper GI tract without endoscopic assistance or sedation.
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Affiliation(s)
- Michalina J. Gora
- ICube Laboratory, CNRS, Strasbourg University, Strasbourg, France.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lucille Quénéhervé
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA.,Institut des Maladies de l’Appareil Digestif, IMAD, CHU Nantes, Hopital Hôtel-Dieu, Nantes, France
| | - Robert W. Carruth
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Weina Lu
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mireille Rosenberg
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jenny S. Sauk
- Department of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Alessio Fasano
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Gregory Y. Lauwers
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Norman S. Nishioka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard-MIT Division of Health Sciences Technology, Cambridge, MA, USA
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Jelvehgaran P, Alderliesten T, Georgiou G, Meijer SL, Bloemen PR, Kodach LL, van Laarhoven HWM, van Berge Henegouwen MI, Hulshof MCCM, Rasch CRN, van Leeuwen TG, de Boer JF, de Bruin M, van Herk M. Feasibility of using optical coherence tomography to detect radiation-induced fibrosis and residual cancer extent after neoadjuvant chemo-radiation therapy: an ex vivo study. BIOMEDICAL OPTICS EXPRESS 2018; 9:4196-4216. [PMID: 30615728 PMCID: PMC6157785 DOI: 10.1364/boe.9.004196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/03/2018] [Accepted: 08/02/2018] [Indexed: 05/11/2023]
Abstract
Treatment of resectable esophageal cancer includes neoadjuvant chemo-radiation therapy (nCRT) followed by esophagectomy in operable patients. High-risk surgery may have been avoided in patients with a pathological complete response (pCR). We investigated the feasibility of optical coherence tomography (OCT) to detect residual cancer and radiation-induced fibrosis in 10 esophageal cancer patients that underwent nCRT followed by esophagectomy. We compared our OCT findings with histopathology. Overall, OCT was able to differentiate between healthy tissue, fibrotic tissue, and residual cancer with a sensitivity and specificity of 79% and 67%, respectively. Hence, OCT has the potential to add to the assessment of a pCR.
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Affiliation(s)
- Pouya Jelvehgaran
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Institute for Laser Life and Biophotonics Amsterdam, Department of Physics and Astronomy, VU University Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Tanja Alderliesten
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Giota Georgiou
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Sybren L. Meijer
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Paul R. Bloemen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Liudmila L. Kodach
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Amsterdam UMC and Cancer Center Amsterdam, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Mark I. van Berge Henegouwen
- Department of Surgery, Amsterdam UMC and Cancer Center Amsterdam, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Maarten C. C. M. Hulshof
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Coen R. N. Rasch
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Ton G. van Leeuwen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Johannes F. de Boer
- Institute for Laser Life and Biophotonics Amsterdam, Department of Physics and Astronomy, VU University Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Martijn de Bruin
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Marcel van Herk
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Manchester Cancer Research Centre, Division of Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, UK
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Optical Coherence Tomography. Stroke 2018; 49:1044-1050. [DOI: 10.1161/strokeaha.117.019818] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 12/22/2017] [Accepted: 01/09/2018] [Indexed: 11/16/2022]
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10
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Wang J, Xu Y, Boppart SA. Review of optical coherence tomography in oncology. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-23. [PMID: 29274145 PMCID: PMC5741100 DOI: 10.1117/1.jbo.22.12.121711] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/04/2017] [Indexed: 05/06/2023]
Abstract
The application of optical coherence tomography (OCT) in the field of oncology has been prospering over the past decade. OCT imaging has been used to image a broad spectrum of malignancies, including those arising in the breast, brain, bladder, the gastrointestinal, respiratory, and reproductive tracts, the skin, and oral cavity, among others. OCT imaging has initially been applied for guiding biopsies, for intraoperatively evaluating tumor margins and lymph nodes, and for the early detection of small lesions that would often not be visible on gross examination, tasks that align well with the clinical emphasis on early detection and intervention. Recently, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This paper reviews the evolution of OCT technologies for the clinical application of OCT in surgical and noninvasive interventional oncology procedures and concludes with a discussion of the future directions for OCT technologies, with particular emphasis on their applications in oncology.
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Affiliation(s)
- Jianfeng Wang
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Yang Xu
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
| | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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11
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Jelvehgaran P, Alderliesten T, Weda JJA, de Bruin M, Faber DJ, Hulshof MCCM, van Leeuwen TG, van Herk M, de Boer JF. Visibility of fiducial markers used for image-guided radiation therapy on optical coherence tomography for registration with CT: An esophageal phantom study. Med Phys 2017; 44:6570-6582. [DOI: 10.1002/mp.12624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/14/2017] [Accepted: 10/03/2017] [Indexed: 12/13/2022] Open
Affiliation(s)
- Pouya Jelvehgaran
- Department of Biomedical Engineering and Physics; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
- Department of Radiation Oncology; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
- Institute for Laser Life and Biophotonics Amsterdam; Physics and Astronomy; VU University Amsterdam; Amsterdam HV 1081 The Netherlands
| | - Tanja Alderliesten
- Department of Radiation Oncology; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
| | - Jelmer J. A. Weda
- Institute for Laser Life and Biophotonics Amsterdam; Physics and Astronomy; VU University Amsterdam; Amsterdam HV 1081 The Netherlands
| | - Martijn de Bruin
- Department of Biomedical Engineering and Physics; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
- Department of Urology; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
| | - Dirk J. Faber
- Department of Biomedical Engineering and Physics; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
| | - Maarten C. C. M. Hulshof
- Department of Radiation Oncology; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
| | - Ton G. van Leeuwen
- Department of Biomedical Engineering and Physics; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
| | - Marcel van Herk
- Department of Biomedical Engineering and Physics; Academic Medical Center; University of Amsterdam; Amsterdam AZ 1105 The Netherlands
- Institute of Cancer Sciences; University of Manchester; Manchester UK
| | - Johannes F. de Boer
- Institute for Laser Life and Biophotonics Amsterdam; Physics and Astronomy; VU University Amsterdam; Amsterdam HV 1081 The Netherlands
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12
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Wang HW, Chen Y. Clinical applications of optical coherence tomography in urology. INTRAVITAL 2014; 3:e28770. [PMID: 28243507 PMCID: PMC5312717 DOI: 10.4161/intv.28770] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 12/20/2022]
Abstract
Since optical coherence tomography (OCT) was first demonstrated in 1991, it has advanced significantly in technical aspects such as imaging speed and resolution, and has been clinically demonstrated in a diverse set of medical and surgical applications, including ophthalmology, cardiology, gastroenterology, dermatology, oncology, among others. This work reviews current clinical applications in urology, particularly in bladder, urether, and kidney. Clinical applications in bladder and urether mainly focus on cancer detection and staging based on tissue morphology, image contrast, and OCT backscattering. The application in kidney includes kidney cancer detection based on OCT backscattering attenuation and non-destructive evaluation of transplant kidney viability or acute tubular necrosis based on both tissue morphology from OCT images and function from Doppler OCT (DOCT) images. OCT holds the promise to positively impact the future clinical practices in urology.
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Affiliation(s)
- Hsing-Wen Wang
- Fischell Department of Bioengineering; University of Maryland; College Park, MD USA
| | - Yu Chen
- Fischell Department of Bioengineering; University of Maryland; College Park, MD USA
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13
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Abstract
Barrett's esophagus (BE) is an acquired condition characterized by replacement of stratified squamous epithelium by a cancer predisposing metaplastic columnar epithelium. Endoscopy with systemic biopsy protocols plays a vital role in diagnosis. Technological advancements in dysplasia detection improves outcomes in surveillance and treatment of patients with BE and dysplasia. These advances in endoscopic technology radically changed the treatment for dysplastic BE and early cancer from being surgical to organ-sparing endoscopic therapy. A multimodal treatment approach combining endoscopic resection of visible and/or raised lesions with ablation techniques for flat BE mucosa, followed by long-term surveillance improves the outcomes of BE. Safe and effective endoscopic treatment can be either tissue acquiring as in endoscopic mucosal resection and endoscopic submucosal dissection or tissue ablative as with photodynamic therapy, radiofrequency ablation and cryotherapy. Debatable issues such as durability of response, recognition and management of sub-squamous BE and optimal management strategy in patients with low-grade dysplasia and non-dysplastic BE need to be studied further. Development of safer wide field resection techniques, which would effectively remove all BE and obviate the need for long-term surveillance, is another research goal. Shared decision making between the patient and physician is important while considering treatment for dysplasia in BE.
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14
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Booth CL, Thompson KS. Barrett's esophagus: A review of diagnostic criteria, clinical surveillance practices and new developments. J Gastrointest Oncol 2012; 3:232-42. [PMID: 22943014 DOI: 10.3978/j.issn.2078-6891.2012.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 04/18/2012] [Indexed: 12/25/2022] Open
Abstract
Barrett's esophagus is defined by metaplastic glandular changes to the distal esophagus and is linked to an increased risk of esophageal adenocarcinoma. Controversy exists whether the definition should be limited to intestinal type glands with goblet cells or should be expanded to include non-goblet cell columnar epithelium. Barrett's esophagus may be asymptomatic in a large proportion of the population but screening should be considered for those with certain clinical findings. The diagnosis of Barrett's should be based on the combination of careful endoscopic evaluation and histologic review of the biopsy material. Continued surveillance biopsies may be necessary in cases of indeterminate or low grade dysplasia. Clinical follow-up of patients with high grade dysplasia should be tailored to the individual patient. Development of newer endoscopy techniques including chemoendoscopy, chromoendoscopy and use of biomarkers on frozen tissue have shown some promise of identifying patients at risk for malignancy.
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Affiliation(s)
- Cassie L Booth
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, California, USA
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15
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Sethi A. Endoscopic retrograde cholangioscopy and advanced biliary imaging. Gastrointest Endosc Clin N Am 2012; 22:451-60. [PMID: 22748242 DOI: 10.1016/j.giec.2012.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Developments in endoscopic retrograde cholangioscopy provide multiple new advanced methods of biliary imaging. Cholangioscopy provides direct visualization of epithelium with white light as well as advanced modalities, such as narrow band imaging and autofluorescence. In vivo histologic images can be achieved with confocal endomicroscopy. Cross-sectional imaging is also possible with intraductal ultrasonography and optical coherence tomography. This article describes these advanced imaging techniques, which can be used together to assist in the diagnosis of biliary strictures and lesions.
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Affiliation(s)
- Amrita Sethi
- Division of Gastroenterology and Hepatology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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16
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Han JP, Hong SJ. Diagnosis of Barrett's Esophagus. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2012. [DOI: 10.7704/kjhugr.2012.12.2.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jae Pil Han
- Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Bucheon, Korea
| | - Su Jin Hong
- Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Bucheon, Korea
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17
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Mujat M, Greco K, Galbally-Kinney KL, Hammer DX, Ferguson RD, Iftimia N, Mulhall P, Sharma P, Pikal MJ, Kessler WJ. Optical coherence tomography-based freeze-drying microscopy. BIOMEDICAL OPTICS EXPRESS 2012; 3:55-63. [PMID: 22254168 PMCID: PMC3255342 DOI: 10.1364/boe.3.000055] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 12/01/2011] [Accepted: 12/02/2011] [Indexed: 05/31/2023]
Abstract
A new type of freeze-drying microscope based upon time-domain optical coherence tomography is presented here (OCT-FDM). The microscope allows for real-time, in situ 3D imaging of pharmaceutical formulations in vials relevant for manufacturing processes with a lateral resolution of <7 μm and an axial resolution of <5 μm. Correlation of volumetric structural imaging with product temperature measured during the freeze-drying cycle allowed investigation of structural changes in the product and determination of the temperature at which the freeze-dried cake collapses. This critical temperature is the most important parameter in designing freeze-drying processes of pharmaceutical products.
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Affiliation(s)
- Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA.
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18
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Abstract
Endoscopy has a vital role in the diagnosis, screening, surveillance and treatment of Barrett esophagus. Over the past few decades, tremendous advances have been made in endoscopic technology, and the management of dysplasia and early cancer in Barrett esophagus has changed radically from being surgical to organ-sparing endoscopic therapy. Proper endoscopic techniques and systematic biopsy protocols improve dysplasia detection, and endoscopic surveillance improves outcomes in patients with Barrett esophagus and dysplasia. Endoscopic treatment can be tissue acquiring (as in endoscopic mucosal resection and endoscopic submucosal dissection) or ablative (as with photodynamic therapy, radiofrequency ablation and cryotherapy). Treatment is usually multimodal, combining endoscopic resection of visible lesions with one or more mucosal ablation techniques, followed by long-term surveillance. Such treatment is safe and effective. Shared decision-making between the patient and physician is important while considering treatment for dysplasia in Barrett esophagus. Issues such as durability of response, importance of subsquamous Barrett epithelium and the optimal management strategy in patients with low-grade dysplasia and nondysplastic Barrett esophagus need to be studied further. Development of safer wide-field resection techniques, which would effectively remove all Barrett esophagus and obviate the need for long-term surveillance, is needed.
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Affiliation(s)
- Aparna Repaka
- Division of Gastroenterology, University Hospitals Case Medical Center, Case Western Reserve University, Wearn 247, 11100 Euclid Avenue, Cleveland, OH 44106, USA
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19
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Popescu DP, Choo-Smith LP, Flueraru C, Mao Y, Chang S, Disano J, Sherif S, Sowa MG. Optical coherence tomography: fundamental principles, instrumental designs and biomedical applications. Biophys Rev 2011; 3:155. [PMID: 28510064 PMCID: PMC5418377 DOI: 10.1007/s12551-011-0054-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 07/08/2011] [Indexed: 12/20/2022] Open
Abstract
The advances made in the last two decades in interference technologies, optical instrumentation, catheter technology, optical detectors, speed of data acquisition and processing as well as light sources have facilitated the transformation of optical coherence tomography from an optical method used mainly in research laboratories into a valuable tool applied in various areas of medicine and health sciences. This review paper highlights the place occupied by optical coherence tomography in relation to other imaging methods that are used in medical and life science areas such as ophthalmology, cardiology, dentistry and gastrointestinal endoscopy. Together with the basic principles that lay behind the imaging method itself, this review provides a summary of the functional differences between time-domain, spectral-domain and full-field optical coherence tomography, a presentation of specific methods for processing the data acquired by these systems, an introduction to the noise sources that plague the detected signal and the progress made in optical coherence tomography catheter technology over the last decade.
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Affiliation(s)
- Dan P Popescu
- National Research Council of Canada, Institute for Biodiagnostics, 435 Ellice Avenue, Winnipeg, MB, Canada, R3B 1Y6.
| | - Lin-P'ing Choo-Smith
- National Research Council of Canada, Institute for Biodiagnostics, 435 Ellice Avenue, Winnipeg, MB, Canada, R3B 1Y6
| | - Costel Flueraru
- National Research Council of Canada, Institute for Microstructural Sciences, 1200 Montreal Road, Ottawa, ON, Canada, K1A 0R6
| | - Youxin Mao
- National Research Council of Canada, Institute for Microstructural Sciences, 1200 Montreal Road, Ottawa, ON, Canada, K1A 0R6
| | - Shoude Chang
- National Research Council of Canada, Institute for Microstructural Sciences, 1200 Montreal Road, Ottawa, ON, Canada, K1A 0R6
| | - John Disano
- National Research Council of Canada, Institute for Microstructural Sciences, 1200 Montreal Road, Ottawa, ON, Canada, K1A 0R6
| | - Sherif Sherif
- Electrical and Computer Engineering, University of Manitoba, 75A Chancellor Drive, Winnipeg, MB, Canada, R3T 5V6
| | - Michael G Sowa
- National Research Council of Canada, Institute for Biodiagnostics, 435 Ellice Avenue, Winnipeg, MB, Canada, R3B 1Y6
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20
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Ahn YC, Chung J, Wilder-Smith P, Chen Z. Multimodality approach to optical early detection and mapping of oral neoplasia. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:076007. [PMID: 21806268 PMCID: PMC3146547 DOI: 10.1117/1.3595850] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 04/28/2011] [Accepted: 05/10/2011] [Indexed: 05/15/2023]
Abstract
Early detection of cancer remains the best way to ensure patient survival and quality of life. Squamous cell carcinoma is usually preceded by dysplasia presenting as white, red, or mixed red and white epithelial lesions on the oral mucosa (leukoplakia, erythroplakia). Dysplastic lesions in the form of erythroplakia can carry a risk for malignant conversion of 90%. A noninvasive diagnostic modality would enable monitoring of these lesions at regular intervals and detection of treatment needs at a very early, relatively harmless stage. The specific aim of this work was to test a multimodality approach [three-dimensional optical coherence tomography (OCT) and polarimetry] to noninvasive diagnosis of oral premalignancy and malignancy using the hamster cheek pouch model (nine hamsters). The results were compared to tissue histopathology. During carcinogenesis, epithelial down grow, eventual loss of basement membrane integrity, and subepithelial invasion were clearly visible with OCT. Polarimetry techniques identified a four to five times increased retardance in sites with squamous cell carcinoma, and two to three times greater retardance in dysplastic sites than in normal tissues. These techniques were particularly useful for mapping areas of field cancerization with multiple lesions, as well as lesion margins.
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Affiliation(s)
- Yeh-Chan Ahn
- Pukyong National University, Department of Biomedical Engineering, 45 Yongso-ro, Nam-gu, Busan, 608-737 Korea.
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21
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SPECHLER STUARTJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association technical review on the management of Barrett's esophagus. Gastroenterology 2011; 140:e18-52; quiz e13. [PMID: 21376939 PMCID: PMC3258495 DOI: 10.1053/j.gastro.2011.01.031] [Citation(s) in RCA: 773] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Kang W, Wang H, Pan Y, Jenkins MW, Isenberg GA, Chak A, Atkinson M, Agrawal D, Hu Z, Rollins AM. Endoscopically guided spectral-domain OCT with double-balloon catheters. OPTICS EXPRESS 2010; 18:17364-72. [PMID: 20721123 PMCID: PMC3408909 DOI: 10.1364/oe.18.017364] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Fourier-domain optical coherence tomography (OCT) and balloon-based catheters have furthered the potential of OCT as a real-time surveillance tool for Barrett's esophagus (BE). However, a balloon catheter, which expands the esophagus and centers the catheter, applies direct pressure on the esophagus. This may affect the tissue appearance and the ability to detect dysplasia in BE. To study this effect, we propose a double-balloon catheter to allow imaging with and without balloon-tissue contact. A system design based on a spectral-domain OCT platform is reported and validated by acquisition of high quality, volumetric images of swine esophagus in vivo.
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Affiliation(s)
- Wei Kang
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
- These authors contributed equally to this work
| | - Hui Wang
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
- These authors contributed equally to this work
| | - Yinsheng Pan
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Michael W. Jenkins
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Gerard A. Isenberg
- Department of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Amitabh Chak
- Department of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Matthew Atkinson
- Department of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Deepak Agrawal
- Department of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Zhilin Hu
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
| | - Andrew M. Rollins
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
- Department of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106,
USA
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23
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DeCoro M, Wilder-Smith P. Potential of optical coherence tomography for early diagnosis of oral malignancies. Expert Rev Anticancer Ther 2010; 10:321-9. [PMID: 20214513 DOI: 10.1586/era.09.191] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With nearly 1,500,000 new patients diagnosed every year in the USA, cancer poses a considerable challenge to healthcare today. Oral cancer is responsible for a sizeable portion of deaths due to cancer, primarily because it is diagnosed at a late stage when the prognosis is poor. Current methods for diagnosing oral cancer need to be augmented by better early detection, monitoring and screening modalities. A new approach is needed that provides real-time, accurate, noninvasive diagnosis. The results of early clinical trials using in vivo optical coherence tomography for the diagnosis of oral dysplasia and malignancy are encouraging.
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Affiliation(s)
- Michael DeCoro
- Beckman Laser Institute, 1002 Health Sciences Road East, University of California, Irvine, CA 92612, USA.
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Cobb MJ, Hwang JH, Upton MP, Chen Y, Oelschlager BK, Wood DE, Kimmey MB, Li X. Imaging of subsquamous Barrett's epithelium with ultrahigh-resolution optical coherence tomography: a histologic correlation study. Gastrointest Endosc 2010; 71:223-30. [PMID: 19846077 DOI: 10.1016/j.gie.2009.07.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 07/02/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) is being developed as a potentially valuable method for high-resolution cross-sectional imaging of the esophageal mucosal and submucosal layers. One potential application of OCT imaging is to identify subsquamous Barrett's epithelium in patients who have undergone ablative therapy, which is not visible on standard endoscopic examination. However, histologic correlation confirming the ability of OCT to image subsquamous Barrett's epithelium has yet to be performed. DESIGN Histologic correlation study. OBJECTIVE To perform histologic correlation of ultrahigh-resolution optical coherence tomography (UHR-OCT) imaging for identification of subsquamous Barrett's epithelium. SETTING Academic Medical Center (University of Washington, Seattle, WA). PATIENTS Fourteen patients with pathologic biopsy specimens, proven to be high-grade dysplasia or adenocarcinoma underwent esophagectomy. INTERVENTIONS UHR-OCT imaging was performed on ex vivo esophagectomy specimens immediately after resection. MAIN OUTCOME MEASUREMENTS Correlation of UHR-OCT images with histologic images. RESULTS Subsquamous Barrett's epithelium was clearly identified by using UHR-OCT images and was confirmed by corresponding histology. LIMITATIONS Difficulty distinguishing some subsquamous Barrett's glands from blood vessels in ex vivo tissue (because of the lack of blood flow) in some cases. Imaging was performed with a bench-top system. CONCLUSIONS Results from this study demonstrate that UHR-OCT imaging is capable of identifying subsquamous Barrett's epithelium.
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Affiliation(s)
- Michael J Cobb
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
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25
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In vivo imaging of human labial glands using advanced optical coherence tomography. ACTA ACUST UNITED AC 2009; 108:425-9. [PMID: 19716509 DOI: 10.1016/j.tripleo.2009.05.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 05/20/2009] [Accepted: 05/21/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Optical coherence tomography (OCT) has emerged as a high-resolution noninvasive clinical imaging application. The purpose of this study was to show OCT images of human labial glands obtained using a swept-source (SS) OCT system. STUDY DESIGN Labial gland OCT imaging was carried out using our new SS-OCT system for 5 healthy volunteers using a hand-held in vivo OCT scanning probe. The labial tissue was scanned in a superior to inferior direction in 2 and 3 dimensions. RESULTS The resulting 2- and 3-dimensional ultrahigh-resolution images of in vivo OCT human labial minor salivary glands revealed the epithelium, connective tissue, lobes, and duct. OCT was capable of providing simultaneous and noninvasive structural information with high resolution. CONCLUSION This clinical imaging modality promises to have clinical impact in the diagnosis of such conditions as Sjögren syndrome and xerostomia.
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26
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Testoni PA, Mangiavillano B, Mariani A, Carrara S, Notaristefano C, Arcidiacono PG. Investigation of Oddi sphincter structure by optical coherence tomography in patients with biliary-type 1 dysfunction: a pilot in vivo study. Dig Liver Dis 2009; 41:907-12. [PMID: 19403347 DOI: 10.1016/j.dld.2009.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2008] [Revised: 12/08/2008] [Accepted: 03/18/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND Type 1 sphincter of Oddi dysfunction is a clinical entity characterised by biliary-type pain, elevated liver biochemical tests, and common bile duct dilation. Sphincter fibrosis is a common finding in this type of dysfunction and may require in some cases a differential diagnosis with a malignant intra-papillary disease. Optical coherence tomography permits high-resolution, real-time imaging of the sphincter of Oddi microstructure by a probe inserted into the common bile duct through an ERCP catheter. No data exist on the evaluation of sphincter of Oddi fibrosis by optical coherence tomography during ERCP in vivo. OBJECTIVE To assess the feasibility of optical coherence tomography investigation of the sphincter of Oddi structure and assess its potential for diagnosing type 1 sphincter of Oddi dysfunction. PATIENTS Ten consecutive patients, five with biliary-type 1 sphincter of Oddi dysfunction and five with pancreatic head/mid-body adenocarcinoma not involving the papillary region, who underwent both endoscopic ultrasound and therapeutic ERCP, were investigated by optical coherence tomography immediately before biliary sphincterotomy or stenting. RESULTS In all sphincter of Oddi dysfunction patients optical coherence tomography recognised a hyper-reflective intermediate, fibro-muscular layer, significantly thicker than in patients with non-pathological sphincter of Oddi (p<0.0001). CONCLUSIONS Optical coherence tomography imaging recognised an increased thickness and reflectance of the fibro-muscular layer of the sphincter of Oddi, very likely determined by fibrosis, and was not time-consuming; it can be safely used during ERCP to confirm the diagnosis in difficult cases. Its use in clinical practice has one important limitation since it requires magnification in the post-procedure computer analysis to obtain images useful for diagnosis.
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Affiliation(s)
- P A Testoni
- Division of Gastroenterology & Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
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27
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Testoni PA, Mangiavillano B. Optical coherence tomography for bile and pancreatic duct imaging. Gastrointest Endosc Clin N Am 2009; 19:637-53. [PMID: 19917469 DOI: 10.1016/j.giec.2009.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Optical coherence tomography (OCT) is an optical imaging modality introduced in 1991 that performs high-resolution, cross-sectional, subsurface tomographic imaging of the microstructure in materials and biologic systems by measuring backscattered or backreflected infrared light. OCT has been used for biomedical applications where many factors affect the feasibility and effectiveness of any imaging technique. The highly scattering and absorbing living tissues greatly limit the application of optical imaging modalities. In the last decade, OCT technology has evolved from an experimental laboratory tool to a new diagnostic imaging modality with a wide spectrum of clinical applications in medical practice, including the gastrointestinal (GI) tract and pancreaticobiliary ductal system.
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Affiliation(s)
- Pier Alberto Testoni
- Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Scientific Institute San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
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28
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Yokosawa S, Koike T, Kitagawa Y, Hatta W, Uno K, Abe Y, Iijima K, Imatani A, Ohara S, Shimosegawa T. Identification of the layered morphology of the esophageal wall by optical coherence tomography. World J Gastroenterol 2009; 15:4402-9. [PMID: 19764091 PMCID: PMC2747060 DOI: 10.3748/wjg.15.4402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess each layer of the optical coherence tomography (OCT) image of the esophageal wall with reference to the histological structure.
METHODS: Resected specimens of fresh pig esophagus was used as a model for the esophageal wall. We injected cyanoacrylate adhesive into the specimens to create a marker, and scanned them using a miniature OCT probe. The localization of these markers was assessed in the OCT images. Then we compared the OCT-imaged morphology with the corresponding histological section, guided by the cyanoacrylate adhesive markers. We prepared a second set of experiments using nylon sutures as markers.
RESULTS: The OCT image of the esophageal specimen has a clear five-layered morphology. First, it consisted of a relatively less reflective layer; second, a more reflective layer; third, a less reflective layer; fourth, a more reflective layer; and fifth, a less reflective layer. Comparing the OCT images with marked histological sections showed that the first layer corresponded to stratified squamous epithelium; the second to lamina propria; the third to muscularis mucosa; fourth, submucosa; and fifth, muscularis propria with deeper structures of the esophageal wall.
CONCLUSION: We demonstrated that the OCT image of the normal esophageal wall showed a five-layered morphology, which corresponds to histological esophageal wall components.
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Kah JCY, Olivo M, Chow TH, Song KS, Koh KZY, Mhaisalkar S, Sheppard CJR. Control of optical contrast using gold nanoshells for optical coherence tomography imaging of mouse xenograft tumor model in vivo. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:054015. [PMID: 19895117 DOI: 10.1117/1.3233946] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The control of image contrast is essential toward optimizing a contrast enhancement procedure in optical coherence tomography (OCT). In this study, the in vivo control of optical contrast in a mouse tumor model with gold nanoshells as a contrast agent is examined. Gold nanoshells are administered into mice, with the injected dosage and particle surface parameters varied and its concentration in the tumor under each condition is determined using a noninvasive theoretical OCT modeling technique. The results show that too high a concentration of gold nanoshells in the tumor only enhances the OCT signal near the tissue surface, while significantly attenuating the signal deeper into the tissue. With an appropriate dosage, IV delivery of gold nanoshells allows a moderate concentration of 6.2 x 10(9) particles/ml in tumor to achieve a good OCT signal enhancement with minimal signal attenuation with depth. An increase in the IV dosage of gold nanoshells reveals a corresponding nonlinear increase in their tumor concentration, as well as a nonlinear reduction in the fractional concentration of injected gold nanoshells. Furthermore, this fractional concentration is improved with the use of antiepodermal growth factor receptor (EGFR) surface functionalization, which also reduces the time required for tumor delivery from 6 to 2 h.
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Affiliation(s)
- James Chen Yong Kah
- National University of Singapore, Division of Bioengineering, 7 Engineering Drive 1, Blk E3A, #04-15, Singapore
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Gastrointestinal optical coherence tomography: clinical applications, limitations, and research priorities. Gastrointest Endosc Clin N Am 2009; 19:243-59. [PMID: 19423022 DOI: 10.1016/j.giec.2009.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Optical coherence tomography provides the highest resolution available of any of the technologies currently used in endoscopic imaging. There are several potential clinical applications for optical coherence tomography, particularly with precancerous conditions of the gastrointestinal tract. The future of optical coherence tomography is discussed.
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Testoni PA, Mangiavillano B. Optical coherence tomography in detection of dysplasia and cancer of the gastrointestinal tract and bilio-pancreatic ductal system. World J Gastroenterol 2008; 14:6444-52. [PMID: 19030194 PMCID: PMC2773328 DOI: 10.3748/wjg.14.6444] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Optical coherence tomography (OCT) is an optical imaging modality that performs high-resolution, cross-sectional, subsurface tomographic imaging of the microstructure of tissues. The physical principle of OCT is similar to that of B-mode ultrasound imaging, except that it uses infrared light waves rather than acoustic waves. The in vivo resolution is 10-25 times better (about 10 μm) than with high-frequency ultrasound imaging, but the depth of penetration is limited to 1-3 mm, depending upon tissue structure, depth of focus of the probe used, and pressure applied to the tissue surface. In the last decade, OCT technology has evolved from an experimental laboratory tool to a new diagnostic imaging modality with a wide spectrum of clinical applications in medical practice, including the gastrointestinal (GI) tract and pancreatic-biliary ductal system. OCT imaging from the GI tract can be done in humans by using narrow-diameter, catheter-based probes that can be inserted through the accessory channel of either a conventional front-view endoscope, for investigating the epithelial structure of the GI tract, or a side-view endoscope, inside a standard transparent ERCP catheter, for investigating the pancreatico-biliary ductal system. Esophagus and the esophago-gastric junction has been the most widely investigated organ so far; more recently, also duodenum, colon and pancreatico-biliary ductal system have been extensively investigated. OCT imaging of the gastro-intestinal wall structure is characterized by a multiple-layer architecture that permits an accurate evaluation of the mucosa, lamina propria, muscularis mucosae, and part of the submucosa. The technique may be, therefore, used to identify pre-neoplastic conditions of the GI tract, such as Barrett's epithelium and dysplasia, and evaluate the depth of penetration of early-stage neoplastic lesions. OCT imaging of the pancreatic and biliary ductal system could improve the diagnostic accuracy for ductal epithelial changes and the differential diagnosis between neoplastic and non-neoplastic lesions.
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Fujimoto J, Drexler W. Introduction to Optical Coherence Tomography. OPTICAL COHERENCE TOMOGRAPHY 2008. [DOI: 10.1007/978-3-540-77550-8_1] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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DaCosta RS, Wilson BC, Marcon NE. Recent Advances in Light‐Induced Fluorescence Endoscopy (LIFE) of the Gastrointestinal Tract. Dig Endosc 2007. [DOI: 10.1111/j.1443-1661.1999.tb00206.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Ralph S. DaCosta
- *Department of Medical Biophysics, University of Toronto/Ontario Cancer Institute. Toronto, Canada
| | - Brian C. Wilson
- *Department of Medical Biophysics, University of Toronto/Ontario Cancer Institute. Toronto, Canada
| | - Norman E. Marcon
- **Division of Gastroenterology, The Wellesley Central Site, St. Michael's Hospital, Toronto, Canada
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Gobin AM, Lee MH, Halas NJ, James WD, Drezek RA, West JL. Near-infrared resonant nanoshells for combined optical imaging and photothermal cancer therapy. NANO LETTERS 2007; 7:1929-34. [PMID: 17550297 DOI: 10.1021/nl070610y] [Citation(s) in RCA: 525] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Metal nanoshells are core/shell nanoparticles that can be designed to either strongly absorb or scatter within the near-infrared (NIR) wavelength region ( approximately 650-950 nm). Nanoshells were designed that possess both absorption and scattering properties in the NIR to provide optical contrast for improved diagnostic imaging and, at higher light intensity, rapid heating for photothermal therapy. Using these in a mouse model, we have demonstrated dramatic contrast enhancement for optical coherence tomography (OCT) and effective photothermal ablation of tumors.
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Affiliation(s)
- André M Gobin
- Department of Bioengineering, Rice University, Houston, Texas 77005, USA
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Abstract
Abstract
Background
Optical techniques using previously unexploited properties of light interaction with tissue may be valuable in the detection, diagnosis and staging of colorectal neoplasia.
Methods
A Medline search (1990 to present) was conducted on optical diagnostics in the detection of colorectal neoplasia. The reference list of each identified article was reviewed for further relevant papers.
Results and conclusion
Chromoendoscopy is the only optical adjunct to colonoscopy that has been tested in large randomized clinical trials. It improves the detection of small and flat colorectal adenomas, and of neoplasia in chronic ulcerative colitis and hereditary non-polyposis colorectal cancer. All other techniques are the subject of ongoing research and the practicality of population screening with any of the methods has yet to be established. Optical techniques may, however, permit immediate clinical diagnosis, removing the need for histological analysis. They may also improve the diagnosis of early colonic neoplasia.
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Affiliation(s)
- J C Taylor
- Department of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
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Familiari L, Strangio G, Consolo P, Luigiano C, Bonica M, Barresi G, Barresi V, Familiari P, D'Arrigo G, Alibrandi A, Zirilli A, Fries W, Scaffidi M. Optical coherence tomography evaluation of ulcerative colitis: the patterns and the comparison with histology. Am J Gastroenterol 2006; 101:2833-40. [PMID: 17227526 DOI: 10.1111/j.1572-0241.2006.00826.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
HYPOTHESIS The optical coherence tomography (OCT) is an imaging modality based on infrared light backscattering properties of tissues. OCT studies documented the disappearance of crypts and the alteration in light backscattering as features of ulcerative colitis (UC) in human colon. This technique should be more and more able to identify tissue microstructures with a resolution that is nearly that of histology (optical biopsy). AIM To evaluate whether there are OCT patterns specific for UC and to compare the overall technique performance with the histology. METHODS A total of 27 patients (20-76 yr) with UC underwent OCT imaging during a total colonoscopy. The OCT images were collected both from affected and normal sites in active UC or disease in remission. Two biopsies of the same sites were acquired. The OCT images were separately scored. Two pathologists blinded to the endoscopic and OCT patterns scored the samples. RESULTS Three OCT patterns were identified: the mucosal backscattering alteration (MBA), the delimited dark areas (DDA), and the layered colonic wall (LCW). In colon affected segments of active and UC in remission, these patterns showed a good correspondence with the histology. Moreover, in 14/25 (56%) normal sites above the affected segment, the OCT documented the pathological features, confirmed only in 10/14 by the histology. Thus, the assessed sensitivity and specificity of OCT in normal segments of UC patients have been 100% and 69%, respectively. CONCLUSIONS The in vivo OCT correctly detected disease features in endoscopically affected colon segments, but even in apparently normal segments of UC patients.
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Affiliation(s)
- Luigi Familiari
- Department of Medicine and Pharmacology, University Hospital, Messina, Italy
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Yun SH, Tearney GJ, Vakoc BJ, Shishkov M, Oh WY, Desjardins AE, Suter MJ, Chan RC, Evans JA, Jang IK, Nishioka NS, de Boer JF, Bouma BE. Comprehensive volumetric optical microscopy in vivo. Nat Med 2006; 12:1429-33. [PMID: 17115049 PMCID: PMC2709216 DOI: 10.1038/nm1450] [Citation(s) in RCA: 283] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2006] [Accepted: 06/20/2006] [Indexed: 11/09/2022]
Abstract
Comprehensive volumetric microscopy of epithelial, mucosal and endothelial tissues in living human patients would have a profound impact in medicine by enabling diagnostic imaging at the cellular level over large surface areas. Considering the vast area of these tissues with respect to the desired sampling interval, achieving this goal requires rapid sampling. Although noninvasive diagnostic technologies are preferred, many applications could be served by minimally invasive instruments capable of accessing remote locations within the body. We have developed a fiber-optic imaging technique termed optical frequency-domain imaging (OFDI) that satisfies these requirements by rapidly acquiring high-resolution, cross-sectional images through flexible, narrow-diameter catheters. Using a prototype system, we show comprehensive microscopy of esophageal mucosa and of coronary arteries in vivo. Our pilot study results suggest that this technology may be a useful clinical tool for comprehensive diagnostic imaging for epithelial disease and for evaluating coronary pathology and iatrogenic effects.
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Affiliation(s)
- Seok H Yun
- Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, USA
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Testoni PA, Mangiavillano B, Albarello L, Mariani A, Arcidiacono PG, Masci E, Doglioni C. Optical coherence tomography compared with histology of the main pancreatic duct structure in normal and pathological conditions: an 'ex vivo study'. Dig Liver Dis 2006; 38:688-95. [PMID: 16807151 DOI: 10.1016/j.dld.2006.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2006] [Revised: 04/21/2006] [Accepted: 05/22/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND STUDY AIMS Optical coherence tomography permits high-resolution imaging of tissue microstructures by a probe inserted into the main pancreatic duct through a standard ERCP catheter. The aim of this study was to compare optical coherence tomography images of the main pancreatic duct with histology and identify the optical coherence tomography pattern of the normal and pathological structure of the main pancreatic duct. PATIENTS AND METHODS Multiple sections of neoplastic and non-neoplastic segments of 10 consecutive surgical pancreatic specimens obtained from patients with pancreatic head adenocarcinoma were investigated by optical coherence tomography scanning within 1h of resection. One hundred optical coherence tomography findings were then compared with the corresponding histopathological diagnoses. RESULTS Main pancreatic duct wall architecture appeared at optical coherence tomography investigation as a three-layer structure with a different back-scattered signal from each layer. Optical coherence tomography imaging was concordant with histology in 81.8% and 18.75% of sections with normal tissue and chronic inflammatory changes. The K statistic between the two procedures was equal to 0.059 for non-neoplastic main pancreatic duct wall appearance. In all neoplastic sections optical coherence tomography showed a subverted layer architecture with heterogeneous back-scattering of the signal and was concordant with histology. CONCLUSIONS Optical coherence tomography provided images of main pancreatic duct wall structure that were concordant with histology in 100% of cases in presence of neoplastic ductal changes and did not have false-positive or negative results. Optical coherence tomography images were also concordant with histology in about 80% of cases with normal main pancreatic duct structure; however, the differential diagnosis between normal tissue and chronic pancreatitis or dysplastic changes appeared very difficult.
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Affiliation(s)
- P A Testoni
- Division of Gastroenterology, Vita-Salute-San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy.
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Testoni PA, Mariani A, Mangiavillano B, Albarello L, Arcidiacono PG, Masci E, Doglioni C. Main pancreatic duct, common bile duct and sphincter of Oddi structure visualized by optical coherence tomography: An ex vivo study compared with histology. Dig Liver Dis 2006; 38:409-14. [PMID: 16584931 DOI: 10.1016/j.dld.2006.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 01/26/2006] [Accepted: 02/21/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND Optical coherence tomography has been proposed to obtain high-resolution imaging of tissue structure of GI tract. Up till now, the optical coherence tomography appearance of the common bile duct, main pancreatic duct and sphincter of Oddi wall structure has not yet been defined. AIMS To compare, in a prospective study, optical coherence tomography images of pancreato-biliary ductal system with histology and identify the optical coherence tomography pattern of the normal wall structure of the ducts. METHODS Multiple sections of non-neoplastic segments of five consecutive ex vivo human pancreatic specimens were investigated by optical coherence tomography scanning within 1h of resection. Sixty optical coherence tomography images were compared with the corresponding histological findings. RESULTS Optical coherence tomography appearance of normal common bile duct, main pancreatic duct and sphincter of Oddi is characterized by a differentiated three-layer architecture with a regular surface and a homogeneous back-scattered signal, corresponding to the single layer of epithelial cells, the connective-muscular layer and the muscular or acinar structure, respectively. Optical coherence tomography and histology findings were concordant in all cases. CONCLUSIONS Optical coherence tomography was able to provide in real-time images of wall structure of the normal common bile duct, main pancreatic duct and sphincter of Oddi that are similar to those obtained by histology. These results suggest that optical coherence tomography could enable high-resolution images to be obtained from the pancreato-biliary system during an ERCP procedure.
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Affiliation(s)
- P A Testoni
- Division of Gastroenterology, Vita-Salute-San Raffaele University, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
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Whiteman SC, Yang Y, Gey van Pittius D, Stephens M, Parmer J, Spiteri MA. Optical Coherence Tomography: Real-time Imaging of Bronchial Airways Microstructure and Detection of Inflammatory/Neoplastic Morphologic Changes. Clin Cancer Res 2006; 12:813-8. [PMID: 16467093 DOI: 10.1158/1078-0432.ccr-05-0245] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Current diagnostic imaging modalities for human bronchial airways do not possess sufficient resolution and tissue penetration depth to detect early morphologic changes and to differentiate in real-time neoplastic pathology from nonspecific aberrations. Optical coherence tomography (OCT) possesses the requisite high spatial resolution for reproducible delineation of endobronchial wall profiling. EXPERIMENTAL DESIGN To establish whether OCT could differentiate between the composite microstructural layers of the human airways and simultaneously determine in situ morphologic changes, using a bench-top OCT system, we obtained cross-sectional images of bronchi from 15 patients undergoing lung resections for cancer. All scanned sections underwent subsequent detailed histologic analysis, allowing direct comparisons to be made. RESULTS OCT imaging enables characterization of the multilayered microstructural anatomy of the airways, with a maximum penetration depth up to 2 to 3 mm and 10-microm spatial resolution. The epithelium, subepithelial components, and cartilage are individually defined. The acquired OCT images closely match histologically defined patterns in terms of structural profiles. Furthermore, OCT identifies in situ morphologic changes associated with inflammatory infiltrates, squamous metaplasia, and tumor presence. CONCLUSIONS Our results confirm that OCT is a highly feasible optical tool for real-time near-histologic imaging of endobronchial pathology, with potential for lung cancer surveillance applications in diagnosis and treatment.
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Affiliation(s)
- Suzanne C Whiteman
- Institute of Science and Technology in Medicine, School of Postgraduate Medicine, Keele University, Stoke-on-Trent, United Kingdom.
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Testoni PA, Mangiavillano B, Albarello L, Arcidiacono PG, Mariani A, Masci E, Doglioni C. Optical coherence tomography to detect epithelial lesions of the main pancreatic duct: an Ex Vivo study. Am J Gastroenterol 2005; 100:2777-83. [PMID: 16393235 DOI: 10.1111/j.1572-0241.2005.00326.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) permits high-resolution, real-time, infrared-generated imaging of tissue microstructures by a probe inserted through the endoscope operative channel. Resolution is approximately 10 microm and the penetration depth of the near-focus probe is about 1 mm. The probe can be inserted into the main pancreatic duct (MPD) through a standard endoscopic retrograde cholangiopancreatography catheter. AIMS AND METHODS To assess the ability of OCT to identify the structure of the MPD, to distinguish normal and malignant MPD epithelium, and to assess intra- and interobserver reproducibility of OCT images. Multiple sections of neoplastic and non-neoplastic segments of 10 consecutive surgical pancreatic specimens were obtained from patients with pancreatic head adenocarcinoma who had undergone Whipple resection, and repeated OCT radial and longitudinal scanning was done within 1 h of resection and before pathological examination. We compared 249 good-quality images with 100 histopathological sections. RESULTS OCT recognized a definite, different pattern in 82.9% of tumor-free and in 97.6% of tumor-involved specimens; sensitivity and specificity for discrimination between adenocarcinoma and normal tissue were 78.6% and 88.9%, respectively. Inflammatory and dysplastic changes of the MPD showed an OCT pattern similar to that of the normal tissue in 53.3% of images. Overall, intraobserver reproducibility ranged from 85.1% to 100% and interobserver reproducibility ranged from 69.9% to 100% and from 89.7% to 100% for tumor-free and tumor-involved segments, respectively. CONCLUSIONS OCT identified the neoplastic and non-neoplastic MPD layer structure and appeared to be a reproducible technique. In non-neoplastic conditions, OCT appeared unable to differentiate between normal and abnormal tissues in about half of the cases.
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Affiliation(s)
- Pier Alberto Testoni
- Division of Gastroenterology, Vita-Salute-San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
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Singh P, Chak A, Willis JE, Rollins A, Sivak MV. In vivo optical coherence tomography imaging of the pancreatic and biliary ductal system. Gastrointest Endosc 2005; 62:970-4. [PMID: 16301046 DOI: 10.1016/j.gie.2005.06.054] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Accepted: 06/29/2005] [Indexed: 12/10/2022]
Abstract
BACKGROUND In vivo optical coherence tomography (OCT) imaging has not yet been applied to the pancreatic ductal system. The aim of this study was to obtain in vivo OCT images of dog pancreatic and biliary ducts, and to correlate the images with histology. METHODS Images of dog pancreatic and biliary ducts were obtained by using an in vivo OCT probe introduced through the respective papillary orifices. Each duct was imaged in multiple locations, and the site of imaging was marked with injected India ink. After imaging, the dogs were euthanized, and the pancreaticobiliary system was harvested. Histologic cross sections were correlated with in vivo OCT images by measuring the structures seen on in vivo OCT images and correlating them with structures seen on corresponding histology slides that contained India ink. OBSERVATIONS Eighteen pairs of in vivo OCT images and histology slides from the bile duct and the pancreatic duct were obtained from 5 dogs. The entire duct wall could be visualized. A low reflective in vivo OCT layer corresponding to the epithelium could be discerned on many images. The bile duct showed a more complex architecture and had greater variations within the reflective OCT layers, possibly because of greater cellularity within the lamina propria. Nuclei within cells could not be identified, and structures adjacent to the ducts could not be imaged. CONCLUSIONS In vivo OCT is capable of imaging the pancreaticobiliary ductal system and of identifying the epithelial layer. Because of limited depth of imaging (320-845 micron), OCT is unlikely to serve the purpose of tumor staging.
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Affiliation(s)
- Pankaj Singh
- Division of Gastroenterology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA
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Hsiung PL, Nambiar PR, Fujimoto JG. Effect of tissue preservation on imaging using ultrahigh resolution optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2005; 10:064033. [PMID: 16409098 DOI: 10.1117/1.2147155] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Ultrahigh resolution optical coherence tomography (OCT) is an emerging imaging modality that enables noninvasive imaging of tissue with 1- to 3-microm resolutions. Initial OCT studies have typically been performed using harvested tissue specimens (ex vivo). No reports have investigated postexcision tissue degradation on OCT image quality. We investigate the effects of formalin fixation and commonly used cell culture media on tissue optical scattering characteristics in OCT images at different times postexcision compared to in vivo conditions. OCT imaging at 800-nm wavelength with 1.5-mum axial resolution is used to image the hamster cheek pouch in vivo, followed by excision and imaging during preservation in phosphate-buffered saline (PBS), Dulbecco's Modified Eagle's Media (DMEM), and 10% neutral-buffered formalin. Imaging is performed in vivo and at sequential time points postexcision from 15 min to 10 to 18 h. Formalin fixation results in increases in scattering intensity from the muscle layers, as well as shrinkage of the epithelium, muscle, and connective tissue of approximately 50%. PBS preservation shows loss of optical contrast within two hours, occurring predominantly in deep muscle and connective tissue. DMEM maintains tissue structure and optical scattering characteristics close to in vivo conditions up to 4 to 6 h after excision and best preserved tissue optical properties when compared to in vivo imaging.
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Affiliation(s)
- Pei-Lin Hsiung
- Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Cambridge, Massachusetts 02139, USA
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Hsiung PL, Pantanowitz L, Aguirre AD, Chen Y, Phatak D, Ko TH, Bourquin S, Schnitt SJ, Raza S, Connolly JL, Mashimo H, Fujimoto JG. Ultrahigh-resolution and 3-dimensional optical coherence tomography ex vivo imaging of the large and small intestines. Gastrointest Endosc 2005; 62:561-74. [PMID: 16185971 DOI: 10.1016/j.gie.2005.05.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2003] [Revised: 05/27/2004] [Accepted: 05/02/2005] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ultrahigh-resolution optical coherence tomography (OCT) has an axial resolution of <5 microm, 2 to 3 times finer than standard OCT. This study investigates ultrahigh-resolution and three-dimensional OCT for ex vivo imaging of the large and small intestines and correlates images with histology. METHODS Ultrahigh-resolution OCT imaging was performed on fresh surgical specimens from the large and small intestines in the pathology laboratory, and images were correlated with histology. OCT was performed at 1.3-microm wavelength with 4.5-microm axial x 11-microm transverse resolution and at 1.1-microm wavelength with 3.5-microm axial x 6-microm transverse resolution. Three-dimensional OCT also was investigated. RESULTS Normal and pathologic areas from 23 surgical specimens of the large and small intestines were imaged. Ultrahigh-resolution OCT distinguished the epithelial layer of the mucosa and visualized individual villi, glands, and crypts. Finer transverse resolutions improved visualization of features, e.g., the epithelium, but reduced the depth of field. Architectural distortion of glands from inflammatory and neoplastic processes was observed. Three-dimensional rendering enabled visualization of surface pit pattern and mucosal folds as well as subsurface crypt microstructure. CONCLUSIONS This study evaluates new OCT technology and can provide a baseline for interpreting future ultrahigh-resolution endoscopic OCT studies.
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Affiliation(s)
- Pei-Lin Hsiung
- Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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Han S, El-Abbadi NH, Hanna N, Mahmood U, Mina-Araghi R, Jung WG, Chen Z, Colt H, Brenner M. Evaluation of Tracheal Imaging by Optical Coherence Tomography. Respiration 2005; 72:537-41. [PMID: 16210894 DOI: 10.1159/000087680] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2004] [Accepted: 03/10/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Optical coherence tomography (OCT) is a new technology capable of generating high resolution cross-sectional images of complex tissue in real time. Analogous to ultrasound, OCT measures backscattered light intensity using coherence interferometery to construct topographical images of complex tissue. Since OCT uses infrared light rather than acoustic waves, its spatial resolution is exceptionally high (2-10 microm). Recent advances in data acquisition, analysis, and processing enable real-time imaging, and make OCT a potentially valuable tool for pulmonary airway diagnostic applications, including assisting directed airway biopsies. OBJECTIVE This study evaluates feasibility of OCT for delineating proximal airway microstructures in various animal as well as human tracheas. METHODS Excised trachea samples from New Zealand white rabbits, Duroc pigs, and human trachea were imaged using a compact, 1,300-nm broad-band superluminescent-diode-based prototype fiber OCT device we constructed. The resulting structural OCT images were compared to conventional hematoxilin and eosin (HE) stained histological sections from the same samples. RESULTS OCT was able to delineate microstructures such as the epithelium, mucosa, cartilage, and glands in all samples. CONCLUSION These findings suggest that integration of OCT with flexible fiberoptic bronchoscopy could enhance pulmonary diagnostic medicine and detection of pathologic tissue changes in various respiratory diseases.
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Affiliation(s)
- Sukgu Han
- Department of Biomedical Engineering, Beckman Laser Institute Irvine, Irvine, California, USA
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48
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Abstract
Gastrointestinal (GI) tract malignancies have a tremendous impact on society. Colorectal cancer is the second leading cause of cancer death in the United States and accounts for 10% of all cancer deaths. Significant research efforts are being directed toward using the interaction of light and tissue to detect pre-cancerous lesions of the GI tract. This article reviews the current status of various experimental optical technologies to detect pre-cancerous changes in the GI tract and focuses on the clinical applications of these technologies for the practicing gastroenterologist.
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Affiliation(s)
- Linda S Lee
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, MA 02114, USA
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Hwang JH, Cobb MJ, Kimmey MB, Li X. Optical coherence tomography imaging of the pancreas: a needle-based approach. Clin Gastroenterol Hepatol 2005; 3:S49-52. [PMID: 16012997 DOI: 10.1016/s1542-3565(05)00259-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A novel, high-resolution, needle-based optical coherence tomography (OCT) device for improving the ability to detect early epithelial dysplasia in solid tissues/organs in vivo is currently in development. An instrument capable of real-time imaging of tissue microstructures in vivo could improve the ability to detect pathologic conditions such as dysplasia, and consequently improve patient outcomes. OCT is an emerging technology that can perform real-time cross-sectional imaging of tissue structures at micron-scale resolution in vivo. OCT has been shown to be effective in the imaging of luminal epithelium, capable of detecting epithelial dysplasia in Barrett's esophagus, and colonic polyps. However, OCT imaging depth with conventional probes is limited to the luminal surface (approximately 1-2 mm). The development of a technology and device that enables high-resolution, real-time imaging of solid tissues beyond 1- to 2-mm deep at or near the cellular level in vivo could improve the diagnosis of diseases of the pancreas and other solid organs.
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Affiliation(s)
- Joo Ha Hwang
- Department of Medicine, University of Washington, Seattle, USA.
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50
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Abstract
Dysplasia is a very imperfect biomarker for malignancy in Barrett's esophagus. Invasive cancer has been found in 30-40% of esophagi resected because preoperative endoscopic examinations had shown high-grade dysplasia. Reports on the natural history of this disorder are sometimes contradictory, but suggest that 10-30% of patients with high-grade dysplasia in Barrett's esophagus will develop a demonstrable malignancy within 5 yr of the initial diagnosis. Proposed management strategies for high-grade dysplasia include esophagectomy, endoscopic ablative therapies, endoscopic mucosal resection (EMR), and intensive endoscopic surveillance. Endoscopic ablative therapies and EMR may not be effective if neoplastic cells have invaded the submucosa or disseminated through mucosal lymphatic channels, and a number of studies suggest that the endoscopic therapies usually leave metaplastic or neoplastic epithelium with malignant potential behind. Limited data suggest that intensive endoscopic surveillance might be a reasonable approach for elderly or infirm patients, but some patients managed in this fashion have developed incurable esophageal cancers. The fundamental question of what is the appropriate length of follow-up for studies on dysplasia treatments has not been resolved. Although 5 yr might be considered the absolute minimum duration for a meaningful follow-up on dysplasia therapy, the follow-up duration in most studies is substantially less than 5 yr. Specific recommendations for management based on these considerations are proposed at the end of this report.
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Affiliation(s)
- Stuart Jon Spechler
- Dallas Department of Veterans Affairs Medical Center, the University of Texas Southwestern Medical Center, Dallas, Texas 75216, USA
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