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Ramakonar H, Quirk BC, Kirk RW, Li J, Jacques A, Lind CRP, McLaughlin RA. Intraoperative detection of blood vessels with an imaging needle during neurosurgery in humans. SCIENCE ADVANCES 2018; 4:eaav4992. [PMID: 30585293 PMCID: PMC6300404 DOI: 10.1126/sciadv.aav4992] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/20/2018] [Indexed: 05/05/2023]
Abstract
Intracranial hemorrhage can be a devastating complication associated with needle biopsies of the brain. Hemorrhage can occur to vessels located adjacent to the biopsy needle as tissue is aspirated into the needle and removed. No intraoperative technology exists to reliably identify blood vessels that are at risk of damage. To address this problem, we developed an "imaging needle" that can visualize nearby blood vessels in real time. The imaging needle contains a miniaturized optical coherence tomography probe that allows differentiation of blood flow and tissue. In 11 patients, we were able to intraoperatively detect blood vessels (diameter, >500 μm) with a sensitivity of 91.2% and a specificity of 97.7%. This is the first reported use of an optical coherence tomography needle probe in human brain in vivo. These results suggest that imaging needles may serve as a valuable tool in a range of neurosurgical needle interventions.
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Affiliation(s)
- Hari Ramakonar
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Bryden C. Quirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Rodney W. Kirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Jiawen Li
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Angela Jacques
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Christopher R. P. Lind
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Robert A. McLaughlin
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
- Corresponding author.
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Anterior lens capsule and epithelium thickness measurements using spectral-domain optical coherence tomography. BMC Ophthalmol 2017. [PMID: 28629391 PMCID: PMC5477114 DOI: 10.1186/s12886-017-0489-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background To investigate the anterior lens capsule and epithelium thickness (defined as anterior lens capsular complex: ALCC) in normal Chinese subjects using spectral-domian optical coherence tomography (SD-OCT) and examine the factors that may influence the ALCC, such as age, gender, pupil diameter (PD) and signal strength index (SSI). Methods A prospective observational case series. One-hundred-thirty-four normal subjects (134 eyes) were included. The ALCCs were determined manually via SD-OCT. Using the pupil center as a reference position, the central ALCC (CALCC), nasal 1-mm ALCC (NALCC), temporal 1-mm ALCC (TALCC) and PD were measured manually. Results The mean CALCC, NALCC and TALCC were 33 ± 6 μm, 36 ± 7 μm and 34 ± 6 μm, respectively. The NALCC was significantly thicker than the CALCC (P < .001) and TALCC (P < .001). Moreover, CALCC was significantly thinner than TALCC (P = 0.013). Age was positively correlated with the CALCC (r = 0.292, P < .001), NALCC (r = 0.400, P < .001) and TALCC (r = 0.521, P < .001). PD, gender and SSI were not significantly correlated with the three ALCC parameters. Conclusions The SD-OCT can be used to demonstrate the ALCC thickness, and age is positively correlated with the ALCC in the central, nasal and temporal sides.
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Werkmeister RM, Sapeta S, Schmidl D, Garhöfer G, Schmidinger G, Aranha dos Santos V, Aschinger GC, Baumgartner I, Pircher N, Schwarzhans F, Pantalon A, Dua H, Schmetterer L. Ultrahigh-resolution OCT imaging of the human cornea. BIOMEDICAL OPTICS EXPRESS 2017; 8:1221-1239. [PMID: 28271013 PMCID: PMC5330598 DOI: 10.1364/boe.8.001221] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/19/2016] [Accepted: 12/26/2016] [Indexed: 05/03/2023]
Abstract
We present imaging of corneal pathologies using optical coherence tomography (OCT) with high resolution. To this end, an ultrahigh-resolution spectral domain OCT (UHR-OCT) system based on a broad bandwidth Ti:sapphire laser is employed. With a central wavelength of 800 nm, the imaging device allows to acquire OCT data at the central, paracentral and peripheral cornea as well as the limbal region with 1.2 µm x 20 µm (axial x lateral) resolution at a rate of 140 000 A-scans/s. Structures of the anterior segment of the eye, not accessible with commercial OCT systems, are visualized. These include corneal nerves, limbal palisades of Vogt as well as several corneal pathologies. Cases such as keratoconus and Fuchs's endothelial dystrophy as well as infectious changes caused by diseases like Acanthamoeba keratitis and scarring after herpetic keratitis are presented. We also demonstrate the applicability of our system to visualize epithelial erosion and intracorneal foreign body after corneal trauma as well as chemical burns. Finally, results after Descemet's membrane endothelial keratoplasty (DMEK) are imaged. These clinical cases show the potential of UHR-OCT to help in clinical decision-making and follow-up. Our results and experience indicate that UHR-OCT of the cornea is a promising technique for the use in clinical practice, but can also help to gain novel insight in the physiology and pathophysiology of the human cornea.
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Affiliation(s)
- René M. Werkmeister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Sabina Sapeta
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Singapore Eye Research Institute The Academia, 20 College Road, Discovery Tower Level 6, 169856, Singapore
| | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Gerhard Garhöfer
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Gerald Schmidinger
- Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Valentin Aranha dos Santos
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Gerold C. Aschinger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Isabella Baumgartner
- Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Niklas Pircher
- Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Florian Schwarzhans
- Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria
| | - Anca Pantalon
- Department of Ophthalmology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Sf. Spiridon University Hospital, 16 Universitatii Str, Iasi, 700115, Romania
| | - Harminder Dua
- Academic Section of Ophthalmology, Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust QMC campus, Derby Road, Nottingham, NG7 2UH, UK
| | - Leopold Schmetterer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Singapore Eye Research Institute The Academia, 20 College Road, Discovery Tower Level 6, 169856, Singapore
- Department of Clinical Pharmacology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
- Lee Kong Chian School of Medicine, Nanyang Technological University Novena Campus, 11 Mandalay Road, 308232, Singapore
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McLaughlin RA, Noble PB, Sampson DD. Optical coherence tomography in respiratory science and medicine: from airways to alveoli. Physiology (Bethesda) 2015; 29:369-80. [PMID: 25180266 DOI: 10.1152/physiol.00002.2014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Optical coherence tomography is a rapidly maturing optical imaging technology, enabling study of the in vivo structure of lung tissue at a scale of tens of micrometers. It has been used to assess the layered structure of airway walls, quantify both airway lumen caliber and compliance, and image individual alveoli. This article provides an overview of the technology and reviews its capability to provide new insights into respiratory disease.
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Affiliation(s)
- Robert A McLaughlin
- Optical & Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, Australia;
| | - Peter B Noble
- School of Anatomy, Physiology & Human Biology, and Centre for Neonatal Research & Education, School of Paediatrics and Child Health, The University of Western Australia, Crawley, Australia; and
| | - David D Sampson
- Optical & Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, Australia; Centre for Microscopy, Characterisation & Analysis, The University of Western Australia, Perth, Australia
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Wang J, Abou Shousha M, Perez VL, Karp CL, Yoo SH, Shen M, Cui L, Hurmeric V, Du C, Zhu D, Chen Q, Li M. Ultra-high resolution optical coherence tomography for imaging the anterior segment of the eye. Ophthalmic Surg Lasers Imaging Retina 2012; 42 Suppl:S15-27. [PMID: 21790108 DOI: 10.3928/15428877-20110627-02] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 02/25/2011] [Indexed: 11/20/2022]
Abstract
Developments in optical coherence tomography (OCT) have expanded its clinical applications for ultra-high resolution imaging of the anterior segment of the human eye. This review presents the latest advances for imaging the anterior segment of the eye using ultra-high resolution OCT (UHR-OCT). Unique applications of UHR-OCT technology in clinical and basic scientific laboratory research are discussed and a summary of the results is provided. The authors focused on the use of UHR-OCT for imaging of tear dynamics, contact lens interactions with the corneal surface, and in vivo histological diagnosis of disorders of the cornea, as well as the future direction in this field.
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Affiliation(s)
- Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 1638 NW 10th Avenue, Miami, FL 33136, USA.
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