Spectral domain optical coherence tomography of multi-MHz A-scan rates at 1310 nm range and real-time 4D-display up to 41 volumes/second

OCTSharp: an open-source and real-time OCT imaging software based on C

Optical coherence tomography (OCT) demands massive data processing and real-time displaying during high-speed imaging. Current OCT imaging software is predominantly based on C++, aiming to maximize performance through low-level hardware management. However, the steep learning curve of C++ hinders agile prototyping, particularly for research purposes. Moreover, manual memory management poses challenges for novice developers and may lead to potential security issues. To address these limitations, OCTSharp is developed as an open-source OCT software based on the memory-safe language C#. Within the managed C# environment, OCTSharp offers synchronized hardware control, minimal memory management, and GPU-based parallel processing. The software has been thoroughly tested and proven capable of supporting real-time image acquisition, processing, and visualization with spectral-domain OCT systems equipped with the latest advanced hardware. With these enhancements, OCTSharp is positioned to serve as an open-source platform tailored for various applications.

Rapid optical tomographic vibrometry using a swept multi-gigahertz comb

We propose a rapid tomographic vibrometer technique using an optical comb to measure internal vibrations, transient phenomena, and tomographic distributions in biological tissue and microelectromechanical system devices at high frequencies. This method allows phase-sensitive tomographic measurement in the depth direction at a multi-MHz scan rate using a frequency-modulated broadband electrooptic multi-GHz supercontinuum comb. The frequency spacing was swept instantaneously in time and axisymmetrically about the center wavelength via a dual-drive Mach-Zehnder modulator driven by a variable radio frequency signal. This unique sweeping method permits direct measurement of fringe-free interferometric amplitude and phase with arbitrarily changeable measurement range and scan rate. Therefore, a compressive measurement can be made in only the depth region where the vibration exists, reducing the number of measurement points. In a proof-of-principle experiment, the interferometric amplitude and phase were investigated for in-phase and quadrature phase-shifted interferograms obtained by a polarization demodulator. Tomographic transient displacement measurements were performed using a 0.12 mm thick glass film and piezo-electric transducer oscillating at 10-100 kHz with scan rates in the range 1-20 MHz. The depth resolution and precision of the vibrometer were estimated to be approximately 25 µm and 1.0 nm, respectively.

Flexible A-scan rate MHz-OCT: efficient computational downscaling by coherent averaging

In order to realize adjustable A-scan rates of fast optical coherence tomography (OCT) systems, we investigate averaging of OCT image data acquired with a MHz-OCT system based on a Fourier Domain Mode Locked (FDML) laser. Increased system sensitivity and image quality can be achieved with the same system at the cost of lower imaging speed. Effectively, the A-scan rate can be reduced in software by a freely selectable factor. We demonstrate a detailed technical layout of the strategies necessary to achieve efficient coherent averaging. Since there are many new challenges specific to coherent averaging in swept source MHz-OCT, we analyze them point by point and describe the appropriate solutions. We prove that coherent averaging is possible at MHz OCT-speed without special interferometer designs or digital phase stabilization. We find, that in our system up to ∼100x coherent averaging is possible while achieving a sensitivity increase close to the ideal values. This corresponds to a speed reduction from 3.3 MHz to 33 kHz and a sensitivity gain of 20 dB. We show an imaging comparison between coherent and magnitude averaging of a human finger knuckle joint in vivo with 121 dB sensitivity for the coherent case. Further, the benefits of computational downscaling in low sensitivity MHz-OCT systems are analyzed.

Characterization of early-stage cutaneous radiation injury by using optical coherence tomography angiography

Cutaneous radiation injury (CRI) is a skin injury caused by exposure to high dose ionizing radiation (IR). Diagnosis and treatment of CRI is difficult due to its initial clinically latent period and the following inflammatory bursts. Early detection of CRI before clinical symptoms will be helpful for effective treatment, and various optical methods have been applied with limitations. Here we show that optical coherence tomography angiography (OCTA) could detect changes in the skin during the latent period in CRI mouse models non-invasively. CRI was induced on the mouse hindlimb with exposure to various IR doses and the injured skin regions were imaged longitudinally by OCTA until the onset of clinical symptoms. OCTA detected several changes in the skin including the skin thickening, the dilation of large blood vessels, and the irregularity in vessel boundaries. Some of OCTA findings were confirmed by histology. The study results showed that OCTA could be used for early CRI detection.

Optical coherence tomography using physical domain data compression to achieve MHz A-scan rates

The three-dimensional volumetric imaging capability of optical coherence tomography (OCT) leads to the generation of large amounts of data, which necessitates high speed acquisition followed by high dimensional image processing and visualization. This signal acquisition and processing pipeline demands high A-scan rates on the front end, which has driven researchers to push A-scan acquisition rates into the MHz regime. To this end, the optical time-stretch approach uses a mode locked laser (MLL) source, dispersion in optical fiber, and a single analog-to-digital converter (ADC) to achieve multi-MHz A-scan rates. While enabling impressive performance this Nyquist sampling approach is ultimately constrained by the sampling rate and bandwidth of the ADC. Additionally such an approach generates massive amounts of data. Here we present a compressed sensing (CS) OCT system that uses a MLL, electro-optic modulation, and optical dispersion to implement data compression in the physical domain and rapidly acquire real-time compressed measurements of the OCT signals. Compression in the analog domain prior to digitization allows for the use of lower bandwidth ADCs, which reduces cost and decreases the required data capacity of the sampling interface. By leveraging a compressive A-scan optical sampling approach and the joint sparsity of C-scan data we demonstrate 14.4-MHz to 144-MHz A-scan acquisition speeds using a sub-Nyquist 1.44 Gsample/sec ADC sampling rate. Furthermore we evaluate the impact of data compression and resulting imaging speed on image quality.

Compressed sensing spectral domain optical coherence tomography with a hardware sparse-sampled camera

We present a sparse-sampled camera for compressed sensing spectral domain optical coherence tomography (CS SD-OCT), which is mainly composed of a novel mask with specially designed coating and a commercially available CCD camera. The sparse-sampled camera under-samples the SD-OCT spectrum in hardware, thus reduces the acquired image data and can achieve faster A-scan speed than conventional CCD camera with the same pixel number. Compared with a conventional SD-OCT system, the CS SD-OCT system equipped with the sparse-sampled camera has better fall-off and SNR performance. CS-OCT imaging of bio-tissue is also demonstrated.

Live video rate volumetric OCT imaging of the retina with multi-MHz A-scan rates

Surgical microscopes are vital tools for ophthalmic surgeons. The recent development of an integrated OCT system for the first time allows to look at tissue features below the surface. Hence, these systems can drastically improve the quality and reduce the risk of surgical interventions. However, current commercial OCT-enhanced ophthalmic surgical microscopes provide only one additional cross sectional view to the standard microscope image and feature a low update rate. To present volumetric data at a high update rate, much faster OCT systems than the ones applied in today's surgical microscopes need to be developed. We demonstrate live volumetric retinal OCT imaging, which may provide a sufficiently large volume size (330x330x595 Voxel) and high update frequency (24.2 Hz) such that the surgeon may even purely rely on the OCT for certain surgical maneuvers. It represents a major technological step towards the possible application of OCT-only surgical microscopes in the future which would be much more compact thus enabling many additional minimal invasive applications. We show that multi-MHz A-scan rates are essential for such a device. Additionally, advanced phase-based OCT techniques require 3D OCT volumes to be detected with a stable optical phase. These techniques can provide additional functional information of the retina. Up to now, classical OCT was to slow for this, so our system can pave the way to holographic OCT with a traditional confocal flying spot approach. For the first time, we present point scanning volumetric OCT imaging of the posterior eye with up to 191.2 Hz volume rate. We show that this volume rate is high enough to enable a sufficiently stable optical phase to a level, where remaining phase errors can be corrected. Applying advanced post processing concepts for numerical refocusing or computational adaptive optics should be possible in future with such a system.

Live video rate volumetric OCT imaging of the retina with multi-MHz A-scan rates

Surgical microscopes are vital tools for ophthalmic surgeons. The recent development of an integrated OCT system for the first time allows to look at tissue features below the surface. Hence, these systems can drastically improve the quality and reduce the risk of surgical interventions. However, current commercial OCT-enhanced ophthalmic surgical microscopes provide only one additional cross sectional view to the standard microscope image and feature a low update rate. To present volumetric data at a high update rate, much faster OCT systems than the ones applied in today's surgical microscopes need to be developed. We demonstrate live volumetric retinal OCT imaging, which may provide a sufficiently large volume size (330x330x595 Voxel) and high update frequency (24.2 Hz) such that the surgeon may even purely rely on the OCT for certain surgical maneuvers. It represents a major technological step towards the possible application of OCT-only surgical microscopes in the future which would be much more compact thus enabling many additional minimal invasive applications. We show that multi-MHz A-scan rates are essential for such a device. Additionally, advanced phase-based OCT techniques require 3D OCT volumes to be detected with a stable optical phase. These techniques can provide additional functional information of the retina. Up to now, classical OCT was to slow for this, so our system can pave the way to holographic OCT with a traditional confocal flying spot approach. For the first time, we present point scanning volumetric OCT imaging of the posterior eye with up to 191.2 Hz volume rate. We show that this volume rate is high enough to enable a sufficiently stable optical phase to a level, where remaining phase errors can be corrected. Applying advanced post processing concepts for numerical refocusing or computational adaptive optics should be possible in future with such a system.

Microscope-Integrated Intraoperative Ultrahigh-Speed Swept-Source Optical Coherence Tomography for Widefield Retinal and Anterior Segment Imaging

BACKGROUND AND OBJECTIVE

To demonstrate the feasibility of retinal and anterior segment intraoperative widefield imaging using an ultrahigh-speed, swept-source optical coherence tomography (SS-OCT) surgical microscope attachment.

PATIENTS AND METHODS

A prototype post-objective SS-OCT using a 1,050-nm wavelength, 400 kHz A-scan rate, vertical cavity surface-emitting laser (VCSEL) light source was integrated to a commercial ophthalmic surgical microscope after the objective. Each widefield OCT data set was acquired in 3 seconds (1,000 × 1,000 A-scans, 12 × 12 mm² for retina and 10 × 10 mm² for anterior segment).

RESULTS

Intraoperative SS-OCT was performed in 20 eyes of 20 patients. In six of seven membrane peels and five of seven rhegmatogenous retinal detachment repair surgeries, widefield retinal imaging enabled evaluation pre- and postoperatively. In all seven cataract cases, anterior imaging evaluated the integrity of the posterior lens capsule.

CONCLUSIONS

Ultrahigh-speed SS-OCT enables widefield intraoperative viewing in the posterior and anterior eye. Widefield imaging visualizes ocular structures and pathology without requiring OCT realignment. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:94-102.].

Recovering distance information in spectral domain interferometry

This work evaluates the performance of the Complex Master Slave (CMS) method, that processes the spectra at the interferometer output of a spectral domain interferometry device without involving Fourier transforms (FT) after data acquisition. Reliability and performance of CMS are compared side by side with the conventional method based on FT, phase calibration with dispersion compensation (PCDC). We demonstrate that both methods provide similar results in terms of resolution and sensitivity drop-off. The mathematical operations required to produce CMS results are highly parallelizable, allowing real-time, simultaneous delivery of data from several points of different optical path differences in the interferometer, not possible via PCDC.

Constant linear velocity spiral scanning for near video rate 4D OCT ophthalmic and surgical imaging with isotropic transverse sampling

Ultrahigh speed optical coherence tomography (OCT) systems with >100 kHz A-scan rates can generate volumes rapidly with minimal motion artifacts and are well suited for 4D imaging (volumes through time) applications such as intra-operative imaging. In such systems, high OCT data acquisition efficiency (defined as the fraction of usable A-scans generated during the total acquisition time) is desired to maximize the volumetric frame rate and sampling pitch. However, current methods for beam scanning using non-resonant and resonant mirror scanners can result in severe scan distortion and transverse oversampling as well as require acquisition dead times, which limit the acquisition efficiency and performance of ultrahigh speed 4D OCT. We introduce constant linear velocity spiral scanning (CLV-SC) as a novel beam scanning method to maximize the data acquisition efficiency of ultrahigh speed 4D OCT systems. We demonstrate that CLV-SC does not require acquisition dead times and achieves more uniform transverse sampling compared to raster scanning. To assess its clinical utility, we implement CLV-SC with a 400 kHz OCT system and image the anterior eye and retina of healthy adults at up to 10 volumes per second with isotropic transverse sampling, allowing B-scans with equal sampling pitch to be extracted from arbitrary locations within a single volume. The feasibility of CLV-SC for intra-operative imaging is also demonstrated using a 800 kHz OCT system to image simulated retinal surgery at 15 volumes per second with isotropic transverse sampling, resulting in high quality volume renders that enable clear visualization of surgical instruments and manipulation of tissue.

Real-time corneal segmentation and 3D needle tracking in intrasurgical OCT

Ophthalmic procedures demand precise surgical instrument control in depth, yet standard operating microscopes supply limited depth perception. Current commercial microscope-integrated optical coherence tomography partially meets this need with manually-positioned cross-sectional images that offer qualitative estimates of depth. In this work, we present methods for automatic quantitative depth measurement using real-time, two-surface corneal segmentation and needle tracking in OCT volumes. We then demonstrate these methods for guidance of ex vivo deep anterior lamellar keratoplasty (DALK) needle insertions. Surgeons using the output of these methods improved their ability to reach a target depth, and decreased their incidence of corneal perforations, both with statistical significance. We believe these methods could increase the success rate of DALK and thereby improve patient outcomes.

Phase-stable Doppler OCT at 19 MHz using a stretched-pulse mode-locked laser

We present a swept-wavelength optical coherence tomography (OCT) system with a 19 MHz laser source and electronic phase-locking of the source, acquisition clock, and beam scanning mirrors. The laser is based on stretched-pulse active mode-locking using an electro-optic modulator. Beam scanning in the fast axis uses a resonant micro-electromechanical systems (MEMS) -based mirror at ~23.8 kHz. Acquisition is performed at 1.78 Gigasamples per second using an external fixed clock. Phase sensitive imaging without need for k-clocking, A-line triggers, or phase-calibration methods is demonstrated. The system was used to demonstrate inter-frame and inter-volume Doppler imaging in the mouse ear and brain at 4D acquisition rates of 1, 30, 60 and 100 volumes/sec (V-scans/s). Angiography based on inter-frame and inter-volume methods are presented. The platform offers extremely fast and phase-stable measurements that can be used in preclinical angiographic and Doppler investigations of perfusion dynamics.

Flexible wide-field optical micro-angiography based on Fourier-domain multiplexed dual-beam swept source optical coherence tomography

Wide-field optical coherence tomography angiography (OCTA) is gaining interest in clinical imaging applications. In this pursuit, it is challenging to maintain the imaging resolution and sensitivity throughout the wide field of view (FoV). Here, we propose a novel method/system of dual-beam arrangement and Fourier-domain multiplexing to achieve wide-field OCTA when imaging the uneven surface samples. The proposed system provides 2 separate FoVs, with flexibility that the imaging area, focus of the imaging beam and imaging depth range can be individually adjusted for each FoV, leading to either (1) increased system imaging FoV or (2) capability of targeting 2 regions of interests that locate at depths with large difference between each other. We demonstrate this novel method by employing 100 kHz laser source in a swept source OCTA to achieve an effective 200 kHz sweeping rate, covering a 22 × 22 mm FoV. The results are verified by a SS-OCTA system employing a 200 kHz laser source, together with the experimental demonstrations when imaging whole brain vasculature in rodent models and skin blood perfusion in human fingers, show-casing the capability of proposed system to image live large samples with complex surface topography.

Review of optical coherence tomography in oncology

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.

Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery

Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into the operating suite may have a similar impact on surgical visualization and treatment. In this article, we review the evolution of OCT for retinal surgery, from perioperative analysis to live volumetric (four-dimensional, 4D) image-guided surgery. We begin by briefly addressing the benefits and limitations of the operating microscope, the progression of OCT technology, and OCT applications in clinical/perioperative retinal imaging. Next, we review intraoperative OCT (iOCT) applications using handheld probes during surgical pauses, two-dimensional (2D) microscope-integrated OCT (MIOCT) of live surgery, and volumetric MIOCT of live surgery. The iOCT discussion focuses on technological advancements, applications during human retinal surgery, translational difficulties and limitations, and future directions.

Review of intraoperative optical coherence tomography: technology and applications [Invited]

During microsurgery, en face imaging of the surgical field through the operating microscope limits the surgeon's depth perception and visualization of instruments and sub-surface anatomy. Surgical procedures outside microsurgery, such as breast tumor resections, may also benefit from visualization of the sub-surface tissue structures. The widespread clinical adoption of optical coherence tomography (OCT) in ophthalmology and its growing prominence in other fields, such as cancer imaging, has motivated the development of intraoperative OCT for real-time tomographic visualization of surgical interventions. This article reviews key technological developments in intraoperative OCT and their applications in human surgery. We focus on handheld OCT probes, microscope-integrated OCT systems, and OCT-guided laser treatment platforms designed for intraoperative use. Moreover, we discuss intraoperative OCT adjuncts and processing techniques currently under development to optimize the surgical feedback derivable from OCT data. Lastly, we survey salient clinical studies of intraoperative OCT for human surgery.

High-speed OCT light sources and systems [Invited]

Imaging speed is one of the most important parameters that define the performance of optical coherence tomography (OCT) systems. During the last two decades, OCT speed has increased by over three orders of magnitude. New developments in wavelength-swept lasers have repeatedly been crucial for this development. In this review, we discuss the historical evolution and current state of the art of high-speed OCT systems, with focus on wavelength swept light sources and swept source OCT systems.

Qualitative and quantitative evaluation of in vivo SD-OCT measurement of rat brain

OCT has been demonstrated as an efficient imaging modality in various biomedical and clinical applications. However, there is a missing link with respect to the source of contrast between OCT and other modern imaging modalities, no quantitative comparison has been demonstrated between them, yet. We evaluated, to our knowledge, for the first time in vivo OCT measurement of rat brain with our previously proposed forward imaging method by both qualitatively and quantitatively correlating OCT with the corresponding T1-weighted and T2-weighted magnetic resonance images, fiber density map (FDM), and two types of histology staining (cresyl violet and acetylcholinesterase AchE), respectively. Brain anatomical structures were identified and compared across OCT, MRI and histology imaging modalities. Noticeable resemblances corresponding to certain anatomical structures were found between OCT and other image profiles. Correlation was quantitatively assessed by estimating correlation coefficient (R) and mutual information (MI). Results show that the 1-D OCT measurements in regards to the intensity profile and estimated attenuation factor, do not have profound linear correlation with the other image modalities suggested from correlation coefficient estimation. However, findings in mutual information analysis demonstrate that there are markedly high MI values in OCT-MRI signals.

Computational fluid dynamics assisted characterization of parafoveal hemodynamics in normal and diabetic eyes using adaptive optics scanning laser ophthalmoscopy

Diabetic retinopathy (DR) is the leading cause of visual loss in working-age adults worldwide. Previous studies have found hemodynamic changes in the diabetic eyes, which precede clinically evident pathological alterations of the retinal microvasculature. There is a pressing need for new methods to allow greater understanding of these early hemodynamic changes that occur in DR. In this study, we propose a noninvasive method for the assessment of hemodynamics around the fovea (a region of the eye of paramount importance for vision). The proposed methodology combines adaptive optics scanning laser ophthalmoscopy and computational fluid dynamics modeling. We compare results obtained with this technique with in vivo measurements of blood flow based on blood cell aggregation tracking. Our results suggest that parafoveal hemodynamics, such as capillary velocity, wall shear stress, and capillary perfusion pressure can be noninvasively and reliably characterized with this method in both healthy and diabetic retinopathy patients.

Optical computing for optical coherence tomography

We propose an all-optical Fourier transformation system for real-time massive data processing in high speed optical coherence tomography (OCT). In the so-called optical computing OCT, fast Fourier transformation (FFT) of A-scan signal is optically processed in real time before being detected by photoelectric detector. Therefore, the processing time for interpolation and FFT in traditional Fourier domain OCT can be dramatically eliminated. A processing rate of 10 mega-A-scans/second was experimentally achieved, which is, to our knowledge, the highest speed for OCT imaging. Due to its fiber based all-optical configuration, this optical computing OCT system is ideal for ultrahigh speed volumetric OCT imaging in clinical application.

Multi-modal optical imaging characterization of atherosclerotic plaques

We combined cross-polarization optical coherence tomography (CP OCT) and non-linear microscopy based on second harmonic generation (SHG) and two-photon-excited fluorescence (2PEF) to assess collagen and elastin fibers and other vascular structures in the development of atherosclerosis, including identification of vulnerable plaques, which remains an important clinical problem and imaging application. CP OCT's ability to visualize tissue birefringence and cross-scattering adds new information about the microstructure and composition of the plaque. However its interpretation can be ambiguous, because backscattering contrast may have a similar appearance to the birefringence related fringes. Our results represent a step towards minimally invasive characterization and monitoring of different stages of atherosclerosis, including vulnerable plaques. CP OCT image of intimal thickening in the human coronary artery. The dark stripe in the cross-polarization channel (arrow) is a polarization fringe related to the phase retardation between two eigen polarization states. It is histologically located in the area of the lipid pool, however this stripe is a polarization artifact, rather than direct visualization of the lipid pool.

Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography

Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging.

Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography

Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon’s capabilities.

Functional optical coherence tomography of rat olfactory bulb with periodic odor stimulation

In rodent olfactory bulb (OB), optical intrinsic signal imaging (OISI) is commonly used to investigate functional maps to odorant stimulations. However, in such studies, the spatial resolution in depth direction (z-axis) is lost because of the integration of light from different depths. To solve this problem, we propose functional optical coherence tomography (fOCT) with periodic stimulation and continuous recording. In fOCT experiments of in vivo rat OB, propionic acid and m-cresol were used as odor stimulus presentations. Such a periodic stimulation enabled us to detect the specific odor-responses from highly scattering brain tissue. Swept source OCT operating at a wavelength of 1334 nm and a frequency of 20 kHz, was employed with theoretical depth and lateral resolutions of 6.7 μm and 15.4 μm, respectively. We succeeded in visualizing 2D cross sectional fOCT map across the neural layer structure of OCT in vivo. The detected fOCT signals corresponded to a few glomeruli of the medial and lateral parts of dorsal OB. We also obtained 3D fOCT maps, which upon integration across z-axis agreed well with OISI results. We expect such an approach to open a window for investigating and possibly addressing toward inter/intra-layer connections at high resolutions in the future.

On the possibility of producing true real-time retinal cross-sectional images using a graphics processing unit enhanced master-slave optical coherence tomography system

In a previous report, we demonstrated master-slave optical coherence tomography (MS-OCT), an OCT method that does not need resampling of data and can be used to deliver en face images from several depths simultaneously. In a separate report, we have also demonstrated MS-OCT's capability of producing cross-sectional images of a quality similar to those provided by the traditional Fourier domain (FD) OCT technique, but at a much slower rate. Here, we demonstrate that by taking advantage of the parallel processing capabilities offered by the MS-OCT method, cross-sectional OCT images of the human retina can be produced in real time. We analyze the conditions that ensure a true real-time B-scan imaging operation and demonstrate in vivo real-time images from human fovea and the optic nerve, with resolution and sensitivity comparable to those produced using the traditional FD-based method, however, without the need of data resampling.

Enhancement of optical coherence microscopy in turbid media by an optical parametric amplifier

We report the enhancement in imaging performance of a spectral-domain optical coherence microscope (OCM) in turbid media by incorporating an optical parametric amplifier (OPA). The OPA provides a high level of optical gain to the sample arm, thereby improving the signal-to-noise ratio of the OCM by a factor of up to 15 dB. A unique nonlinear confocal gate is automatically formed in the OPA, which enables selective amplification of singly scattered (ballistic) photons against the multiply-scattered light background. Simultaneous enhancement in both imaging depth and spatial resolution in imaging microstructures in highly light-scattering media are demonstrated with the combined OPA-OCM setup. Typical OCM inteferograms (left) and images (right) without and with OPA.

High-performance multi-megahertz optical coherence tomography based on amplified optical time-stretch

As the key prerequisite of high-speed volumetric structural and functional tissue imaging in real-time, scaling the A-scan rate beyond MHz has been one of the major pursuits in the development of optical coherence tomography (OCT). Along with a handful of techniques enabling multi-MHz, amplified optical time-stretch OCT (AOT-OCT) has recently been demonstrated as a viable alternative for ultrafast swept-source OCT well above MHz without the need for the mechanical wavelength-tuning mechanism. In this paper, we report a new generation of AOT-OCT demonstrating superior performance to its older generation and all other time-stretch-based OCT modalities in terms of shot-to-shot stability, sensitivity (~90dB), roll-off performance (>4 mm/dB) and A-scan rate (11.5 MHz). Such performance is mainly attributed to the combined contribution from the stable operation of the broadband and compact mode-locked fiber laser as well as the optical amplification in-line with the time-stretch process. The system allows us, for the first time, to deliver volumetric time-stretch-based OCT of biological tissues with the single-shot A-scan rate beyond 10 MHz. Comparing with the existing high-speed OCT systems, the inertia-free AOT-OCT shows promises to realize high-performance 3D OCT imaging at video rate.

Feasibility of ablative fractional laser-assisted drug delivery with optical coherence tomography

Fractional resurfacing creates hundreds of microscopic wounds in the skin without injuring surrounding tissue. This technique allows rapid wound healing owing to small injury regions, and has been proven as an effective method for repairing photodamaged skin. Recently, ablative fractional laser (AFL) treatment has been demonstrated to facilitate topical drug delivery into skin. However, induced fractional photothermolysis depends on several parameters, such as incident angle, exposure energy, and spot size of the fractional laser. In this study, we used fractional CO2 laser to induce microscopic ablation array on the nail for facilitating drug delivery through the nail. To ensure proper energy delivery without damaging tissue structures beneath the nail plate, optical coherence tomography (OCT) was implemented for quantitative evaluation of induced microscopic ablation zone (MAZ). Moreover, to further study the feasibility of drug delivery, normal saline was dripped on the exposure area of fingernail and the speckle variance in OCT signal was used to observe water diffusion through the ablative channels into the nail plate. In conclusion, this study establishes OCT as an effective tool for the investigation of fractional photothermolysis and water/drug delivery through microscopic ablation channels after nail fractional laser treatment.

Performance of megahertz amplified optical time-stretch optical coherence tomography (AOT-OCT)

Enabled by the ultrahigh-speed all-optical wavelength-swept mechanism and broadband optical amplification, amplified optical time-stretch optical coherence tomography (AOT-OCT) has recently been demonstrated as a practical alternative to achieve ultrafast A-scan rate of multi-MHz in OCT. With the aim of identifying the optimal scenarios for MHz operation in AOT-OCT, we here present a theoretical framework to evaluate its performance metric. In particular, the analysis discusses the unique features of AOT-OCT, such as its superior coherence length, and the relationship between the optical gain and the A-scan rate. More importantly, we evaluate the sensitivity of AOT-OCT in the MHz regime under the influence of the amplifier noise. Notably, the model shows that AOT-OCT is particularly promising when operated at the A-scan rate well beyond multi-MHz--not trivially achievable by any existing swept-source OCT platform. A sensitivity beyond 90 dB, close to the shot-noise limit, can be maintained in the range of 2 - 10 MHz with an optical net gain of ~10 dB. Experimental measurement also shows excellent agreement with the theoretical prediction. While distributed fiber Raman amplification is mainly considered in this paper, the theoretical model is generally applicable to any type of amplification schemes. As a result, our analysis serves as a useful tool for further optimization of AOT-OCT system--as a practical alternative to enable MHz OCT operation.

Scalable multiplexing for parallel imaging with interleaved optical coherence tomography

We demonstrate highly parallel imaging with interleaved optical coherence tomography (iOCT) using an in-house-fabricated, air-spaced virtually-imaged phased array (VIPA). The air-spaced VIPA performs spectral encoding of the interferograms from multiple lateral points within a single sweep of the source and allows us to tune and balance several imaging parameters: number of multiplexed points, ranging depth, and sensitivity. In addition to a thorough discussion of the parameters and operating principles of the VIPA, we experimentally demonstrate the effect of different VIPA designs on the multiplexing potential of iOCT. Using a 200-kHz light source, we achieve an effective A-scan rate of 3.2-MHz by multiplexing 16 lateral points onto a single wavelength sweep. The improved sensitivity of this system is demonstrated for 3D imaging of biological samples such as a human finger and a fruit fly.

High definition live 3D-OCT in vivo: design and evaluation of a 4D OCT engine with 1 GVoxel/s

We present a 1300 nm OCT system for volumetric real-time live OCT acquisition and visualization at 1 billion volume elements per second. All technological challenges and problems associated with such high scanning speed are discussed in detail as well as the solutions. In one configuration, the system acquires, processes and visualizes 26 volumes per second where each volume consists of 320 x 320 depth scans and each depth scan has 400 usable pixels. This is the fastest real-time OCT to date in terms of voxel rate. A 51 Hz volume rate is realized with half the frame number. In both configurations the speed can be sustained indefinitely. The OCT system uses a 1310 nm Fourier domain mode locked (FDML) laser operated at 3.2 MHz sweep rate. Data acquisition is performed with two dedicated digitizer cards, each running at 2.5 GS/s, hosted in a single desktop computer. Live real-time data processing and visualization are realized with custom developed software on an NVidia GTX 690 dual graphics processing unit (GPU) card. To evaluate potential future applications of such a system, we present volumetric videos captured at 26 and 51 Hz of planktonic crustaceans and skin.

Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration

PURPOSE

To detect and quantify choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography.

DESIGN

Observational, cross-sectional study.

PARTICIPANTS

A total of 5 normal subjects and 5 subjects with neovascular AMD were included.

METHODS

A total of 5 eyes with neovascular AMD and 5 normal age-matched controls were scanned by a high-speed (100 000 A-scans/seconds) 1050-nm wavelength swept-source OCT. The macular angiography scan covered a 3 × 3-mm area and comprised 200 × 200 × 8 A-scans acquired in 3.5 seconds. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were removed by 3-dimensional (3D) orthogonal registration and merging of 4 scans. The 3D angiography was segmented into 3 layers: inner retina (to show retinal vasculature), outer retina (to identify CNV), and choroid. En face maximum projection was used to obtain 2-dimensional angiograms from the 3 layers. The CNV area and flow index were computed from the en face OCT angiogram of the outer retinal layer. Flow (decorrelation) and structural data were combined in composite color angiograms for both en face and cross-sectional views.

MAIN OUTCOME MEASURES

The CNV angiogram, CNV area, and CNV flow index.

RESULTS

En face OCT angiograms of CNV showed sizes and locations that were confirmed by fluorescein angiography (FA). Optical coherence tomography angiography provided more distinct vascular network patterns that were less obscured by subretinal hemorrhage. The en face angiograms also showed areas of reduced choroidal flow adjacent to the CNV in all cases and significantly reduced retinal flow in 1 case. Cross-sectional angiograms were used to visualize CNV location relative to the retinal pigment epithelium and Bruch's layer and classify type I and type II CNV. A feeder vessel could be identified in 1 case. Higher flow indexes were associated with larger CNV and type II CNV.

CONCLUSIONS

Optical coherence tomography angiography provides depth-resolved information and detailed images of CNV in neovascular AMD. Quantitative information regarding CNV flow and area can be obtained. Further studies are needed to assess the role of quantitative OCT angiography in the evaluation and treatment of neovascular AMD.

Optical coherence tomography angiography of optic disc perfusion in glaucoma

PURPOSE

To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma.

DESIGN

Observational, cross-sectional study.

PARTICIPANTS

Twenty-four normal subjects and 11 patients with glaucoma were included.

METHODS

One eye of each subject was scanned by a high-speed 1050-nm-wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute 3-dimensional optic disc angiography. A disc flow index was computed from 4 registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc (C/D) ratios. Wide-field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness.

MAIN OUTCOME MEASURES

Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations among disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression.

RESULTS

In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in subjects with glaucoma. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV, respectively. The disc flow index was reduced by 25% in the glaucoma group (P = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R(2) = 0.752, P = 0.001). These correlations were significant even after accounting for age, C/D area ratio, NFL, and rim area.

CONCLUSIONS

Optical coherence tomography angiography, generated by the new SSADA, repeatably measures optic disc perfusion and may be useful in the evaluation of glaucoma and glaucoma progression.

The impact of real-time 3d imaging by ultra-high speed optical coherence tomography in urothelial carcinoma

BACKGROUND

Optical coherence tomography (OCT) has become a promising diagnostic tool in many medical fields. In particular, noninvasive real-time optical biopsy of internal organs is one of the most attractive applications of OCT, enabling in situ diagnosis of carcinoma at an early stage. We used an ultra-high speed OCT system for real-time three-dimensional (3D) imaging of three excised specimens of advanced urothelial carcinoma (UC) and investigated the association of the images with results from histopathological examination.

CASE PRESENTATIONS

Case 1 was a 69-year-old man underwent radical cystectomy for muscle-invasive UC (pT2). Case 2 was a 53-year-old man underwent laparoscopic nephroureterectomy and partial cystectomy for left ureter carcinoma (pT2) and case 3 was a 77-year-old woman underwent radical cystectomy for advanced bladder carcinoma (pT3b). Real-time 3D OCT images of normal bladder wall and ureter showed three layers, including the urothelium, lamina propria, and muscularis layer. In contrast, normal structure was not seen in the muscle-invasive UC area or the scar tissue area.

CONCLUSIONS

This study highlighted a new diagnostic method with potential application for UC diagnosis. We will investigate more cases in the future and expect improvement in the diagnosing efficiency of carcinoma in situ or organ-confined muscle-invasive cancer by cystoscopy or ureteroscopy with ultra-high speed OCT.

Interleaved optical coherence tomography

We present a novel and cost-effective technique--interleaved optical coherence tomography (iOCT)--to enhance the imaging speed of swept source OCT systems by acquiring data from multiple lateral positions simultaneously during a single wavelength sweep, using a single detector and a virtually imaged phase array (VIPA) as a multi-band demultiplexer. This technique uses spectral encoding to convert coherence length into higher imaging speed; the speed enhancement factor is independent of the source speed or center wavelength, and the effective A-scan rate scales linearly with sweep speed. The optical configuration requires only a change in the sample arm of a traditional OCT system and preserves the axial resolution and fall-off characteristic of a traditional SS-OCT using the same light source. Using 10 kHz, 20 kHz and 100 kHz sources we provide a first demonstration of image speed enhancement factors of up to 12, 6 and 10, respectively, which yield effective A-scan rates of 120 kHz, 120 kHz and 1 MHz for B-scan imaging, with a sensitivity of up to 82.5 dB. We also show that iOCT can image faster dynamics than traditional OCT B-scan imaging and is capable of 3D biological imaging. The iOCT concept suggests a new route to high-speed OCT imaging for laser developers: that is, by focusing on improving the coherence length and linewidth of existing and emerging sources. Hence, iOCT is a nice complement to ongoing research and commercial efforts to enable faster imaging through development of lasers with faster sweep rates, and offers new hope for existing sources with slow sweep rates and potential for enhancement of coherence length to compete with faster sources to achieve high-speed OCT.

Space-division multiplexing optical coherence tomography

High speed, high resolution and high sensitivity are desirable for optical coherence tomography (OCT). Here, we demonstrate a space-division multiplexing (SDM) technology that translates long coherence length of a commercially available wavelength tunable laser into high OCT imaging speed. We achieved an effective 800,000 A-scans/s imaging speed using a 100,000 Hz tunable vertical cavity surface-emitting laser (VCSEL). A sensitivity of 94.6 dB and a roll-off of < 2 dB over ~30 mm imaging depth were measured from a single channel in the prototype SDM-OCT system. An axial resolution of ~11 μm in air (or ~8.3 μm in tissue) was achieved throughout the entire depth range. An in vivo, 3D SDM-OCT volume of an entire Drosophila larva consisting of 400 x 605 A-scans was acquired in 0.37 seconds. Synchronized cross-sectional OCT imaging of three different segments of a beating Drosophila larva heart is demonstrated. The SDM technology provides a new orthogonal dimension for further speed improvement for OCT with favorable cost scaling. SDM-OCT also preserves image resolution and allows synchronized cross-sectional and three-dimensional (3D) imaging of biological samples, enabling new biomedical applications.

Miniature spectrometer and beam splitter for an optical coherence tomography on a silicon chip

Optical coherence tomography (OCT) has enabled clinical applications that revolutionized in vivo medical diagnostics. Nevertheless, its current limitations owing to cost, size, complexity, and the need for accurate alignment must be overcome by radically novel approaches. Exploiting integrated optics, we assemble the central components of a spectral-domain OCT system on a silicon chip. The spectrometer comprises an arrayed-waveguide grating with 136-nm free spectral range and 0.21-nm wavelength resolution. The beam splitter is realized by a non-uniform adiabatic coupler with its 3-dB splitting ratio being nearly constant over 150 nm. With this device whose overall volume is 0.36 cm(3) we demonstrate high-quality in vivo imaging in human skin with 1.4-mm penetration depth, 7.5-µm axial resolution, and a signal-to-noise ratio of 74 dB. Considering the reasonable performance of this early OCT on-a-chip system and the anticipated improvements in this technology, a completely different range of devices and new fields of applications may become feasible.

Multi-MHz retinal OCT

We analyze the benefits and problems of in vivo optical coherence tomography (OCT) imaging of the human retina at A-scan rates in excess of 1 MHz, using a 1050 nm Fourier-domain mode-locked (FDML) laser. Different scanning strategies enabled by MHz OCT line rates are investigated, and a simple multi-volume data processing approach is presented. In-vivo OCT of the human ocular fundus is performed at different axial scan rates of up to 6.7 MHz. High quality non-mydriatic retinal imaging over an ultra-wide field is achieved by a combination of several key improvements compared to previous setups. For the FDML laser, long coherence lengths and 72 nm wavelength tuning range are achieved using a chirped fiber Bragg grating in a laser cavity at 419.1 kHz fundamental tuning rate. Very large data sets can be acquired with sustained data transfer from the data acquisition card to host computer memory, enabling high-quality averaging of many frames and of multiple aligned data sets. Three imaging modes are investigated: Alignment and averaging of 24 data sets at 1.68 MHz axial line rate, ultra-dense transverse sampling at 3.35 MHz line rate, and dual-beam imaging with two laser spots on the retina at an effective line rate of 6.7 MHz.