Continuous spectral zooming for in vivo live 4D-OCT with MHz A-scan rates and long coherence

Intraoperative Fast Adaptive Focus Tracking Robotic OCT Enables Real-Time Tumor Grading and Large-Area Microvascular Imaging in Human Spinal Cord Surgery

Current surgical procedures for spinal cord tumors lack in vivo high-resolution multifunctional imaging systems, hindering precise tumor resection. This study introduces the fast adaptive focus tracking robotic optical coherence tomography (FACT-ROCT) system, which provides real-time, artifact-free imaging during surgery, addressing motion artifacts and resolution degradation. Imaging occurs in 22 patients, including 13 with gliomas (WHO grade I-IV). This represents the first in situ OCT imaging of human spinal cord tumors, enabling the differentiation of tumor types in real-time. The standard deviation of the attenuation coefficient serves as a physical marker, achieving 90.2%  ±  2.7% accuracy in distinguishing high- from low-grade gliomas intraoperatively at a threshold of 0.75  ±  0.01 mm-1. FACT-ROCT also enables microvascular imaging, covering areas of 70 mm × 13 mm × 10 mm within 2 min and revealing greater vascular tortuosity in higher-grade tumors. This extensive imaging capability provides critical information that guides surgical strategies, enhancing surgical outcomes. Overall, FACT-ROCT represents a significant advancement in intraoperative imaging, offering high-resolution, high-speed, and comprehensive insights into spinal cord tumor structure and vasculature.

Microscope integrated MHz optical coherence tomography system for neurosurgery: development and clinical in-vivo imaging

Neurosurgical interventions on the brain are impeded by the requirement to keep damages to healthy tissue at a minimum. A new contrast channel enhancing the visual separation of malign tissue should be created. A commercially available surgical microscope was modified with adaptation optics adapting the MHz speed optical coherence tomography (OCT) imaging system developed in our group. This required the design of a scanner optics and beam delivery system overcoming constraints posed by the mechanical and optical parameters of the microscope. High quality volumetric OCT C-scans with dense sample spacing can be acquired in-vivo as part of surgical procedures within seconds and are immediately available for post-processing.

Multiple scattering suppression for in vivo optical coherence tomography measurement using the B-scan-wise multi-focus averaging method

We demonstrate a method that reduces the noise caused by multi-scattering (MS) photons in an in vivo optical coherence tomography image. This method combines a specially designed image acquisition (i.e., optical coherence tomography scan) scheme and subsequent complex signal processing. For the acquisition, multiple cross-sectional images (frames) are sequentially acquired while the depth position of the focus is altered for each frame by an electrically tunable lens. In the signal processing, the frames are numerically defocus-corrected, and complex averaged. Because of the inconsistency in the MS-photon trajectories among the different electrically tunable lens-induced defocus, this averaging reduces the MS signal. Unlike the previously demonstrated volume-wise multi-focus averaging method, our approach requires the sample to remain stable for only a brief period, approximately 70 ms, thus making it compatible with in vivo imaging. This method was validated using a scattering phantom and in vivo unanesthetized small fish samples, and was found to reduce MS noise even for unanesthetized in vivo measurement.

Large area robotically assisted optical coherence tomography (LARA-OCT)

We demonstrate large-area robotically assisted optical coherence tomography (LARA-OCT), utilizing a seven-degree-of-freedom robotic arm in conjunction with a 3.3 MHz swept-source OCT to raster scan samples of arbitrary shape. By combining multiple fields of view (FOV), LARA-OCT can probe a much larger area than conventional OCT. Also, nonplanar and curved surfaces like skin on arms and legs can be probed. The lenses in the LARA-OCT scanner with their normal FOV can have fewer aberrations and less complex optics compared to a single wide field design. This may be especially critical for high resolution scans. We directly use our fast MHz-OCT for tracking and stitching, making additional machine vision systems like cameras, positioning, tracking or navigation devices obsolete. This also eliminates the need for complex coordinate system registration between OCT and the machine vision system. We implemented a real time probe-to-surface control that maintains the probe alignment orthogonal to the sample by only using surface information from the OCT images. We present OCT data sets with volume sizes of 140 × 170 × 20 mm3, captured in 2.5 minutes.

ATN-Res2Unet: an advanced deep learning network for the elimination of saturation artifacts in endoscopy optical coherence tomography

Endoscopic optical coherence tomography (OCT) possesses the capability to non-invasively image internal lumens; however, it is susceptible to saturation artifacts arising from robust reflective structures. In this study, we introduce an innovative deep learning network, ATN-Res2Unet, designed to mitigate saturation artifacts in endoscopic OCT images. This is achieved through the integration of multi-scale perception, multi-attention mechanisms, and frequency domain filters. To address the challenge of obtaining ground truth in endoscopic OCT, we propose a method for constructing training data pairs. Experimental in vivo data substantiates the effectiveness of ATN-Res2Unet in reducing diverse artifacts while preserving structural information. Comparative analysis with prior studies reveals a notable enhancement, with average quantitative indicators increasing by 45.4-83.8%. Significantly, this study marks the inaugural exploration of leveraging deep learning to eradicate artifacts from endoscopic OCT images, presenting considerable potential for clinical applications.

High-resolution rectoscopy using MHz optical coherence tomography: a step towards real time 3D endoscopy

Colonoscopy and endoscopic ultrasound play pivotal roles in the assessment of rectal diseases, especially rectal cancer and inflammatory bowel diseases. Optical coherence tomography (OCT) offers a superior depth resolution, which is a critical factor for individualizing the therapeutic concept and evaluating the therapy response. We developed two distinct rectoscope prototypes, which were integrated into a 1300 nm MHz-OCT system constructed at our facility. The rapid rotation of the distal scanning probe at 40,000 revolutions per minute facilitates a 667 Hz OCT frame rate, enabling real-time endoscopic imaging of large areas. The performance of these OCT-rectoscopes was assessed in an ex vivo porcine colon and a post mortem human in-situ colon. The OCT-rectoscope consistently distinguished various layers of the intestinal wall, identified gut-associated lymphatic tissue, and visualized a rectal polyp during the imaging procedure with 3D-reconstruction in real time. Subsequent histological examination confirmed these findings. The body donor was preserved using an ethanol-glycerol-lysoformin-based technique for true-to-life tissue consistency. We could demonstrate that the novel MHZ-OCT-rectoscope effectively discriminates rectal wall layers and crucial tissue characteristics in a post mortem human colon in-situ. This real-time-3D-OCT holds promise as a valuable future diagnostic tool for assessing disease state and therapy response on-site in rectal diseases.

Virtual Hall sensor triggered multi-MHz endoscopic OCT imaging for stable real-time visualization

Circumferential scanning in endoscopic imaging is crucial across various disciplines, and optical coherence tomography (OCT) is often the preferred choice due to its high-speed, high-resolution, and micron-scale imaging capabilities. Moreover, real-time and high-speed 3D endoscopy is a pivotal technology for medical screening and precise surgical guidance, among other applications. However, challenges such as image jitter and non-uniform rotational distortion (NURD) are persistent obstacles that hinder real-time visualization during high-speed OCT procedures. To address this issue, we developed an innovative, low-cost endoscope that employs a brushless DC motor for scanning, and a sensorless technique for triggering and synchronizing OCT imaging with the scanning motor. This sensorless approach uses the motor's electrical feedback (back electromotive force, BEMF) as a virtual Hall sensor to initiate OCT image acquisition and synchronize it with a Fourier Domain Mode-Locked (FDML)-based Megahertz OCT system. Notably, the implementation of BEMF-triggered OCT has led to a substantial reduction in image jitter and NURD (<4 mrad), thereby opening up a new window for real-time visualization capabilities. This approach suggests potential benefits across various applications, aiming to provide a more accurate, deployable, and cost-effective solution. Subsequent studies can explore the adaptability of this system to specific clinical scenarios and its performance under practical endoscopic conditions.

High-speed k-linear swept laser using acousto-optic deflectors with Doppler shift compensation for optical coherence tomography

Swept laser based on the acousto-optic deflector (AOD) is a promising swept source in optical coherence tomography (OCT) applications for its high wavenumber linear sweep without mechanical motion. However, the poor coherence length and the elongated cavity of the laser imposed limitations on the acquisition of high-quality images with adequate imaging depth and high imaging speed. In this Letter, we demonstrate a compact high-speed wavenumber linear swept laser based on AOD using Doppler shift compensation, achieving a high linearity of Pearson's R of 0.999991, a duty cycle of ∼100%, an extended coherence length of 5.7 mm, an output power of 18 mW, and excellent phase stability at a sweep speed of 500 kHz. OCT structural images with a system sensitivity of 103.2 dB and OCT angiography (OCTA) of human palm in vivo have been successfully performed, serving as a compelling demonstration of the excellent performance of this swept laser. We believe that the proposed laser will be of high potential in various clinical and industrial applications in the future.

828 kHz retinal imaging with an 840 nm Fourier domain mode locked laser

This paper presents a Fourier domain mode locked (FDML) laser centered around 840 nm. It features a bidirectional sweep repetition rate of 828 kHz and a spectral bandwidth of 40 nm. An axial resolution of ∼9.9 µm in water and a 1.4 cm sensitivity roll-off are achieved. Utilizing a complex master-slave (CMS) recalibration method and due to a sufficiently high sensitivity of 84.6 dB, retinal layers of the human eye in-vivo can be resolved during optical coherence tomography (OCT) examination. The developed FDML laser enables acquisition rates of 3D-volumes with a size of 200 × 100 × 256 voxels in under 100 milliseconds. Detailed information on the FDML implementation, its challenging design tasks, and OCT images obtained with the laser are presented in this paper.

Optical coherence elastography and its applications for the biomechanical characterization of tissues

The biomechanical characterization of the tissues provides significant evidence for determining the pathological status and assessing the disease treatment. Incorporating elastography with optical coherence tomography (OCT), optical coherence elastography (OCE) can map the spatial elasticity distribution of biological tissue with high resolution. After the excitation with the external or inherent force, the tissue response of the deformation or vibration is detected by OCT imaging. The elastogram is assessed by stress-strain analysis, vibration amplitude measurements, and quantification of elastic wave velocities. OCE has been used for elasticity measurements in ophthalmology, endoscopy, and oncology, improving the precision of diagnosis and treatment of disease. In this article, we review the OCE methods for biomechanical characterization and summarize current OCE applications in biomedicine. The limitations and future development of OCE are also discussed during its translation to the clinic.