In vivo ultrahigh-resolution optical coherence tomography

Visualization of CO2 electrolysis using optical coherence tomography

Electrolysers offer an appealing technology for conversion of CO2 into high-value chemicals. However, there are few tools available to track the reactions that occur within electrolysers. Here we report an electrolysis optical coherence tomography platform to visualize the chemical reactions occurring in a CO2 electrolyser. This platform was designed to capture three-dimensional images and videos at high spatial and temporal resolutions. We recorded 12 h of footage of an electrolyser containing a porous electrode separated by a membrane, converting a continuous feed of liquid KHCO3 to reduce CO2 into CO at applied current densities of 50-800 mA cm-2. This platform visualized reactants, intermediates and products, and captured the strikingly dynamic movement of the cathode and membrane components during electrolysis. It also linked CO production to regions of the electrolyser in which CO2 was in direct contact with both membrane and catalyst layers. These results highlight how this platform can be used to track reactions in continuous flow electrochemical reactors.

Multi-shaping sparse-continuous reconstruction for an optical coherence tomography sidelobe suppression

Optical coherence tomography (OCT) images are commonly affected by sidelobe artifacts due to spectral non-uniformity and spectral leakage. Conventional frequency domain spectral shaping methods widen the mainlobe and compromise axial resolution. While image-domain deconvolution techniques can address the trade-off between axial resolution and artifact suppression, their reconstruction quality relies on accurate measurement or estimation of system point spread function (PSF). Inaccurate PSF estimation leads to loss of details in the reconstructed images. In this Letter, we introduce multi-shaping sparse-continuous reconstruction (MSSCR) for an OCT image, a novel, to the best of our knowledge, framework that combines spectral multi-shaping and iterative image reconstruction with sparse-continuous priors. The MSSCR achieves sidelobe suppression without requiring any PSF measurement or estimation and effectively preserving the axial resolution. The experimental results demonstrate that the MSSCR achieves sidelobe suppression of more than 8 dB. We believe that the MSSCR holds potential for addressing sidelobe artifacts in OCT.

Physical compensation method for dispersion of multiple materials in swept source optical coherence tomography

An ophthalmic swept source-optical coherence tomography (SS-OCT) system based on a high-speed scanning laser at 1060 nm with a scanning rate of 100 KHz is constructed. Since the sample arm of the interferometer is comprised of multiple glass materials, the ensuing dispersion severely degrades imaging quality. In this article, second-order dispersion simulation analysis for various materials was performed first, and dispersion equilibrium was implemented utilizing physical compensation methods. After dispersion compensation, an imaging depth in air of 4.013 mm was achieved in model eye experiments, and signal-to-noise ratio was enhanced by 11.6%, with a value of 53.8 dB. In vivo imaging of the human retina was performed to demonstrate structurally distinguishable retinal images, characterized by an axial resolution improvement of 19.8%, with a value of 7.7 μm close to the theoretical value of 7.5 μm. The proposed physical dispersion compensation method enhances imaging performance in SS-OCT systems, enabling visualization of several low scattering mediums.

Line-field confocal optical coherence tomography coupled with artificial intelligence algorithms to identify quantitative biomarkers of facial skin ageing

Quantitative biomarkers of facial skin ageing were studied from one hundred healthy Caucasian female volunteers, aged 20-70 years, using in vivo 3D Line-field Confocal Optical Coherence Tomography (LC-OCT) imaging coupled with Artificial Intelligence (AI)-based quantification algorithms. Layer metrics, i.e. stratum corneum thickness (SC), viable epidermal thickness and Dermal-Epidermal Junction (DEJ) undulation, as well as cellular metrics were measured for the temple, cheekbone and mandible. For all three investigated facial areas, minimal age-related variations were observed in the thickness of the SC and viable epidermis layers. A flatter and more homogeneous epidermis (decrease in the standard deviation of the number of layers means), a less dense cellular network with fewer cells per layer (decrease in cell surface density), and larger and more heterogeneous nuclei within each layer (increase in nuclei volume and their standard deviation) were found with significant variations with age. The higher atypia scores further reflected the heterogeneity of nuclei throughout the viable epidermis. The 3D visualisation of fine structures in the skin at the micrometric resolution and the 1200 µm × 500 µm field of view achieved with LC-OCT imaging enabled to compute relevant quantitative biomarkers for a better understanding of skin biology and the ageing process in vivo.

Visible-light optical coherence tomography platform for the characterization of the skin barrier

We demonstrate a free-space, trolley-mountable Fourier domain visible-light optical coherence tomography (OCT) system for studying the stratum corneum in non-palmar human skin. An axial resolution of 1 µm in tissue and at least -75 dB sensitivity have been achieved. High-quality B-scans, containing 1600 A-scans, are acquired at a rate of 39 Hz. Images from the dorsal hand, ventral wrist and ventral forearm areas are obtained, with a clearly resolved stratum corneum layer (typically 5-15 µm thick) presenting as a hypoechogenic dark layer below the bright entrance signal, similar to that found in palmar skin with traditional OCT systems. We find that the appearance of the stratum corneum layer strongly depends on its water content, becoming brighter after occlusive hydration.

Advancing full-field metrology: rapid 3D imaging with geometric phase ferroelectric liquid crystal technology in full-field optical coherence microscopy

Optical coherence microscopy (OCM) is a variant of OCT in which a high-numerical aperture lens is used. Full-field OCM (FF-OCM) is an emerging non-invasive, label-free, interferometric technique for imaging of surface structures or semi-transparent biomedical subjects with micron-scale resolutions. Different approaches to three dimensional full-field optical metrology are reviewed. The usual method for the phase-shifting technique in FF-OCM involves mechanically moving a mirror to change the optical path difference for obtaining en-face OCM images. However, with the use of a broadband source in FF-OCM, the phase shifts of different spectral components are not the same, resulting in the ambiguities in 3D image reconstruction. In this study, we demonstrate, by imaging tissues and cells, a unique geometric phase-shifter based on ferroelectric liquid crystal technology, to realize achromatic phase-shifting for rapid three-dimensional imaging in a FF-OCM system.

Phase retardation and corneal sublayer thickness repeatability using ultrahigh-resolution polarization-sensitive OCT

PURPOSE

To assess phase retardation and corneal sublayer thickness repeatability using ultrahigh-resolution polarization-sensitive optical coherence tomography (PS-OCT).

SETTING

Narayana Nethralaya Eye Hospital, Bangalore.

DESIGN

Observational.

METHODS

In this study, all eyes were imaged using a custom-built ultrahigh-resolution PS-OCT and high-resolution hybrid OCT (MS-39). The repeatability of phase retardation en face maps and corneal sublayer thickness profiles was evaluated. The reflectivity and phase retardation were calculated from the 2 orthogonal polarization channels to generate en face maps of phase retardation and corneal sublayer thicknesses. 3 consecutive measurements of all participants were acquired for each eye. For each measurement, the participant was asked to sit back and was realigned again. The repeatability was assessed using the intraclass correlation coefficient (ICC).

RESULTS

The study included 20 healthy eyes of 20 participants. The phase retardation en face maps showed preferential arrangement of collagen fibrils with least retardation in the apex and maximum retardation in the periphery. The phase retardation showed excellent repeatability (ICC >0.95) in all zones. The Bowman layer and stromal layer thicknesses were measured with excellent repeatability (ICC >0.93 and >0.99, respectively). Significant differences ( P < .05) in stromal layer thickness were observed between MS-39 and PS-OCT. The repeatability of epithelial thickness measurements was better with PS-OCT than MS-39.

CONCLUSIONS

The combinational assessment of corneal birefringence and sublayer thicknesses shows the advanced potential of ultrahigh-resolution PS-OCT in routine clinical practice over current OCT devices.

Hyperreflective Membrane at the Vitreoretinal Interface in Diabetic Macular Edema: A Finding in Ultra-High-Resolution Optical Coherence Tomography

Purpose

Detecting subtle vitreoretinal interface (VRI) findings, such as a posterior hyaloid membrane, is difficult with conventional retinal imaging. We compared ultra-high-resolution spectral domain optical coherence tomography (UHR-SD-OCT) with standard-resolution OCT (SD-OCT) for the imaging of VRI abnormalities in diabetic retinopathy (DR).

Methods

This prospective cross-sectional study included 113 consecutive patients (91 patients with diabetes and 22 healthy controls). The VRI was evaluated, and the results were compared between the conventional SD-OCT and UHR-SD-OCT images. VRI findings were also investigated before and after internal limiting membrane peeling during vitrectomy for proliferative DR.

Results

A total of 159 eyes (87.4%) of 91 patients with diabetes were analyzed. UHR-SD-OCT could detect a hyperreflective layer at the VRI, in which en face OCT showed a membrane-like structure, termed the hyperreflective membrane (HRMe). The preoperative HRMe could not be detected in all patients with proliferative DR who underwent internal limiting membrane peeling during vitrectomy. Although the HRMe did not correlate with the DR stage, eyes with diabetic macular edema (DME) (64.5%) showed a significant HRMe with UHR-SD-OCT more frequently than those without DME (35.8%) (P = 0.005).

Conclusions

UHR-SD-OCT can detect the HRMe at the VRI in DR eyes, particularly in eyes with DME. The HRMe may present a thickened posterior hyaloid membrane that contributes to DME development.

Translational Relevance

UHR-SD-OCT detects slight changes in the VRI in DR eyes. In the future, it may help to elucidate the mechanism of DME formation.

Magnetic Field-Modulated Plasmonic Scattering of Hybrid Nanorods for FFT-Weighted OCT Imaging in NIR-II

We report a method for fast Fourier transform (FFT)-weighted optical coherence tomography (OCT) in the second biological tissue transparency window by actively modulating the plasmonic scattering of Fe₃O₄@Au hybrid nanorods using magnetic fields. Instead of tracking the nanoparticles' lateral displacement in conventional magnetomotive OCT imaging, we monitor the nanorod rotation and optical signal changes under an alternating magnetic field in real time. The coherent rotation of the nanorods with the field produces periodic OCT signals, and the FFT is then used to convert the periodic OCT signals in the time domain to a single peak in the frequency domain. This allows automatic screening of nanorod signals from the random biological noises and reconstruction of FFT-weighted images using a computer program based on a time-sequence image set. Compared with conventional magnetomotive OCT, the FFT-weighted imaging technique creates enhanced OCT images with dB-scale contrast over an order of magnitude higher than the original images.

Ultra-broadband wavelength-swept Ti:sapphire crystal fiber laser

An ultra-broadband wavelength-swept laser (WSL) was generated using glass-clad Ti:sapphire crystal fiber as the gain media. Due to the low signal propagation loss of the crystal fiber, the swept laser has a tuning bandwidth of 250 nm (i.e., 683 nm to 933 nm) at a repetition rate of 1200 Hz. The steady-state and pulsed dynamics of the WSL were analyzed. The 0.018-nm instantaneous linewidth corresponds to a 3-dB coherence roll-off of 7 mm. When using the laser for swept-source optical coherence tomography, an estimated axial resolution of 1.8 µm can be achieved.

Convolutional dictionary learning for blind deconvolution of optical coherence tomography images

In this study, we demonstrate a sparsity-regularized, complex, blind deconvolution method for removing sidelobe artefacts and stochastic noise from optical coherence tomography (OCT) images. Our method estimates the complex scattering amplitude of tissue on a line-by-line basis by estimating and deconvolving the complex, one-dimensional axial point spread function (PSF) from measured OCT A-line data. We also present a strategy for employing a sparsity weighting mask to mitigate the loss of speckle brightness within tissue-containing regions caused by the sparse deconvolution. Qualitative and quantitative analyses show that this approach suppresses sidelobe artefacts and background noise better than traditional spectral reshaping techniques, with negligible loss of tissue structure. The technique is particularly useful for emerging OCT applications where OCT images contain strong specular reflections at air-tissue boundaries that create large sidelobe artefacts.

Non-Destructive Techniques for the Condition and Structural Health Monitoring of Wind Turbines: A Literature Review of the Last 20 Years

A complete surveillance strategy for wind turbines requires both the condition monitoring (CM) of their mechanical components and the structural health monitoring (SHM) of their load-bearing structural elements (foundations, tower, and blades). Therefore, it spans both the civil and mechanical engineering fields. Several traditional and advanced non-destructive techniques (NDTs) have been proposed for both areas of application throughout the last years. These include visual inspection (VI), acoustic emissions (AEs), ultrasonic testing (UT), infrared thermography (IRT), radiographic testing (RT), electromagnetic testing (ET), oil monitoring, and many other methods. These NDTs can be performed by human personnel, robots, or unmanned aerial vehicles (UAVs); they can also be applied both for isolated wind turbines or systematically for whole onshore or offshore wind farms. These non-destructive approaches have been extensively reviewed here; more than 300 scientific articles, technical reports, and other documents are included in this review, encompassing all the main aspects of these survey strategies. Particular attention was dedicated to the latest developments in the last two decades (2000-2021). Highly influential research works, which received major attention from the scientific community, are highlighted and commented upon. Furthermore, for each strategy, a selection of relevant applications is reported by way of example, including newer and less developed strategies as well.

Integrated deep learning framework for accelerated optical coherence tomography angiography

Label-free optical coherence tomography angiography (OCTA) has become a premium imaging tool in clinics to obtain structural and functional information of microvasculatures. One primary technical drawback for OCTA, however, is its imaging speed. The current protocols require high sampling density and multiple acquisitions of cross-sectional B-scans to form one image frame, resulting in low acquisition speed. Recently, deep learning (DL)-based methods have gained attention in accelerating the OCTA acquisition process. They achieve faster acquisition using two independent reconstructing approaches: high-quality angiograms from a few repeated B-scans and high-resolution angiograms from undersampled data. While these approaches have shown promising results, they provide limited solutions that only partially account for the OCTA scanning mechanism. Herein, we propose an integrated DL method to simultaneously tackle both factors and further enhance the reconstruction performance in speed and quality. We designed an end-to-end deep neural network (DNN) framework with a two-staged adversarial training scheme to reconstruct fully-sampled, high-quality (8 repeated B-scans) angiograms from their corresponding undersampled, low-quality (2 repeated B-scans) counterparts by successively enhancing the pixel resolution and the image quality. Using an in-vivo mouse brain vasculature dataset, we evaluate our proposed framework through quantitative and qualitative assessments and demonstrate that our method can achieve superior reconstruction performance compared to the conventional means. Our DL-based framework can accelerate the OCTA imaging speed from 16 to 256[Formula: see text] while preserving the image quality, thus enabling a convenient software-only solution to enhance preclinical and clinical studies.

Control of Surface Plasmon Resonance in Silver Nanocubes by CEP-Locked Laser Pulse

Localized surface plasmon resonance (LSPR) of metal nanoparticles has attracted increasing attention in surface-enhanced Raman scattering, chemical and biological sensing applications. In this article, we calculate the optical extinction spectra of a silver nanocube driven by an ultrashort carrier envelope phase (CEP)-locked laser pulse. Five LSPR modes are clearly excited in the optical spectra. We analyze the physical origin of each mode from the charge distribution on different parts of the cubic particle and the dipole and quadrupole excitation features at the LSPR peaks. The charge distribution follows a simple rule that when the charge concentrates from the face to the corners of the cubic particle, the resonant wavelength red-shifts. Then we modulate the LSPR spectra by changing CEP. The results show that CEP has selective plasmon mode excitation functionality and can act as a novel modulation role on LSPR modes. Our work suggests a novel means to regulate LSPR modes and the corresponding optical properties of metal nanoparticles via various freedoms of controlled optical field, which can be useful for optimized applications in chemical and biological sensors, single molecule detection, and so on.

Three-dimensional dynamics optical coherence tomography for tumor spheroid evaluation

We present a completely label-free three-dimensional (3D) optical coherence tomography (OCT)-based tissue dynamics imaging method for visualization and quantification of the metabolic and necrotic activities of tumor spheroid. Our method is based on a custom 3D scanning protocol that is designed to capture volumetric tissue dynamics tomography images only in a few tens of seconds. The method was applied to the evaluation of a tumor spheroid. The time-course viability alteration and anti-cancer drug response of the spheroid were visualized qualitatively and analyzed quantitatively. The similarity between the OCT-based dynamics images and fluorescence microscope images was also demonstrated.

Toward a clinical optoretinogram: a review of noninvasive, optical tests of retinal neural function

The past few years have witnessed rapid development of the optoretinogram—a noninvasive, optical measurement of neural function in the retina, and especially the photoreceptors (Ph). While its recent development has been rapid, it represents the culmination of hundreds of experiments spanning decades. Early work showed measurable and reproducible changes in the optical properties of retinal explants and suspensions of Ph, and uncovered some of the biophysical and biochemical mechanisms underlying them. That work thus provided critical motivation for more recent work based on clinical imaging platforms, whose eventual goal is the improvement of ophthalmic care and streamlining the discovery of novel therapeutics. The first part of this review consists of a selective summary of the early work, and identifies four kinds of stimulus-evoked optical signals that have emerged from it: changes in light scattered from the membranous discs of the Ph’s outer segment (OS), changes in light scattered by the front and back boundaries of the OS, rearrangement of scattering material in and near the OS, and changes in the OS length. In the past decade, all four of these signals have continued to be investigated using imaging systems already used in the clinic or intended for clinical and translational use. The second part of this review discusses these imaging modalities, their potential to detect and quantify the signals of interest, and other factors influencing their translational promise. Particular attention is paid to phase-sensitive optical coherence tomography (OCT) with adaptive optics (AO), a method in which both the amplitude and the phase of light reflected from individual Ph is monitored as visible stimuli are delivered to them. The record of the light’s phase is decoded to reveal a reproducible pattern of deformation in the OS, while the amplitude reveals changes in scattering and structural rearrangements. The method has been demonstrated in a few labs and has been used to measure responses from both rods and cones. With the ability to detect responses to stimuli isomerizing less than 0.01% of photopigment, this technique may prove to be a quick, noninvasive, and objective way to measure subtle disease-related dysfunction at the cellular level, and thus to provide an entirely new and complementary biomarker for retinal disease and recovery.

Intensity correlation OCT is a classical mimic of quantum OCT providing up to twofold resolution improvement

Quantum Optical Coherence Tomography (Q-OCT) uses quantum properties of light to provide several advantages over its classical counterpart, OCT: it achieves a twice better axial resolution with the same spectral bandwidth and it is immune to even orders of dispersion. Since these features are very sought-after in OCT imaging, many hardware and software techniques have been created to mimic the quantum behaviour of light and achieve these features using traditional OCT systems. The most recent, purely algorithmic scheme—an improved version of Intensity Correlation Spectral Domain OCT named ICA-SD-OCT—showed even-order dispersion cancellation and reduction of artefacts. The true capabilities of this method were unfortunately severely undermined, both in terms of its relation to Q-OCT and its main performance parameters. In this work, we provide experimental demonstrations as well as numerical and analytical arguments to show that ICA-SD-OCT is a true classical equivalent of Q-OCT, more specifically its Fourier domain version, and therefore it enables a true two-fold axial resolution improvement. We believe that clarification of all the misconceptions about this very promising algorithm will highlight the great value of this method for OCT and consequently lead to its practical applications for resolution- and quality-enhanced OCT imaging.

Review of Current Advances in the Mechanical Description and Quantification of Aortic Dissection Mechanisms

Aortic dissection is a life-threatening event associated with a very poor outcome. A number of complex phenomena are involved in the initiation and propagation of the disease. Advances in the comprehension of the mechanisms leading to dissection have been made these last decades, thanks to improvements in imaging and experimental techniques. However, the micro-mechanics involved in triggering such rupture events remains poorly described and understood. It constitutes the primary focus of the present review. Towards the goal of detailing the dissection phenomenon, different experimental and modeling methods were used to investigate aortic dissection, and to understand the underlying phenomena involved. In the last ten years, research has tended to focus on the influence of microstructure on initiation and propagation of the dissection, leading to a number of multiscale models being developed. This review brings together all these materials in an attempt to identify main advances and remaining questions.

Preclinical techniques to investigate exercise training in vascular pathophysiology

Atherosclerosis is a dynamic process starting with endothelial dysfunction and inflammation and eventually leading to life-threatening arterial plaques. Exercise generally improves endothelial function in a dose-dependent manner by altering hemodynamics, specifically by increased arterial pressure, pulsatility, and shear stress. However, athletes who regularly participate in high-intensity training can develop arterial plaques, suggesting alternative mechanisms through which excessive exercise promotes vascular disease. Understanding the mechanisms that drive atherosclerosis in sedentary versus exercise states may lead to novel rehabilitative methods aimed at improving exercise compliance and physical activity. Preclinical tools, including in vitro cell assays, in vivo animal models, and in silico computational methods, broaden our capabilities to study the mechanisms through which exercise impacts atherogenesis, from molecular maladaptation to vascular remodeling. Here, we describe how preclinical research tools have and can be used to study exercise effects on atherosclerosis. We then propose how advanced bioengineering techniques can be used to address gaps in our current understanding of vascular pathophysiology, including integrating in vitro, in vivo, and in silico studies across multiple tissue systems and size scales. Improving our understanding of the antiatherogenic exercise effects will enable engaging, targeted, and individualized exercise recommendations to promote cardiovascular health rather than treating cardiovascular disease that results from a sedentary lifestyle.

Optical Coherence Tomography for Ophthalmology Imaging

Optical coherence tomography (OCT) is a depth-resolved imaging modality, which is able to achieve micrometer-scale resolution within biological tissue noninvasively. In the past 30 years, researchers all around the world had made several essential efforts on techniques relevant to OCT. OCT has become a routine process for eye diseases with different types. In this chapter, the three important stages in the development of OCT are briefly illustrated, including the time domain OCT (TD-OCT), the frequency domain OCT (FD-OCT) and the optical coherence tomography angiography (OCTA). Each of the technique has made great progress for use on living human eye imaging in clinical applications. TD-OCT was first proposed and commercialized, which is able to achieve acceptable 2D depth-resolved cross-sectional images of human retina in vivo. FD-OCT was the upgraded OCT technique compared with TD-OCT. By capturing the coherent signal within the Fourier space, the FD-OCT could improve the image sensitivity compared with TD-OCT, and achieve dozens of kilo hertz imaging speed. OCTA is the newest developments of OCT technique, which is able to visualize the micro vasculature networks of human retina in vivo. With OCTA technique, the newest ophthalmologic OCT system is able to achieve detailed diagnosis for both micro-structure and vasculature abnormalities for clinical applications. The further development of OCT technique on imaging speed, contrast, resolution, field of view, and so on will make OCT to be a more powerful tool for clinical usages.

Spectrally sparse optical coherence tomography

Swept-source optical coherence tomography (OCT) typically relies on expensive and complex swept-source lasers, the cost of which currently limits the suitability of OCT for new applications. In this work, we demonstrate spectrally sparse OCT utilizing randomly spaced low-bandwidth optical chirps, suitable for low-cost implementation with telecommunications grade devices. Micron scale distance estimation accuracy with a resolution of 40 μm at a standoff imaging distance greater than 10 cm is demonstrated using a stepped chirp approach with approximately 23% occupancy of 4 THz bandwidth. For imaging of sparse scenes, comparable performance to full bandwidth occupancy is verified for metallic targets.

Effect of spectral leakage on the image formation of Fourier-domain optical coherence tomography

We report on the investigation of spectral leakage's impact on the reconstruction of Fourier-domain optical coherence tomography (FD-OCT). We discuss the shift-variant nature introduced by the spectral leakage and develop a novel spatial-domain FD-OCT image formation model. A proof-of-concept phantom experiment is conducted to validate our model. Compared with previous models, the proposed framework could better describe the image formation process, especially when the fineness of the axial structure approaches the theoretical resolution limit.

Line-field confocal optical coherence tomography for three-dimensional skin imaging

This paper reports on the latest advances in line-field confocal optical coherence tomography (LC-OCT), a recently invented imaging technology that now allows the generation of either horizontal (x × y) section images at an adjustable depth or vertical (x × z) section images at an adjustable lateral position, as well as three-dimensional images. For both two-dimensional imaging modes, images are acquired in real-time, with real-time control of the depth and lateral positions. Three-dimensional (x × y × z) images are acquired from a stack of horizontal section images. The device is in the form of a portable probe. The handle of the probe has a button and a scroll wheel allowing the user to control the imaging modes. Using a supercontinuum laser as a broadband light source and a high numerical microscope objective, an isotropic spatial resolution of ∼1 µm is achieved. The field of view of the three-dimensional images is 1.2 mm × 0.5 mm × 0.5 mm (x × y × z). Images of skin tissues are presented to demonstrate the potential of the technology in dermatology.

Fourier domain quantum optical coherence tomography

Quantum optical coherence tomography (Q-OCT) is the non-classical counterpart of optical coherence tomography (OCT), a high-resolution 3D imaging technique based on white-light interferometry. Because Q-OCT uses a source of frequency-entangled photon pairs, not only is the axial resolution not affected by dispersion mismatch in the interferometer but is also inherently improved by a factor of two. Unfortunately, practical applications of Q-OCT are hindered by image-scrambling artefacts and slow acquisition times. Here, we present a theoretical analysis of a novel approach that is free of these problems: Fourier domain Q-OCT (Fd-Q-OCT). Based on a photon pair coincidence detection as in the standard Q-OCT configuration, it also discerns each photon pair by their wavelength. We show that all the information about the internal structures of the object is encoded in the joint spectrum and can be easily retrieved through Fourier transformation. No depth scanning is required, making our technique potentially faster than standard Q-OCT. Finally, we show that the data available in the joint spectrum enables artefact removal and discuss prospective algorithms for doing so.

Retinal choroidal vessel imaging based on multi-wavelength fundus imaging with the guidance of optical coherence tomography

A multispectral fundus camera (MSFC), as a novel noninvasive technology, uses an extensive range of monochromatic light sources that enable the view of different sectional planes of the retinal and choroidal structures. However, MSFC imaging involves complex processes affected by various factors, and the recognized theory based on light absorption above the choroid is not sufficient. In an attempt to supplement the relevant explanations, in this study, we used optical coherence tomography (OCT), a three-dimensional tomography modality, to analyze MSFC results at the retina and choroid. The swept-source OCT system at 1060 nm wavelength with a 200 kHz A-scan rate and an MSFC with 11 bands at 470 to 845 nm are employed. A quantitative evaluation procedure is proposed to compare MSFC and OCT en face images. The comparative study shows that 1) the MSFC images with the illumination wavelength of less than 605 nm could mainly provide the retinal structure information; 2) Relative choroidal layer thickness information could be inferred from the MSFC images, especially the image acquiring under the wavelength more than 605 nm. According to the results, further investigation revealed the contribution of the perivascular tissue and the sclera scattering in the difference of vascular brightness in MSFC images.

Optical coherence tomography and fluorescence microscopy dual-modality imaging for in vivo single-cell tracking with nanowire lasers

Emerging cell-based therapies such as stem cell therapy and immunotherapy have attracted broad attention in both biological research and clinical practice. However, a long-standing technical gap of cell-based therapies is the difficulty of directly assessing treatment efficacy via tracking therapeutically administered cells. Therefore, imaging techniques to follow the in vivo distribution and migration of cells are greatly needed. Optical coherence tomography (OCT) is a clinically available imaging technology with ultrahigh-resolution and excellent imaging depth. It also shows great potential for in vivo cellular imaging. However, due to the homogeneity of current OCT cell labeling contrast agents (such as gold and polymer nanoparticles), only the distribution of entire cell populations can be observed. Precise tracking of the trajectory of individual single cells is not possible with such conventional contrast agents. Microlasers may provide a route to track unique cell identifiers given their small size, high emission intensities, rich emission spectra, and narrow linewidths. Here, we demonstrate that nanowire lasers internalized by cells provide both OCT and fluorescence signal. In addition, cells can be individually identified by the unique lasing emission spectra of the nanowires that they carry. Furthermore, single cell migration trajectories can be monitored both in vitro and in vivo with OCT and fluorescence microscopy dual-modality imaging system. Our study demonstrates the feasibility of nanowire lasers combined with the dual-modality imaging system for in vivo single cell tracking with a high spatial resolution and identity verification, an approach with great utility for stem cell and immunomodulatory therapies.

Detection and compensation of dispersion mismatch for frequency-domain optical coherence tomography based on A-scan's spectrogram

Balanced dispersion between reference and sample arms is critical in frequency-domain optical coherence tomography (FD-OCT) to perform imaging with the optimal axial resolution, and the spectroscopic analysis of each voxel in FD-OCT can provide the metric of the spectrogram. Here we revisited dispersion mismatch in the spectrogram view using the spectroscopic analysis of voxels in FD-OCT and uncovered that the dispersion mismatch disturbs the A-scan's spectrogram and reshapes the depth-resolved spectra in the spectrogram. Based on this spectroscopic effect of dispersion mismatch on A-scan's spectrogram, we proposed a numerical method to detect dispersion mismatch and perform dispersion compensation for FD-OCT. The proposed method can visually and quantitatively detect and compensate for dispersion mismatch in FD-OCT, with visualization, high sensitivity, and independence from sample structures. Experimental results of tape and mouse eye suggest that this technique can be an effective method for the detection and compensation of dispersion mismatch in FD-OCT.

Estimation and compensation of phase errors induced by axial bulk motion of a sample in wavelength-sweeping parallel Fourier domain OCT

We report a new, to the best of our knowledge, approach to correct image blurring due to the axial bulk motion of a sample in wavelength-sweeping Fourier domain parallel optical coherence tomography (OCT). This approach can estimate phase errors changing rapidly in time through direct measurements of the apparent axial shift during the sampling interval using common phase changes in parallel detection without additional hardware. To demonstrate the performance of the proposed algorithm, a single reflection and scattering sample were imaged with wavelength-sweeping parallel OCT implemented by scanning a spectrally dispersed line-field along the line direction. In addition, we quantitatively demonstrated that even a small axial movement of the sample could cause serious image blur at a high nonlinear degree of movement.

High-Speed, Ultrahigh-Resolution Spectral-Domain OCT with Extended Imaging Range Using Reference Arm Length Matching

Purpose

To develop high-speed, extended-range, ultrahigh-resolution spectral-domain optical coherence tomography (UHR SD-OCT) and demonstrate scan protocols for clinical retinal imaging.

Methods

A UHR SD-OCT operating at 840-nm with 150-nm bandwidths was developed. The axial imaging range was extended by dynamically matching reference arm length to the retinal contour during acquisition. Two scan protocols were demonstrated for imaging healthy participants and patients with dry age-related macular degeneration. A high-definition raster protocol with intra–B-scan reference arm length matching (ReALM) was used for high-quality cross-sectional imaging. A cube volume scan using horizontal and vertical rasters with inter–B-scan ReALM and software motion correction was used for en face and cross-sectional imaging. Linear OCT signal display enhanced visualization of outer retinal features.

Results

UHR SD-OCT was demonstrated at 128- and 250-kHz A-scan rates with 2.7 µm axial resolution and a 1.2-mm, 6-dB imaging range in the eye. Dynamic ReALM was used to maintain the retina within the 6-dB imaging range over wider fields of view. Outer retinal features, including the rod and cone interdigitation zones, retinal pigment epithelium, and Bruch's membrane were visualized and alterations observed in age-related macular degeneration eyes.

Conclusions

Technological advances and dynamic ReALM improve the imaging performance and clinical usability of UHR SD-OCT.

Translational Relevance

These advances should simplify clinical imaging workflow, reduce imaging session times, and improve yield of high quality images. Improved visualization of photoreceptors, retinal pigment epithelium, and Bruch's membrane may facilitate diagnosis and monitoring of age-related macular degeneration and other retinal diseases.

Ultra-high-resolution SD-OCM imaging with a compact polarization-aligned 840 nm broadband combined-SLED source

We analyze the influence of intrinsic polarization alignment on image quality and axial resolution employing a broadband 840 nm light source with an optical bandwidth of 160 nm and an output power of 12 mW tailored for spectral-domain optical coherence microscopy (SD-OCM) applications. Three superluminescent diodes (SLEDs) are integrated into a 14-pin butterfly module using a free-space micro-optical bench architecture, maintaining a constant polarization state across the full spectral output. We demonstrate superior imaging performance in comparison to traditionally coupled-SLED broadband light sources in a teleost model organism in-vivo.

Mirau-based line-field confocal optical coherence tomography

Line-field confocal optical coherence tomography (LC-OCT) is an imaging technique in which A-scans are acquired in parallel through line illumination with a broadband laser and line detection with a line-scan camera. B-scan imaging at high spatial resolution is achieved by dynamic focusing in a Linnik interferometer. This paper presents an LC-OCT device based on a custom-designed Mirau interferometer that offers similar spatial resolution and detection sensitivity. The device has the advantage of being more compact and lighter. In vivo imaging of human skin with a resolution of 1.3 µm × 1.1 µm (lateral × axial) is demonstrated over a field of 0.9 mm × 0.4 mm (lateral × axial) at 12 frames per second.

Dual-mode line-field confocal optical coherence tomography for ultrahigh-resolution vertical and horizontal section imaging of human skin in vivo

Line-field confocal optical coherence tomography (LC-OCT) is a recently introduced technique for ultrahigh-resolution vertical section (B-scan) imaging of human skin in vivo. This work presents a new implementation of the LC-OCT technique to obtain horizontal section images (C-scans) in addition to B-scans. C-scan imaging is achieved with this dual-mode LC-OCT system using a mirror galvanometer for lateral scanning along with a piezoelectric chip for modulation of the interferometric signal. A quasi-identical spatial resolution of ∼ 1 µm is measured for both B-scans and C-scans. The images are acquired in both modes at a rate of 10 frames per second. The horizontal field of view of the C-scans is 1.2 × 0.5 mm², identical to the vertical field of view of the B-scans. The user can switch between the two modes by clicking a button. In vivo cellular-resolution imaging of human skin is demonstrated in both B-scan and C-scan modes, with the possibility to navigate within the skin tissues in real time.

Comparative study of deep learning models for optical coherence tomography angiography

Optical coherence tomography angiography (OCTA) is a promising imaging modality for microvasculature studies. Meanwhile, deep learning has achieved rapid development in image-to-image translation tasks. Some studies have proposed applying deep learning models to OCTA reconstruction and have obtained preliminary results. However, current studies are mostly limited to a few specific deep neural networks. In this paper, we conducted a comparative study to investigate OCTA reconstruction using deep learning models. Four representative network architectures including single-path models, U-shaped models, generative adversarial network (GAN)-based models and multi-path models were investigated on a dataset of OCTA images acquired from rat brains. Three potential solutions were also investigated to study the feasibility of improving performance. The results showed that U-shaped models and multi-path models are two suitable architectures for OCTA reconstruction. Furthermore, merging phase information should be the potential improving direction in further research.

Vectorial birefringence imaging by optical coherence microscopy for assessing fibrillar microstructures in the cornea and limbus

The organization of fibrillar tissue on the micrometer scale carries direct implications for health and disease but remains difficult to assess in vivo. Polarization-sensitive optical coherence tomography measures birefringence, which relates to the microscopic arrangement of fibrillar tissue components. Here, we demonstrate a critical improvement in leveraging this contrast mechanism by employing the improved spatial resolution of focus-extended optical coherence microscopy (1.4 µm axially in air and 1.6 µm laterally, over more than 70 µm depth of field). Vectorial birefringence imaging of sheep cornea ex vivo reveals its lamellar organization into thin sections with distinct local optic axis orientations, paving the way to resolving similar features in vivo.

Selective retinex enhancement based on the clustering algorithm and block-matching 3D for optical coherence tomography images

It is important to enhance the contrast and remove the speckle noise for optical coherence tomography (OCT) images. In this paper, we propose a selective retinex enhancement method based on the fuzzy c-means (FCM) clustering algorithm to enhance only the structure part in OCT images and combines with the block-matching 3D (BM3D) algorithm for filtering. In the proposed selective retinex enhancement method, we first calculate the feature image of the original image, which includes the mean value and standard deviation of each pixel in the original image and its correlation image. Second, by applying the FCM clustering algorithm to the feature image, a mask is generated that can distinguish the structure part from the background part in the OCT image. Then, the mask is applied to the multi-scale retinex algorithm, and only the structure part in the OCT image is enhanced. Moreover, the BM3D method is applied to filter the enhanced image. Experimental results demonstrate that the proposed method performs impressively in improving the contrast and removing the speckle noise of OCT images, and it provides better quantitative performance in terms of signal-to-noise ratio, contrast-to-noise ratio, equivalent number of looks, and the edge preservation parameter $ \beta $β.

A deep learning based pipeline for optical coherence tomography angiography

Optical coherence tomography angiography (OCTA) is a relatively new imaging modality that generates microvasculature map. Meanwhile, deep learning has been recently attracting considerable attention in image-to-image translation, such as image denoising, super-resolution and prediction. In this paper, we propose a deep learning based pipeline for OCTA. This pipeline consists of three parts: training data preparation, model learning and OCTA predicting using the trained model. To be mentioned, the datasets used in this work were automatically generated by a conventional system setup without any expert labeling. Promising results have been validated by in-vivo animal experiments, which demonstrate that deep learning is able to outperform traditional OCTA methods. The image quality is improved in not only higher signal-to-noise ratio but also better vasculature connectivity by laser speckle eliminating, showing potential in clinical use. Schematic description of the deep learning based optical coherent tomography angiography pipeline.

Enhanced Grid-Based Visual Analysis of Retinal Layer Thickness with Optical Coherence Tomography

Optical coherence tomography enables high-resolution 3D imaging of retinal layers in the human eye. The thickness of the layers is commonly assessed to understand a variety of retinal and systemic disorders. Yet, the thickness data are complex and currently need to be considerably reduced prior to further processing and analysis. This leads to a loss of information on localized variations in thickness, which is important for early detection of certain retinal diseases. We propose an enhanced grid-based reduction and exploration of retinal thickness data. Alternative grids are computed, their representation quality is rated, and best fitting grids for given thickness data are suggested. Selected grids are then visualized, adapted, and compared at different levels of granularity. A visual analysis tool bundles all computational, visual, and interactive means in a flexible user interface. We demonstrate the utility of our tool in a complementary analysis procedure, which eases the evaluation of ophthalmic study data. Ophthalmologists successfully applied our solution to study localized variations in thickness of retinal layers in patients with diabetes mellitus.

Ghost optical coherence tomography

We demonstrate experimentally ghost optical coherence tomography using a broadband incoherent supercontinuum light source with shot-to-shot random spectral fluctuations. The technique is based on ghost imaging in the spectral domain where the object is the spectral interference pattern generated from an optical coherence tomography interferometer in which a physical sample is placed. The axial profile of the sample is obtained from the Fourier transform of the correlation between the spectrally resolved intensity fluctuations of the supercontinuum and the integrated signal measured at the output of the interferometer. The results are in excellent agreement with measurements obtained from a conventional optical coherence tomography system.

Origin of improved depth penetration in dual-axis optical coherence tomography: a Monte Carlo study

Recent studies have demonstrated that extended imaging depth can be achieved using dual-axis optical coherence tomography (DA-OCT). By illuminating and collecting at an oblique angle, multiple forward scattered photons from large probing depths are preferentially detected. However, the mechanism behind the enhancement of imaging depth needs further illumination. Here, the signal of a DA-OCT system is studied using a Monte Carlo simulation. We modeled light transport in tissue and recorded the spatial and angular distribution of photons exiting the tissue surface. Results indicate that the spatial separation and offset angle created by the non-telecentric scanning configuration promote the collection of more deeply propagating photons than conventional on-axis OCT.

Comparison of tissue dispersion measurement techniques based on optical coherence tomography

The effects of dispersion on optical coherence tomography (OCT) images have long been documented. The imbalance of spectral broadening, caused by dispersion mismatches in the two arms of the OCT interferometer, can result in significant resolution degradation. Efforts to correct this phenomenon have resulted in improved image quality using various techniques. However, dispersion is also present and varies in tissues. As a result, group velocity dispersion (GVD) can be used to detect changes in tissues and provide useful information for diagnosis. Several methods can be utilized to measure the GVD from OCT images: (i) the degradation of the point spread function (PSF), (ii) the shift (walk-off) between images taken at different wavelengths, (iii) the changes in the second derivative of the spectral phase, as well as two new methods, which do not require a reflector and are applicable in intact tissues, i.e., using (iv) the speckle degradation, and (v) the speckle cross correlation. A systematic, experimental, evaluation of these methods is presented to elucidate the capabilities, the limitations, and the accuracy of each technique when attempting to estimate the GVD in scattering samples. The most precise values were obtained from the estimation of the PSF degradation, whereas using the phase derivative method was only applicable to minimally scattering samples. Speckle broadening appears to be the most robust method for tissue GVD measurements.

Super-achromatic optical coherence tomography capsule for ultrahigh-resolution imaging of esophagus

Endoscopic optical coherence tomography (OCT) is a noninvasive technology allowing for imaging of tissue microanatomies of luminal organs in real time. Conventional endoscopic OCT operates at 1300 nm wavelength region with a suboptimal axial resolution limited to 8-20 μm. In this paper, we present the first ultrahigh-resolution tethered OCT capsule operating at 800 nm and offering about 3- to 4-fold improvement of axial resolution (plus enhanced imaging contrast). The capsule uses diffractive optics to manage chromatic aberration over a full ~200 nm spectral bandwidth centering around 830 nm, enabling to achieve super-achromaticity and an axial resolution of ~2.6 μm in air. The performance of the OCT capsule is demonstrated by volumetric imaging of swine esophagus ex vivo and sheep esophagus in vivo, where fine anatomic structures including the sub-epithelial layers are clearly identified. The ultrahigh resolution and excellent imaging contrast at 800 nm of the tethered capsule suggest the potential of the technology as an enabling tool for surveillance of early esophageal diseases on awake patients without the need for sedation.

Simultaneous dual-band line-field confocal optical coherence tomography: application to skin imaging

Line-field confocal optical coherence tomography (LC-OCT) operating in two distinct spectral bands centered at 770 nm and 1250 nm is reported, using a single supercontinuum light source and two different line-scan cameras. B-scans are acquired simultaneously in the two bands at 4 frames per second. Greyscale representation and color fusion of the images are performed to either produce a single image with both high resolution (1.3 µm × 1.2 µm, lateral × axial, measured at the surface) in the superficial part of the image and deep penetration, or to highlight the spectroscopic properties of the sample. In vivo images of fair and dark skin are presented with a penetration depth of ∼700 µm.

Line-field confocal time-domain optical coherence tomography with dynamic focusing

A time-domain optical coherence tomography technique is introduced for high-resolution B-scan imaging in real-time. The technique is based on a two-beam interference microscope with line illumination and line detection using a broadband spatially coherent light source and a line-scan camera. Multiple (2048) A-scans are acquired in parallel by scanning the sample depth while adjusting the focus. Quasi-isotropic spatial resolution of 1.3 µm × 1.1 µm (lateral × axial) is achieved. In vivo cellular-level resolution imaging of human skin is demonstrated at 10 frames per second with a penetration depth of ∼500 µm.

In Vivo and Ex Vivo Microscopy: Moving Toward the Integration of Optical Imaging Technologies Into Pathology Practice

The traditional surgical pathology assessment requires tissue to be removed from the patient, then processed, sectioned, stained, and interpreted by a pathologist using a light microscope. Today, an array of alternate optical imaging technologies allow tissue to be viewed at high resolution, in real time, without the need for processing, fixation, freezing, or staining. Optical imaging can be done in living patients without tissue removal, termed in vivo microscopy, or also in freshly excised tissue, termed ex vivo microscopy. Both in vivo and ex vivo microscopy have tremendous potential for clinical impact in a wide variety of applications. However, in order for these technologies to enter mainstream clinical care, an expert will be required to assess and interpret the imaging data. The optical images generated from these imaging techniques are often similar to the light microscopic images that pathologists already have expertise in interpreting. Other clinical specialists do not have this same expertise in microscopy, therefore, pathologists are a logical choice to step into the developing role of microscopic imaging expert. Here, we review the emerging technologies of in vivo and ex vivo microscopy in terms of the technical aspects and potential clinical applications. We also discuss why pathologists are essential to the successful clinical adoption of such technologies and the educational resources available to help them step into this emerging role.

Intraoperative detection of blood vessels with an imaging needle during neurosurgery in humans

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.

New clinical ultrahigh-resolution SD-OCT using A-scan matching algorithm

PURPOSE

A new clinical ultrahigh-resolution spectral domain optical coherence tomography (UHR-SD-OCT) system using an original averaging technique named "A-scan matching algorithm" was developed. The aim of this study was to determine whether our new UHR-SD-OCT system can obtain clearer sectional images of the retina than conventional standard resolution SD-OCT systems (SR-SD-OCT).

METHODS

We recorded horizontal B-scan images of 42 normal eyes using our new UHR-SD-OCT device (Bi-μ, Kowa) and a conventional SR-SD-OCT (Spectralis, Heidelberg). To evaluate the clarity of the interdigitation zone (IZ) subjectively, the integrity of IZ was divided into three types by two raters. To evaluate the clarity of the IZ objectively, a peak height score (PHS) was calculated at five different points of the macula using the longitudinal reflectivity profile.

RESULTS

The mean (± SD) of the subjective visibility score of the IZ in the UHR-SD-OCT images was 2.64 ± 0.54 which was significantly higher than the 2.46 ± 0.46 in the SR-SD-OCT images (P = 0.02). The PHS was also significantly higher for the UHR-SD-OCT than for the SR-SD-OCT images at all five locations (all P < 0.01).

CONCLUSION

The results indicate that the newly developed clinical UHR-SD-OCT instrument using the A-scan matching algorithm can obtain clearer images of the IZ, and they suggest that this device should be clinically useful in detecting finer structural abnormalities of the outer retina.

Line-field confocal optical coherence tomography for high-resolution noninvasive imaging of skin tumors

An optical technique called line-field confocal optical coherence tomography (LC-OCT) is introduced for high-resolution, noninvasive imaging of human skin in vivo. LC-OCT combines the principles of time-domain optical coherence tomography and confocal microscopy with line illumination and detection using a broadband laser and a line-scan camera. LC-OCT measures the echo-time delay and amplitude of light backscattered from cutaneous microstructures through low-coherence interferometry associated with confocal spatial filtering. Multiple A-scans are acquired simultaneously while dynamically adjusting the focus. The resulting cross-sectional B-scan image is produced in real time at 10  frame  /  s. With an isotropic spatial resolution of ∼1  μm, the LC-OCT images reveal a comprehensive structural mapping of skin at the cellular level down to a depth of ∼500  μm. LC-OCT has been applied to the imaging of various skin lesions, in vivo, including carcinomas and melanomas. LC-OCT images are found to strongly correlate with conventional histopathological images. The use of LC-OCT as an adjunct tool in medical practice could significantly improve clinical diagnostic accuracy while reducing the number of biopsies of benign lesions.

Nano-optic endoscope for high-resolution optical coherence tomography in vivo

Acquisition of high-resolution images from within internal organs using endoscopic optical imaging has numerous clinical applications. However, difficulties associated with optical aberrations and the trade-off between transverse resolution and depth-of-focus significantly limit the scope of applications. Here, we integrate a metalens, with the ability to modify the phase of incident light at sub-wavelength level, into the design of an endoscopic optical coherence tomography catheter (termed nano-optic endoscope) to achieve near diffraction-limited imaging through negating non-chromatic aberrations. Remarkably, the tailored chromatic dispersion of the metalens in the context of spectral interferometry is utilized to maintain high-resolution imaging beyond the input field Rayleigh range, easing the trade-off between transverse resolution and depth-of-focus. We demonstrate endoscopic imaging both in resected human lung specimens and in sheep airways in vivo. The combination of the superior resolution and higher imaging depth-of-focus of the nano-optic endoscope will likely increase the clinical utility of endoscopic optical imaging.

Application of cmOCT and continuous wavelet transform analysis to the assessment of skin microcirculation dynamics

Correlation mapping optical coherence tomography (cmOCT) is a powerful technique for the imaging of skin microvessels structure, based on the discrimination of the static and dynamic regions of the tissue. Although the suitability of cmOCT to visualize the microcirculation has been proved in humans and animal models, less evidence has been provided about its application to examine functional dynamics. Therefore, the goal of this research was validating the cmOCT method for the investigation into microvascular function and vasomotion. A spectral domain optical coherence tomography (SD-OCT) device was employed to image 90 sequential three-dimensional (3-D) OCT volumes from the forearm of 12 volunteers during a 25-min postocclusive reactive hyperemia (PORH) test. The volumes were processed using cmOCT to generate blood flow maps at selected cutaneous depths. The maps clearly trace flow variations during the PORH response for both capillaries and arterioles/venules microvascular layers. Continuous blood flow signals were reconstructed from cmOCT maps to study vasomotion by applying wavelet transform spectral analysis, which revealed fluctuations of flow during PORH, reflecting the regulation of microvascular tone mediated by endothelial cells and sympathetic nerves. The results clearly demonstrate that cmOCT allows the generation of functional information that may be used for diagnostic applications.