Tethered capsule endomicroscopy (TCE) is a recently developed form of in vivo microscopy based on optical coherence tomography (OCT). With TCE, a small tethered pill is swallowed, procuring high resolution microscopic images of the esophageal wall. TCE does not require sedation and is thus a more rapid and convenient procedure comparing to traditional endoscopic examination. Our group and others have successfully conducted OCT-TCE in pilot, single-center studies that demonstrated the potential of this technology for upper GI tract diagnosis. Here, we demonstrate and evaluate the feasibility and safety of a next generation OCT-TCE system and device in patients with Barrett’s esophagus (BE) and report the initial longitudinal analysis of the natural history of BE.
Optical coherence tomography (OCT) has been a useful clinical tool for diagnosing coronary artery disease through a flexible catheter, but its full promise relies on resolving cellular and sub-cellular structures in vivo. Previously, visualizing cellular structures through an imaging catheter is not possible due to limited depth of focus (DOF) of a tightly focused Gaussian beam: typically, a Gaussian beam with 2-3 μm resolution has a DOF within 100 μm, which is not sufficient for in vivo catheter imaging. Therefore, we developed a self-imaging wavefront division optical system that generates a coaxially-focused multimode (CAFM) beam with a DOF that is approximately one order of magnitude longer than that of a Gaussian beam. In this study, we present a high-resolution, extended DOF catheter based on self-imaging wavefront division optics. The catheter generates a CAFM beam with a lateral resolution of 3 μm and a DOF close to 2 mm. To correct the aberration introduced by catheter sheath, we incorporated a cylindrical prism to compensate the sheath astigmatism. When the catheter is incorporated into a micro-resolution OCT (μOCT) system with rotational scanning mechanics, cellular-resolution cross-sectional images of the coronary artery wall can be obtained. The device serves as an important step toward characterizing cellular and sub-cellular structures in vivo for coronary artery disease diagnosis.
High resolution micro-optical coherence tomography (µOCT) technology has been demonstrated to be useful for imaging respiratory epithelial functional microanatomy relevant to the study of pulmonary diseases such as cystic fibrosis and COPD. We previously reported the use of a benchtop μOCT imaging technology to image several relevant respiratory epithelial functional microanatomy at 40 fps and at lateral and axial resolutions of 2 and 1.3μm, respectively. We now present the development of a portable μOCT imaging system with comparable optical and imaging performance, which enables the μOCT technology to be translated to the clinic for in vivo imaging of human airways.
The human respiratory system is protected by a defense mechanism termed mucociliary clearance (MCC). Deficiency in MCC leads to respiratory obstruction and pulmonary infection, which often are the main causes of morbidity and mortality in diseases such as cystic fibrosis and chronic obstructive pulmonary disease (COPD). Studying key parameters that govern MCC, including ciliary beat frequency, velocity and volume of airway mucus transport, as well as periciliary liquid layer thickness are therefore of great importance in understanding human respiratory health. However, direct, in vivo visualization of ciliary function and MCC has been challenging, hindering the diagnosis of disease pathogenesis and mechanistic evaluation of novel therapeutics.
Our laboratory has previously developed a 1-µm resolution optical coherence tomography method, termed Micro-OCT, which is a unique tool for visualizing the spatiotemporal features of ciliary function and MCC. We have previously described the design of a flexible 2.5 mm Micro-OCT probe that is compatible with standard flexible bronchoscopes. This device utilizes a common-path interferometer and annular sample arm apodization to attain a sharply focused spot over an extended depth of focus.
Here, we present the most recent iteration of this probe and demonstrate its imaging performance in a mouse trachea tissue culture model. In addition, we have developed an ergonomic assembly for attaching the probe to a standard bronchoscope. The ergonomic assembly fixes the Micro-OCT probe’s within the bronchoscope and contains a means transducing linear motion through the sheath so that the Micro-OCT beam can be scanned along the trachea. We have tested the performance of these devices for Micro-OCT imaging in an anatomically correct model of the human airway. Future studies are planned to use this technology to conduct Micro-OCT in human trachea and bronchi in vivo.
Mucociliary clearance (MCC) plays a significant role in maintaining the health of human respiratory system by eliminating foreign particles trapped within mucus. Failure of this mechanism in diseases such as cystic fibrosis and chronic obstructive pulmonary disease (COPD) leads to airway blockage and lung infection, causing morbidity and mortality. The volume of airway mucus and the periciliary liquid encapsulating the cilia, in addition to ciliary beat frequency and velocity of mucociliary transport, are vital parameters of airway health. However, the diagnosis of disease pathogenesis and advances of novel therapeutics are hindered by the lack of tools for visualization of ciliary function in vivo.
Our laboratory has previously developed a 1-µm resolution optical coherence tomography method, termed Micro-OCT, which is capable of visualizing mucociliary transport and quantitatively capturing epithelial functional metrics. We have also miniaturized Micro-OCT optics in a first-generation rigid 4mm Micro-OCT endoscope utilizing a common-path design and an apodizing prism configuration to produce an annular profile sample beam, and reported the first in vivo visualization of mucociliary transport in swine. We now demonstrate a flexible 2.5 mm Micro-OCT probe that can be inserted through the instrument channel of standard flexible bronchoscopes, allowing bronchoscopic navigation to smaller airways and greatly improving clinical utility. Longitudinal scanning over a field of view of more than 400 µm at a frame rate of 40 Hz was accomplished with a driveshaft transduced by a piezo-electric stack motor.
We present characterization and imaging results from the flexible micro-OCT probe and progress towards clinical translation. The ability of the bronchoscope-compatible micro-OCT probe to image mucus clearance and epithelial function will enable studies of cystic fibrosis pathogenesis in small airways, provide diagnosis of mucociliary clearance disorders, and allow individual responses to treatments to be monitored.
KEYWORDS: Near infrared spectroscopy, Optical coherence tomography, Light sources, Arteries, 3D image processing, In vivo imaging, Imaging technologies, Reliability, Data acquisition, Spectral calibration
Intravascular optical coherence tomography (OCT) is a high-resolution catheter-based imaging method that provides three-dimensional microscopic images of coronary artery in vivo, facilitating coronary artery disease treatment decisions based on detailed morphology. Near-infrared spectroscopy (NIRS) has proven to be a powerful tool for identification of lipid-rich plaques inside the coronary walls. We have recently demonstrated a dual-modality intravascular imaging technology that integrates OCT and NIRS into one imaging catheter using a two-fiber arrangement and a custom-made dual-channel fiber rotary junction. It therefore enables simultaneous acquisition of microstructural and composition information at 100 frames/second for improved diagnosis of coronary lesions.
The dual-modality OCT-NIRS system employs a single wavelength-swept light source for both OCT and NIRS modalities. It subsequently uses a high-speed photoreceiver to detect the NIRS spectrum in the time domain. Although use of one light source greatly simplifies the system configuration, such light source exhibits pulse-to-pulse wavelength and intensity variation due to mechanical scanning of the wavelength. This can be in particular problematic for NIRS modality and sacrifices the reliability of the acquired spectra. In order to address this challenge, here we developed a robust data acquisition and processing method that compensates for the spectral variations of the wavelength-swept light source. The proposed method extracts the properties of the light source, i.e., variation period and amplitude from a reference spectrum and subsequently calibrates the NIRS datasets. We have applied this method on datasets obtained from cadaver human coronary arteries using a polygon-scanning (1230-1350nm) OCT system, operating at 100,000 sweeps per second. The results suggest that our algorithm accurately and robustly compensates the spectral variations and visualizes the dual-modality OCT-NIRS images. These findings are therefore crucial for the practical application and clinical translation of dual-modality intravascular OCT-NIRS imaging when the same swept sources are used for both OCT and spectroscopy.
Introduction: A recent ex-vivo study using micro-CT in patients with chronic obstructive pulmonary disease (COPD) showed that narrowing and disappearance of small conducting airways precedes the onset of emphysematous destruction in COPD. Until recently, the airway remodeling process could not be studied in detail in-vivo. In this study, we investigated the repeatability of navigating an Optical Coherence Tomography (OCT) catheter to image the same airways in smokers with and without COPD. Method: OCT imaging was performed by inserting the catheter through a sub-segmental airway to a small bronchiole. Three-dimensional OCT imaging of 5 cm of airway segments was obtained. The catheter was removed and reinsertion into the same airway was attempted. The number of airway generations and quantitative measurements of the airway wall area were investigated. Results: Sixty-three airways in 30 subjects were analyzed. Repeated insertion into the same airway was observed at 53.8 %, 92.3% and 70.8% of the time in the upper, middle and lower lobes respectively. The percentage differences of paired measurements of airway wall area between matched and unmatched airways in bronchioles were 5.8 ± 4.6 % and 7.3 ± 5.4 % respectively Conclusions: Repeated OCT imaging of airways is possible in the majority of cases except in the upper lobes. For airways that are not completely matched, some of the airway segments can still be used for comparison by careful alignment of the airway. OCT may be a useful method to study the remodeling process in small airways and the effect of therapeutic intervention.
In this paper, we conduct a phantom study for modeling the autofluorescence (AF) properties of tissue. A combined optical coherence tomography (OCT) and AF imaging system is proposed to measure the strength of the AF signal in terms of the scattering layer thickness and concentration. The combined AF-OCT system is capable of estimating the AF loss due to scattering in the epithelium using the thickness and scattering concentration calculated from the co-registered OCT images. We define a correction factor to account for scattering losses in the epithelium and calculate a scatteringcorrected AF signal. We believe the scattering-corrected AF will reduce the diagnostic false-positives rate in the early detection of airway lesions due to confounding factors such as increased epithelial thickness and inflammations.
A combined ultrahigh resolution optical coherence tomography (UHROCT) and a electroretinography (ERG) system is presented for simultaneous imaging of the retinal structure and physiological response to light stimulation in the rodent eye. The 1060-nm UHROCT system provides ~3×5 µm (axial×lateral) resolution in the rat retina and time resolution of 22 µs. A custom-designed light stimulator integrated into the UHROCT imaging probe provides light stimuli with user-selected color, duration, and intensity. The performance of the combined system is demonstrated in vivo in healthy rats, and in a rat model of drug-induced outer retinal degeneration. Experimental results show correlation between the observed structural and physiological changes in the healthy and degenerated retina.
A computational model for an "ideal" light source for in-vivo UHROCT imaging of human and animal retina is presented. The model considers parameters such as the wavelength dependent absorption of water, the length of the human or animal eye, the power limitations for the imaging beam as defined in the ANSI standard, etc., to determinethe broadest possible spectral bandwidth that can result in the best axial OCT resolution in the 1060nm wavelength region. A custom light source with a re-shaped spectrum was used to verify experimentally the results from the computational model. 4.3µm axial OCT resolution was achieved experimentally in free space, corresponding to 3µm resolution in retinal tissue. A custom imaging probe was developed and optimized with ZEMAX to result in 5 µm transverse resolution in the rat retina. 2D and 3D OCT tomograms acquired in-vivo from rat retinas show visualization of tiny capillaries imbedded in the inner and outer plexiform layers of the rat retinas.
A high speed (47,000 A-scan/s), high resoluiton FD-OCT system, operating in the 1060nm wavelength range was used to acquire in-vivo 3D image of healthy and pathological rat retinas. The images were acquired with ~4.3µm axial and ~5µm lateral resolution in the rat eye and 102dB sensitivity at 1.3mW optical power of the imaging beam. The images of the healthy rat retinas show increased penetration into the choroid, clear visualization of all intra-retinal layers and the choroidal blood network, as well as part of the underlying sclera. The high imaging resolution of the OCT system is also sufficient for resolving tiny capillaries imbedded in the inner - and outer plexiform layers of the retina. The high data acquisition rate of the FD-OCT system combined with the high axial resolution is also suitable for probing light induced physiological processes in the retina simultaneously with the morphological imaging.
Hypoxia induced corneal swelling was observed and evaluated in healthy human volunteers by use of high speed, ultrahigh resolution optical coherence tomography (UHROCT). Two dimensional corneal images were acquired at a speed of 47,000 A-scans/s with 3µm x 10µm (axial x lateral) resolution in corneal tissue. The UHROCT tomograms showed clear visualization of all corneal layers, including the Bowman's layer and the Descemet's membrane - Endothelium complex. A segmentation algorithm was developed and used for automatic detection of the boundaries of the different corneal layers and evaluation the individual layer thickness as a function of location. Corneal hypoxia was induced by wear of a soft contact lens (SCL) and an eye patch by 2 healthy volunteers for duration of 3 hours. The thickness of all corneal layers was measured as a function of time, prior to, with and after removal of the SCL. Results from the hypoxia study showed different rates of swelling and de-swelling of the individual corneal layers. About 10% increase in the total cornea thickness was observed, similar to the changes in the stroma, the Bowman's membrane swelled by 20%, while no significant change in the thickness was observed in the Descemet's - Endothelium complex.
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