Clinical imaging with optical coherence tomography.
Explore the source record for details and available documents.
Barrett Esophagus↗
Biomedical subjects
G J Tearney
Publications and source records attributed to G J Tearney.
Diagnosis of specialized intestinal metaplasia by optical coherence tomography.
BACKGROUND AND AIMS: Optical coherence tomography (OCT) is an imaging technique that produces high-resolution cross-sectional images in vivo. The aim of this study was to establish the sensitivity and specificity of OCT for diagnosing specialized intestinal metaplasia (SIM). METHODS: OCT was used to image the stomach and esophagus of 121 patients. A total of 288 biopsy-correlated OCT images were acquired. OCT criteria for SIM were formulated by analyzing 75 images of SIM. The SIM image criteria were retrospectively tested by applying them to images of gastric, squamous, SIM, and cardiac epithelium. The criteria were then tested prospectively to determine the sensitivity and specificity of OCT for diagnosing SIM. RESULTS: OCT images of SIM are characterized by (1) absence of the layered structure of normal squamous epithelium and the vertical "pit and crypt" morphology of gastric mucosa, (2) disorganized architecture with inhomogeneous tissue contrast and an irregular mucosal surface, and (3) presence of submucosal glands. These criteria were 100% sensitive and 93% specific for SIM when applied retrospectively and 97% sensitive and 92% specific when tested prospectively. CONCLUSIONS: OCT is highly sensitive and specific for SIM and may aid in the diagnosis and surveillance of this preneoplastic lesion.
Adult↗
High-resolution imaging of the human esophagus and stomach in vivo using optical coherence tomography.
BACKGROUND: Optical coherence tomography is a new, high spatial-resolution, cross-sectional imaging technique. We investigated the ability of optical coherence tomography to provide detailed images of subsurface structures in the upper gastrointestinal (GI) tract. METHODS: Optical coherence tomography was performed during routine upper GI endoscopy on 32 patients including 20 patients with Barrett's esophagus. An endoscopic mucosal biopsy was obtained immediately after imaging and was used for histopathologic correlation. RESULTS: Optical coherence tomography provided clear delineation of layers of the normal human esophagus extending from the epithelium to the longitudinal muscularis propria. Gastric mucosa was differentiated from esophageal mucosa, Barrett's esophagus was differentiated from normal esophageal mucosa, and esophageal adenocarcinoma was distinguished from normal esophagus and Barrett's esophagus. CONCLUSIONS: Optical coherence tomography allows visualization of the subsurface architectural morphology of the upper GI tract. The diagnostic information provided by this new imaging modality suggests that it may be a useful adjunct to endoscopy.
Anatomy, Cross-Sectional↗
Optical coherence tomography in the gastrointestinal tract.
Optical coherence tomography (OCT) is a high-resolution, cross-sectional optical imaging technique that allows in situ imaging of tissue by measuring back-reflected light. OCT provides images in real time with a resolution approaching that of conventional histopathology, but without the need for tissue removal. OCT imaging can be performed endoscopically to visualize gastrointestinal tissue using a fiberoptic catheter passed through the instrument channel of a conventional endoscope. The resolution of OCT allows visualization of the different layers of gastrointestinal epithelium and the differentiation of Barrett's epithelium from normal gastric and squamous mucosa. OCT has also been used to image esophageal adenocarcinoma and colonic polyps. Recent developments include Doppler OCT, spectroscopic OCT, and ultrahigh-resolution OCT, which can visualize nuclei within single cells. Although still in its infancy as a clinical tool, OCT currently provides high-resolution images over the same imaging depth as conventional mucosal biopsy, and may prove to be a useful and minimally invasive technique for evaluating gastrointestinal tissue, particularly for early neoplastic changes.
Digestive System↗
A novel, noninvasive imaging technique for intraoperative assessment of parathyroid glands: confocal reflectance microscopy.
BACKGROUND: Successful surgical management of primary hyperparathyroidism requires the ability to identify and distinguish normal from abnormal parathyroid tissue. Microscopic pathologic confirmation often helps with the diagnoses and decisions regarding the extent of parathyroid resection. Confocal reflectance microscopy (CRM) is an optical method of noninvasively imaging tissue without fixation, sectioning, and staining as in standard histopathology. The goal of this study was to determine if CRM imaging could be used to distinguish normal from diseased parathyroid tissue intraoperatively. METHODS: In this study, 44 parathyroid glands from 21 patients undergoing operations for primary hyperparathyroidism were imaged immediately after excision. CRM images were compared with conventional hematoxylin-and-eosin stained sections obtained from the same gland. The percentage area occupied by fat cells was calculated in images of both normal and diseased glands. RESULTS: Characteristic microscopic features of parathyroid glands were distinguishable by CRM and correlated well with histopathology. The stromal fat content of normal and diseased glands could easily be determined. The percentage area occupied by fat cells differed significantly (P <.00001) in normal glands (average, 23.0% +/- 10.9%) and adenomatous glands (average, 0.4% +/- 0.7%). CONCLUSIONS: CRM imaging rapidly revealed microscopic features that reliably differentiated normal and diseased parathyroid glands. The success of this preliminary ex vivo study promotes interest in further development of an in situ probe for in vivo clinical diagnostic use.
Adenoma↗
Porcine coronary imaging in vivo by optical coherence tomography.
OBJECTIVE: A high-resolution coronary artery imaging modality has the potential to address important diagnostic and management problems in cardiology. Optical coherence tomography (OCT) is a promising new optical imaging technique with a resolution of approximately 10 microm. The purpose of this study was to use a new OCT catheter to demonstrate the feasibility of performing OCT imaging of normal coronary arteries, intimal dissections, and deployed stents in vivo. METHODS AND RESULTS: Normal coronary arteries, intimal dissections, and stents were imaged in five swine with OCT and compared with intravascular ultrasound (IVUS). In the normal coronary arteries, visualization of all of the layers of the vessel wall was achieved with a saline flush, including the intima which was not identified by IVUS. Following dissection, detailed layered structures including intimal flaps, intimal defects, and disruption of the medial wall were visualized by OCT. IVUS failed to show clear evidence of intimal and medial disruption. Finally, the microanatomic relationships between stents and the vessel walls were clearly identified only by OCT. CONCLUSIONS: In this preliminary experiment, we have demonstrated that in vivo OCT imaging of normal coronary arteries, intimal dissections, and deployed stents is feasible, and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast.
Animals↗
High resolution in vivo intra-arterial imaging with optical coherence tomography.
BACKGROUND: Optical coherence tomography (OCT) is a new method of catheter based micron scale imaging. OCT is analogous to ultrasound, measuring the intensity of backreflected infrared light rather than sound waves. OBJECTIVE: To demonstrate the ability of OCT to perform high resolution imaging of arterial tissue in vivo. METHODS: OCT imaging of the abdominal aorta of New Zealand white rabbits was performed using a 2.9 F OCT imaging catheter. Using an ultrashort pulse laser as a light source for imaging, an axial resolution of 10 micrometer was achieved. RESULTS: Imaging was performed at 4 frames/second and data were saved in either super VHS or digital format. Saline injections were required during imaging because of the signal attenuation caused by blood. Microstructure was sharply defined within the arterial wall and correlated with histology. Some motion artefacts were noted at 4 frames/second. CONCLUSIONS: In vivo imaging of the rabbit aorta was demonstrated at a source resolution of 10 micrometer, but required the displacement of blood with saline. The high resolution of OCT allows imaging to be performed near the resolution of histopathology, offering the potential to have an impact both on the identification of high risk plaques and the guidance of interventional procedures.
Animals↗
Optical biopsy with optical coherence tomography.
A need exists in medicine for a technology capable of 'optical biopsy,' imaging at or near the resolution of histopathology without the need for excisional biopsy. Optical coherence tomography (OCT) is a recently developed imaging technology that uses infrared light to generate cross-sectional images on a micron scale. In this work, the feasibility of OCT for optical biopsy was confirmed with in vitro tissue from the skeletal and male reproductive systems. This work supports the hypothesis that OCT is an attractive technology for in vivo optical biopsy.
Biopsy↗
New technology for high-speed and high-resolution optical coherence tomography.
Optical coherence tomography (OCT) is an optical imaging technique that is capable of performing micron-scale, cross-sectional imaging of internal microstructure in biological systems. OCT is analogous to ultrasound B mode imaging except that it uses light rather than sound and performs imaging by measuring the back-scattered intensity of light from structures in tissue. We describe recent advances in OCT technology including the application of short pulse solid state lasers based on Ti: Al2O3 and Cr: Mg2SiO4 to enable high-resolution, high-speed imaging as well as the development of OCT catheter/endoscope delivery to permit imaging of internal organ systems. OCT enables the nonexcisional, in situ, real-time imaging of tissue microstructure and is thus a powerful and promising technique for optical biopsy.
Animals↗
Optical biopsy in human pancreatobiliary tissue using optical coherence tomography.
Optical coherence tomography (OCT) is a new technique for performing high-resolution, cross-sectional tomographic imaging in human tissue. OCT is analogous to ultrasound B mode imaging except that it uses light rather than acoustical waves. As a result, OCT has over 10 times the resolution of currently available clinical high-resolution cross-sectional imaging technologies. In this work, we investigate the capability of OCT to differentiate the architectural morphology of pancreatobiliary tissues. Normal pancreatobiliary tissues, including the gallbladder, common bile duct, pancreatic duct, and pancreas were taken postmortem and imaged using OCT. Images were compared to corresponding histology to confirm tissue identity. Microstructure was delineated in different tissues, including tissue layers, glands, submucosal microvasculature, and pancreatic islets of Langerhans. The ability of OCT to provide high-resolution imaging of pancreatobiliary architectural morphology suggests the feasibility of using OCT as a powerful diagnostic endoscopic imaging technology to image early stages of pancreatobiliary disease.
Biliary Tract↗
Intraoperative assessment of microsurgery with three-dimensional optical coherence tomography.
PURPOSE: To evaluate three-dimensional optical coherence tomography (OCT) for use in the assessment of the microsurgical anastomoses of vessels and nerves. MATERIALS AND METHODS: OCT is an optical analogue of ultrasonography and is capable of imaging nontransparent biologic tissue by detecting backscattered infrared light. Cross-sectional in vitro images of rabbit and human vessels and nerves were obtained in as little as 125 msec at 10-micron resolution by using a solid-state laser as a light source. A surgical microscope was integrated with OCT to perform simultaneous imaging with en face visualization. Cross-sectional images were assembled to produce three-dimensional reconstructions of microsurgical specimens. RESULTS: Three-dimensional OCT reconstructions depicted the structure within an arterial anastomosis and helped identify sites of luminal obstruction. The longitudinal spatial orientation of individual nerve fascicles was tracked in three dimensions to identify changes in position. In vitro human arteries and nerves embedded in highly scattering tissue and not visible at microscopy were located and imaged with OCT at eight frames per second. CONCLUSION: The three-dimensional, micrometer-scale, diagnostic imaging capabilities of OCT permit rapid feedback for assessment of microsurgical procedures. OCT technology can be readily integrated with surgical microscopes and has potential for intraoperative monitoring to improve patient outcome.
Anastomosis, Surgical↗
High resolution imaging of the upper respiratory tract with optical coherence tomography: a feasibility study.
A need exists in respiratory medicine for a technology capable of identifying airway pathology on a micron scale. This study has demonstrated the feasibility of optical coherence tomography (OCT) for ultrahigh resolution imaging of the upper respiratory tract by in vitro studies of human tissue. OCT is a relatively new technique that can be used to noninvasively collect tomographic images of tissue microstructure with micron-scale resolution. OCT is analogous to ultrasound, measuring the intensity of infrared light rather than acoustical waves. Samples throughout the upper respiratory tract, from the epiglottis to the secondary bronchi, were imaged. The resulting images were compared with histopathology and verified the ability of OCT to delineate relevant structures such as the epithelium, mucosa, cartilage and its sublayers, and glands at a resolution higher than any clinical imaging technology. The ability of OCT to generate image resolution in the range close to that of histopathology in real time, as well as easy integration with small, relatively inexpensive endoscopes, low cost, and lack of a need for a transducing medium, supports the hypothesis that this optical technology could become a powerful modality in the diagnosis and management of a wide range of clinical respiratory pathology.
Feasibility Studies↗
Optical biopsy with optical coherence tomography: feasibility for surgical diagnostics.
BACKGROUND: Optical coherence tomography (OCT) is a recently developed compact technology which uses infrared light to perform cross-sectional imaging on a micrometer scale. Since OCT provides imaging at a resolution comparable to conventional histology and does not require direct contact with the tissue surface, a role in real-time surgical diagnostics represents a logical extension. In this work, we test the feasibility of OCT for surgical diagnostics by demonstrating imaging in tissue relevent to microsurgical intervention, a previously undescribed observation. MATERIALS AND METHODS: Over 50 sites on nervous, reproductive, and microvascular specimens from 10 patients were examined postmortem with OCT. After imaging, tissue was registered with microinjections of dye, under visible light laser guidance, followed by routine histologic processing to confirm the identity of microstructure. RESULTS: The 16 +/- 1 microm resolution allowed subsurface microstructure to be identified at unprecedented resolution. Structures identified included fascicles of peripheral nerves, the internal elastic membrane of microvessels, and the granular layer of the cerebellum. CONCLUSIONS: The ability of OCT to provide micrometer-scale definition of tissue microstructure suggests a role in surgical diagnostics. Future in vivo investigations are merited to establish its utility for morbidity reduction associated with surgical intervention.
Animals↗
In vivo endoscopic optical biopsy with optical coherence tomography.
Current medical imaging technologies allow visualization of tissue anatomy in the human body at resolutions ranging from 100 micrometers to 1 millimeter. These technologies are generally not sensitive enough to detect early-stage tissue abnormalities associated with diseases such as cancer and atherosclerosis, which require micrometer-scale resolution. Here, optical coherence tomography was adapted to allow high-speed visualization of tissue in a living animal with a catheter-endoscope 1 millimeter in diameter. This method, referred to as "optical biopsy," was used to obtain cross-sectional images of the rabbit gastrointestinal and respiratory tracts at 10-micrometer resolution.
Anatomy, Cross-Sectional↗
Noninvasive assessment of the developing Xenopus cardiovascular system using optical coherence tomography.
Studies investigating normal and abnormal cardiac development are frequently limited by an inability to assess cardiovascular function within the intact organism. In this work, optical coherence tomography (OCT), a new method of micron-scale, noninvasive imaging based on the measurement of backscattered infrared light, was introduced for the high resolution assessment of structure and function in the developing Xenopus laevis cardiovascular system. Microstructural details, such as ventricular size and wall positions, were delineated with OCT at 16-microm resolution and correlated with histology. Three-dimensional representation of the cardiovascular system also was achieved by repeated cross-sectional imaging at intervals of 25 microm. In addition to structural information, OCT provides high speed in vivo axial ranging and imaging, allowing quantitative dynamic activity, such as ventricular ejection fraction, to be assessed. The sensitivity of OCT for dynamic assessment was demonstrated with an inotropic agent that altered cardiac function and dimensions. Optical coherence tomography is an attractive new technology for assessing cardiovascular development because of its high resolution, its ability to image through nontransparent structures, and its inexpensive portable design. In vivo and in vitro imaging are performed at a resolution approaching that of histopathology without the need for animal killing.
Animals↗
Assessing atherosclerotic plaque morphology: comparison of optical coherence tomography and high frequency intravascular ultrasound.
BACKGROUND: OCT can image plaque microstructure at a level of resolution not previously demonstrated with other imaging techniques because it uses infrared light rather than acoustic waves. OBJECTIVES: To compare optical coherence tomography (OCT) and intravascular ultrasound (IVUS) imaging of in vitro atherosclerotic plaques. METHODS: Segments of abdominal aorta were obtained immediately before postmortem examination. Images of 20 sites from five patients were acquired with OCT (operating at an optical wavelength of 1300 nm which was delivered to the sample through an optical fibre) and a 30 MHz ultrasonic transducer. After imaging, the microstructure of the tissue was assessed by routine histological processing. RESULTS: OCT yielded superior structural information in all plaques examined. The mean (SEM) axial resolution of OCT and IVUS imaging was 16 (1) and 110 (7), respectively, as determined by the point spread function from a mirror. Furthermore, the dynamic range of OCT was 109 dB compared with 43 dB for IVUS imaging. CONCLUSIONS: OCT represents a promising new technology for intracoronary imaging because of its high resolution, broad dynamic range, and ability to be delivered through intravascular catheters.
Aorta, Abdominal↗
Optical biopsy in human urologic tissue using optical coherence tomography.
Optical Coherence Tomography (OCT) is a recently developed non-invasive technique for obtaining high resolution, cross-sectional images of human tissue. This work investigated the capability of OCT to differentiate the architectural morphology of urologic tissue with the long term aim of using OCT as an adjunct to endoscopic imaging and to improve the efficiency of interventional procedures such as transurethral prostatectomy (TURP). Urologic tissues were taken postmortem, dissected, and imaged using OCT. Microstructure was delineated in different urologic tissues, including the prostatic urethra, prostate, bladder, and ureter, with an axial resolution of 16 +/- 1 microm., higher than any clinically available endoscopic intraluminal imaging technology. The ability of OCT to provide non-contact high resolution imaging of urologic tissue architectural morphology (i.e. optical biopsy), without the need for excisional biopsy, suggests the potential of using OCT to obtain information on tissue microstructure that could only previously be obtained with conventional biopsy.
Biopsy↗
Optical biopsy in human gastrointestinal tissue using optical coherence tomography.
OBJECTIVES: Optical coherence tomography (OCT) is a new technique for performing high-resolution, cross-sectional tomographic imaging in human tissue. OCT is somewhat analogous to ultrasound B mode imaging except that it uses light rather than acoustical waves. OCT has over 10 times the resolution of currently available clinical high-resolution imaging technologies. In this work, we investigate the capability of OCT to differentiate the architectural morphology of gastrointestinal tissue with the long-term objective of extending OCT to endoscopic based diagnostics. METHODS: Normal and diseased gastrointestinal tissues were taken postmortem and imaged using OCT. Images were compared with corresponding histology to confirm tissue identity and suggest the mechanisms that produce tissue contrast. RESULTS: Microstructure was delineated in different tissues, including the esophagus and colon, at 16 +/- 1 microns resolution, higher than any clinically available cross-sectional imaging technology. Differentiation of tissue layers, such as the mucosa, submucosa, and muscularis were achieved because of their different optical properties. CONCLUSIONS: The ability of OCT to provide high-resolution in situ imaging of gastrointestinal microstructure, without the need for excisional biopsy, suggests the feasibility of using OCT as a powerful diagnostic imaging technology, which can be integrated with conventional endoscopy.
Biopsy↗