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Biomedical subjects

J G Fujimoto

Publications and source records attributed to J G Fujimoto.

At least 19 recordsLinked to original sources

Nonlinear optics with phase-controlled pulses in the sub-two-cycle regime.

Nonlinear optical effects due to the phase between carrier and envelope are observed with 5 fs pulses from a Kerr-lens mode-locked Ti:sapphire laser. These sub-two-cycle pulses with octave spanning spectra are the shortest pulses ever generated directly from a laser oscillator. Detection of the carrier-envelope phase slip is made possible by simply focusing the short pulses directly from the oscillator into a BBO crystal. As a further example of nonlinear optics with such short pulses, the interference between second- and third-harmonic components is also demonstrated.

Journal Article↗

High-resolution imaging of the middle ear with optical coherence tomography: a feasibility study.

BACKGROUND: Optical coherence tomography (OCT) is a new medical imaging technology that generates cross-sectional images of tissue microstructure with micron-scale resolution. Optical coherence tomography is analogous to ultrasound, measuring the intensity of infrared light rather than acoustical waves. OBJECTIVE: To demonstrate the feasibility of using OCT for ultra-high-resolution imaging of the middle ear via ex vivo imaging studies of human tissue. DESIGN: Images of the tympanic membrane and middle ear were acquired ex vivo, through the ear canal, without perforating the tympanic membrane. MATERIALS: Four excised intact temporal bones and the auditory apparatus were harvested from cadavers and imaged fresh, without previous fixation. RESULTS: The resulting images were compared with the gross sample and verified the ability of OCT to delineate relevant structures, such as the tympanic membrane and its sublayers, and the middle ear ossicles, nerves, and tendons at higher resolutions than possible with standard clinical imaging technologies. CONCLUSION: The ability of OCT to produce high-resolution images of tissue structure, without contact and in real time, as well as its ability to be integrated with endoscopes, suggests that this technology could become a useful modality for the diagnosis and management of a range of clinical middle ear abnormalities.

Ear, Middle↗

Real-time optical coherence tomography for minimally invasive imaging of prostate ablation.

OBJECTIVE: Numerous ablation techniques have been developed to alleviate urethral obstruction and improve urodynamics in benign prostatic hyperplasia. Most techniques, however, rely on visual observation of surface changes for ablation end points. The feasibility of using real-time optical coherence tomography (OCT) for minimally invasive imaging to guide and monitor prostate resection is demonstrated with representative techniques of laser and radiofrequency ablation. Empiric comparisons of ablation dynamics are made, and the use of OCT as a high-resolution, subsurface modality for image guidance is evaluated. MATERIALS AND METHODS: Optical coherence tomography is a high-resolution, high-speed near-infrared imaging technique analogous to ultrasound imaging, except that reflections of light are detected rather than sound. High-speed OCT is used to image the dynamic process of laser and radiofrequency ablation of in vitro human prostate tissue. OCT images of ablation sites are compared with corresponding histology. RESULTS: Based on comparisons between OCT images and corresponding histology, OCT imaged transurethral prostate tissue morphology, including urethral sinuses and submucosal glands. Real-time OCT imaging provided rapid feedback and control of ablation dynamics. The compact and portable OCT technology is amenable to minimally invasive beam-delivery devices. CONCLUSIONS: Optical coherence tomography offers a minimally invasive means of assessing transurethral prostate morphology. Real-time OCT has the potential to provide image guidance of prostate resection for many of the existing surgical treatments directed at alleviating urethral obstruction associated with benign prostatic hyperplasia.

Catheter Ablation↗

Correlation of collagen organization with polarization sensitive imaging of in vitro cartilage: implications for osteoarthritis.

OBJECTIVE: Optical coherence tomography (OCT), a new method of high resolution imaging, has shown feasibility for assessing articular cartilage to identify early changes in osteoarthritis (OA) and monitor therapy. OCT is analogous to ultrasound, measuring the intensity of backreflected infrared light rather than sound. The resolution of this technology is up to 25 times higher than existing methods. We investigated the correlation between changes observed by OCT and the degree of collagen organization in OA cartilage. METHODS: Polarization sensitive OCT (PSOCT) imaging was used to assess changes in cartilage collagen organization in vitro. RESULTS: The presence (or absence) of PSOCT changes correlated with collagen organization (or disorganization) on histology as assessed by picrosirius polarization microscopy (no significant difference). In multiple cases, cartilage was abnormal by both PSOCT and polarization microscopy, but was grossly normal by routine staining, showing cartilage thickness > 2 mm and no fibrillations. CONCLUSION: This in vitro study suggests PSOCT changes in cartilage are due to the state of collagen organization. The combination of high resolution structural imaging and birefringence detection make OCT a potentially powerful technology for early assessment of OA.

Cartilage, Articular↗

Assessment of coronary plaque with optical coherence tomography and high-frequency ultrasound.

This study compares the ability of intravascular optical coherence tomography (OCT) and high-frequency intravascular ultrasound (IVUS) to image highly stenotic human coronary arteries in vitro. Current imaging modalities have insufficient resolution to perform risk stratification based on coronary plaque morphology. OCT is a new technology capable of imaging at a resolution of 5 to 20 microm, which has demonstrated the potential for coronary arterial imaging in prior experiments. Human postmortem coronary arteries with severely stenotic segments were imaged with catheter-based OCT and IVUS. The OCT system had an axial resolution of 20 microm and a transverse resolution of 30 microm. OCT was able to penetrate and image near-occlusive coronary plaques. Compared with IVUS, these OCT images demonstrated superior delineation of vessel layers and lack of ring-down artifact, leading to clearer visualization of the vessel plaque and intima. Histology confirmed the accuracy and high contrast of vessel layer boundaries seen on OCT images. Thus, catheter-based OCT systems are able to image near-occlusive coronary plaques with higher resolution than that of IVUS.

Coronary Artery Disease↗

Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies.

Optical coherence tomography (OCT) is a new imaging technology which can perform high-resolution, cross-sectional imaging of the internal microstructure of biological tissues. OCT is analogous to ultrasound, except that it measures the intensity of back-reflected infrared light rather than sound waves. OCT performs two- and three-dimensional imaging of tissue microstructure in situ and in real time. It can achieve image resolutions approaching the cellular level over approximately the same imaging depths as a conventional biopsy. In this article we examine the feasibility of OCT for high-resolution imaging of gastrointestinal malignancies with ex-vivo imaging of normal and pathologic microstructures. Tissue, both normal and neoplastic, was obtained from patients undergoing surgical resection after an initial diagnosis of a gastrointestinal malignancy. The tissue samples were imaged prior to fixation using a laboratory OCT system. The OCT system consists of a fiber optic-based Michelson interferometer, a commercially available amplified superluminscent light source, and a computer for data acquisition. The images were subsequently compared with histological cross-sections corresponding to the imaged areas. The stratified squamous epithelium of the normal esophagus was clearly visible in the OCT images and contrasted to the disorganized and non-uniform nature of the mucosal layers of Barrett's esophagus and squamous carcinoma. The columnar epithelial morphology as well as other mucosal structures in normal colon were distinctly visible using OCT. In contrast, disorganization of the normal mucosal layers and ulcerative lesions were identified in tissues from ulcerative colitis and adenocarcinoma of the colon. The ability of OCT to image tissue microstructure at high resolutions makes it a potentially powerful technology for minimally invasive assessment of the gastrointestinal tract and the evaluation of early neoplastic changes.

Adenocarcinoma↗

Optical coherence tomography: advanced technology for the endoscopic imaging of Barrett's esophagus.

BACKGROUND AND STUDY AIMS: Endoscopic optical coherence tomography (OCT) is an emerging medical technology capable of generating high-resolution cross-sectional imaging of tissue microstructure in situ and in real time. We assess the use and feasibility of OCT for real-time screening and diagnosis of Barrett's esophagus, and also review state-of-the-art OCT technology for endoscopic imaging. MATERIALS AND METHODS: OCT imaging was performed as an adjunct to endoscopic imaging of the human esophagus. Real-time OCT (13-microm resolution) was used to perform image-guided evaluation of normal esophagus and Barrett's esophagus. Beam delivery was accomplished with a 1-mm diameter OCT catheter-probe that can be introduced into the accessory channel of a standard endoscope. Different catheter-probe imaging designs which performed linear and radial scanning were assessed. Novel ultrahigh-resolution (1.1-microm resolution) and spectroscopic OCT techniques were used to image in vitro specimens of Barrett's esophagus. RESULTS: Endoscopic OCT images revealed distinct layers of normal human esophagus extending from the epithelium to the muscularis propria. In contrast, the presence of gland- and crypt-like morphologies and the absence of layered structures were observed in Barrett's esophagus. All OCT images showed strong correlations with architectural morphology in histological findings. Ultrahigh-resolution OCT techniques achieved 1.1-microm image resolution in in vitro specimens and showed enhanced resolution of architectural features. Spectroscopic OCT identified localized regions of wavelength-dependent optical scattering, enhancing the differentiation of Barrett's esophagus. CONCLUSIONS: OCT technology with compact fiberoptic imaging probes can be used as an adjunct to endoscopy for real-time image-guided evaluation of Barrett's esophagus. Linear and radial scan patterns have different advantages and limitations depending upon the application. Ultrahigh-resolution and spectroscopic OCT techniques improve structural tissue recognition and suggest future potential for resolution and contrast enhancements in clinical studies. A new balloon catheter-probe delivery device is proposed for systematic imaging and screening of the esophagus.

Barrett Esophagus↗

High-resolution optical coherence tomography-guided laser ablation of surgical tissue.

BACKGROUND: Optical coherence tomography (OCT) is a compact high-speed imaging technology which uses infrared light to acquire cross-sectional images of tissue on the micrometer scale. Because OCT images are based on the optical backscattering properties of tissue, changes in tissue optical properties due to surgical laser ablation should be detectable using this technique. In this work, we examine the feasibility of using real-time OCT imaging to guide the placement and observe the dynamics of surgical laser ablation in a variety of tissue types. MATERIALS AND METHODS: More than 65 sites on five ex vivo rat organ tissue types were imaged at eight frames per second before, during, and after laser ablation. Ablation was performed with a coincident continuous wave argon laser operating at 514-nm wavelength and varying exposure powers and durations. Following imaging, tissue registration was achieved using microinjections of dye followed by routine histologic processing to confirm the morphology of the ablation site. RESULTS: High-speed OCT imaging at eight frames per second permitted rapid tissue orientation and guided ablation in numerous organ specimens. Acquisition rates were fast enough to capture dynamic changes in optical backscatter which corresponded to thermal tissue damage during laser ablation. CONCLUSIONS: The ability of high-resolution high-speed OCT to guide laser ablation and image the dynamic changes suggests a role in image-guided surgical procedures, such as the ablation of neoplasms. Future in vivo studies are necessary to demonstrate performance intraoperatively.

Abdominal Muscles↗

Evaluation of focal defects of the nerve fiber layer using optical coherence tomography.

OBJECTIVE: To analyze glaucomatous eyes with known focal defects of the nerve fiber layer (NFL), relating optical coherence tomography (OCT) findings to clinical examination, NFL and stereoscopic optic nerve head (ONH) photography, and Humphrey 24-2 visual fields. DESIGN: Cross-sectional prevalence study. PARTICIPANTS: The authors followed 19 patients in the study group and 14 patients in the control group. INTERVENTION: Imaging with OCT was performed circumferentially around the ONH with a circle diameter of 3.4 mm using an internal fixation technique. One hundred OCT scan points taken within 2.5 seconds were analyzed. MAIN OUTCOME MEASURES: Measurements of NFL thickness using OCT were performed. RESULTS: In most eyes with focal NFL defects, OCTs showed significant thinning of the NFL in areas closely corresponding to focal defects visible on clinical examination, to red-free photographs, and to defects on the Humphrey visual fields. Optical coherence tomography enabled the detection of focal defects in the NFL with a sensitivity of 65% and a specificity of 81%. CONCLUSION: Analysis of NFL thickness in eyes with focal defects showed good structural and functional correlation with clinical parameters. Optical coherence tomography contributes to the identification of focal defects in the NFL that occur in early stages of glaucoma.

Cross-Sectional Studies↗

High resolution imaging of endometriosis and ovarian carcinoma with optical coherence tomography: feasibility for laparoscopic-based imaging.

High resolution imaging of gynaecological tissue offers the potential for identifying pathological changes at early stages when interventions are more effective. Optical coherence tomography (OCT) is a high resolution high speed optical imaging technology which is analogous to ultrasound B-mode imaging except reflections of light are detected rather than sound. The OCT technology is capable of being integrated with laparoscopy for real-time subsurface imaging. In this report, the feasibility of OCT for differentiating normal and pathologic laparoscopically-accessible gynaecologic tissue is demonstrated. Differentiation is based on architectural changes of in vitro tissue morphology. OCT has the potential to improve conventional laparoscopy by enabling subsurface imaging near the level of histopathology.

Endometriosis↗

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↗

High resolution imaging of transitional cell carcinoma with optical coherence tomography: feasibility for the evaluation of bladder pathology.

Significant challenges regarding patient morbidity and mortality remain in the management of transitional cell carcinoma (TCC). Among the most important of these challenges is the inability to identify early neoplastic changes and to assess the degree of tumour invasion into the bladder wall in vivo. Optical coherence tomography (OCT) has been recently developed to provide in situ, high resolution, catheter/endoscope based imaging. This study explored the feasibility of OCT for the evaluation of bladder pathology. Both in vitro and in vivo studies were performed. In vitro imaging of pathological human bladder was performed and compared with normal specimens and histopathology. In vivo imaging of normal rabbit bladder was also performed with our current catheter/endoscope based systems. In the in vitro studies, OCT was able to delineate normal microstructure of the bladder, such as the mucosa, submucosa and muscularis layers. This was in contrast to specimens of invasive carcinoma, where a disruption of the normal bladder wall architecture was seen. The in vivo experiment demonstrated current limitations of the catheter/endoscope based systems and provided valuable information for developing an improved system for bladder imaging. The ability of OCT to delineate microstructure of the bladder wall suggests feasibility for endoscopic based imaging. In particular, there is a potential role envisioned for OCT in the management of TCC, identifying pre-malignant states and the depth of tumour invasion.

Animals↗

High resolution imaging of normal and osteoarthritic cartilage with optical coherence tomography.

OBJECTIVE: We describe optical coherence tomography (OCT), a high resolution micron scale imaging technology, for assessment of osteoarthritic articular cartilage microstructure. OCT is analogous to ultrasound, measuring the intensity of backreflected infrared light rather than acoustical waves. METHODS: OCT imaging was performed on over 100 sites on 20 normal and osteoarthritic cartilage specimens in vitro. RESULTS: Microstructures that were identified included fibrillations, fibrosis, cartilage thickness, and new bone growth at resolutions between 5 and 15 microm. In addition, the polarization sensitivity of imaging suggested a diagnostic role of polarization spectroscopy. CONCLUSION: OCT represents an attractive new technology for intraarticular imaging due to its high resolution (greater than any available clinical technology), ability to be integrated into small arthroscopes, compact portable design, and relatively low cost.

Arthrography↗

High-resolution imaging of gynecologic neoplasms using optical coherence tomography.

BACKGROUND: A modality capable of imaging the female reproductive tract, at or near the cellular level, could lead to the detection of diseases at earlier stages than currently possible. Optical coherence tomography achieves high resolutions in the cellular range (4-20 microm) and could accomplish that level of detection. METHOD: Optical coherence tomography imaging of gynecologic tissue was studied in vitro on normal and neoplastic human cervical and uterine tissue. EXPERIENCE: The structures of the normal ectocervix and endocervix, including epithelium, basal membrane, and glands, were identified clearly. These findings were compared with changes associated with carcinoma in situ and invasive carcinoma. The optical coherence tomography images of the uterus also showed changes between microstructural features of normal tissue and endometrial adenocarcinoma. CONCLUSION: Optical coherence tomography of tissue microstructures showed potential for powerful, minimally invasive assessment of the female reproductive tract at a resolution greater than any current clinical imaging method.

Feasibility Studies↗

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↗