Laser tissue coagulation and concurrent optical coherence tomography through a double-clad fiber coupler

Double-clad fiber (DCF) is herein used in conjunction with a double-clad fiber coupler (DCFC) to enable simultaneous and co-registered optical coherence tomography (OCT) and laser tissue coagulation. The DCF allows a single channel fiber-optic probe to be shared: i.e. the core propagating the OCT signal while the inner cladding delivers the coagulation laser light. We herein present a novel DCFC designed and built to combine both signals within a DCF (>90% of single-mode transmission; >65% multimode coupling). Potential OCT imaging degradation mechanisms are also investigated and solutions to mitigate them are presented. The combined DCFC-based system was used to induce coagulation of an ex vivo swine esophagus allowing a real-time assessment of thermal dynamic processes. We therefore demonstrate a DCFC-based system combining OCT imaging with laser coagulation through a single fiber, thus enabling both modalities to be performed simultaneously and in a co-registered manner. Such a system enables endoscopic image-guided laser marking of superficial epithelial tissues or laser thermal therapy of epithelial lesions in pathologies such as Barrett's esophagus.

Toward an automated method for optical coherence tomography characterization

With the increasing use of optical coherence tomography (OCT) in biomedical applications, robust yet simple methods for calibrating and benchmarking a system are needed. We present here a procedure based on a calibration object complemented with an algorithm that analyzes three-dimensional OCT datasets to retrieve key characteristics of an OCT system. The calibration object combines state-of-the-art tissue phantom material with a diamond-turned aluminum multisegment mirror. This method is capable of determining rapidly volumetric field-of-view, axial resolution, and image curvature. Moreover, as the phantom material mimics biological tissue, the system’s signal and noise levels can be evaluated in conditions close to biological experiments. We believe this method could improve OCT quantitative data analysis and help OCT data comparison for longitudinal or multicenter studies.

Surface plasmon resonance sensor interrogation with a double-clad fiber coupler and cladding modes excited by a tilted fiber Bragg grating

We present a novel optical fiber surface plasmon resonance (SPR) sensor scheme using reflected guided cladding modes captured by a double-clad fiber coupler and excited in a gold-coated fiber with a tilted Bragg grating. This new interrogation approach, based on the reflection spectrum, provides an improvement in the operating range of the device over previous techniques. The device allows detection of SPR in the reflected guided cladding modes and also in the transmitted spectrum, allowing comparison with standard techniques. The sensor has a large operating range from 1.335 to 1.432 RIU, and a sensitivity of 510.5 nm/RIU. The device shows strong dependence on the polarization state of the guided core mode which can be used to turn the SPR on or off.

Asymmetric double-clad fiber couplers for endoscopy

We present an asymmetric double-clad fiber coupler (A-DCFC) exploiting a disparity in fiber etendues to exceed the equipartition limit (≤50% extraction of inner cladding multi-mode light). The A-DCFC is fabricated using two commercially available fibers and a custom fusion-tapering setup to achieve >70% extraction of multi-mode inner cladding light without affecting (>95% transmission) single-mode light propagation in the core. Imaging with the A-DCFC is demonstrated in a spectrally encoded imaging setup using a weakly backscattering biological sample. Other applications include the combination of optical coherence tomography with weak fluorescent or Raman scattering signals.

Capturing reflected cladding modes from a fiber Bragg grating with a double-clad fiber coupler

We present a novel measurement scheme using a double-clad fiber coupler (DCFC) and a fiber Bragg grating (FBG) to resolve cladding modes. Direct measurement of the optical spectra and power in the cladding modes is obtained through the use of a specially designed DCFC spliced to a highly reflective FBG written into slightly etched standard photosensitive single mode fiber to match the inner cladding diameter of the DCFC. The DCFC is made by tapering and fusing two double-clad fibers (DCF) together. The device is capable of capturing backward propagating low and high order cladding modes simply and efficiently. Also, we demonstrate the capability of such a device to measure the surrounding refractive index (SRI) with an extremely high sensitivity of 69.769 ± 0.035 μW/RIU and a resolution of 1.433 × 10(-5) ± 8 × 10(-9) RIU between 1.37 and 1.45 RIU. The device provides a large SRI operating range from 1.30 to 1.45 RIU with sufficient discrimination for all individual captured cladding modes. The proposed scheme can be adapted to many different types of bend, temperature, refractive index and other evanescent wave based sensors.

Dual-modality needle probe for combined fluorescence imaging and three-dimensional optical coherence tomography

To the best of our knowledge, we present the first needle probe for combined optical coherence tomography (OCT), and fluorescence imaging. The probe uses double-clad fiber (DCF) that guides the OCT signal and fluorescence excitation light in the core and collects and guides the returning fluorescence in the large-diameter multimode inner cladding. It is interfaced to a 1310 nm swept-source OCT system that has been modified to enable simultaneous 488 nm fluorescence excitation and >500 nm emission detection by using a DCF coupler to extract the returning fluorescence signal in the inner cladding with high efficiency. We present imaging results from an excised sheep lung with fluorescein solution infused through the vasculature. We were able to identify alveoli, bronchioles, and blood vessels. The results demonstrate that the combined OCT plus fluorescence needle images provide improved tissue differentiation over OCT alone.

Quantitative distinction of unique vocal fold subepithelial architectures using optical coherence tomography

OBJECTIVES

The primary objective of this study was to quantitatively analyze ex vivo porcine, fetal human, and adult human vocal folds by use of optical coherence tomography (OCT). A secondary objective was to quantitatively discriminate among 1-, 2-, and 3-layer lamina propria structures.

METHODS

We performed an analysis of the vocal folds of 10 adult pig, 3 adult human, and 2 fetal human vocal fold specimens using OCT and histologic techniques. We present a quantitative comparison of the OCT results and histologic findings.

RESULTS

We found that OCT allowed for the visualization of the subepithelial vocal fold architecture of all imaged tissue, and that it revealed distinct characteristic signal intensities for each type of specimen.

CONCLUSIONS

Optical coherence tomography was developed for in vivo imaging of biological microstructures. This study demonstrates the ability of OCT to differentiate between the vocal fold architectures of 3 histologically distinct types of vocal folds. Future studies aim to develop a quantitative optical imaging algorithm that can be used to facilitate an in vivo longitudinal clinical investigation of the changes that occur in this layered structure over time and maturation.

Optical coherence tomography for the identification of musculoskeletal structures of the spine: a pilot study

Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine requiring in severe cases invasive surgery. Here, we explore the potential of optical coherence tomography (OCT) as a guiding tool for novel fusionless minimally invasive spinal surgeries on an ex vivo porcine model. We show that OCT, despite its limited penetration depth, may be used to precisely locate structures such as growth plate, bone and intervertebral disk using relative attenuation coefficients. We further demonstrate a segmentation algorithm that locates growth plates automatically on en-face OCT reconstructions.

Double-clad fiber with a tapered end for confocal endomicroscopy

We present a double-clad fiber coupler (DCFC) for use in confocal endomicroscopy to reduce speckle contrast, increase signal collection while preserving optical sectioning. The DCFC is made by incorporating a double-clad tapered fiber (DCTF) to a fused-tapered DCFC for achromatic transmission (from 1265 nm to 1325 nm) of > 95% illumination light trough the single mode (SM) core and collection of > 40% diffuse light through inner cladding modes. Its potential for confocal endomicroscopy is demonstrated in a spectrally-encoded imaging setup which shows a 3 times reduction in speckle contrast as well as 5.5 × increase in signal collection compared to imaging with a SM fiber.

Measurement of cerebral microvascular compliance in a model of atherosclerosis with optical coherence tomography

Optical coherence tomography (OCT) has recently been used to produce 3D angiography of microvasculature and blood flow maps of large vessels in the rodent brain in-vivo. However, use of this optical method for the study of cerebrovascular disease has not been fully explored. Recent developments in neurodegenerative diseases has linked common cardiovascular risk factors to neurodegenerative risk factors hinting at a vascular hypothesis for the development of the latter. Tools for studying cerebral blood flow and the myogenic tone of cerebral vasculature have thus far been either highly invasive or required ex-vivo preparations therefore not preserving the delicate in-vivo conditions. We propose a novel technique for reconstructing the flow profile over a single cardiac cycle in order to evaluate flow pulsatility and vessel compliance. A vascular model is used to simulate changes in vascular compliance and interpret OCT results. Comparison between atherosclerotic and wild type mice show a trend towards increased compliance in the smaller arterioles of the brain (diameter < 80μm) in the disease model. These results are consistent with previously published ex-vivo work confirming the ability of OCT to investigate vascular dysfunction.

Dispersion-based pulse shaping for multiplexed two-photon fluorescence microscopy

We demonstrate selective two-photon excited fluorescence microscopy with shaped pulses produced with a simple yet efficient scheme based on dispersive optical components. The pulse train from a broadband oscillator is split into two subtrains that are sent through different amounts of glass. Beam recombination results in pulse-shape switching at a rate of 150MHz. Time-resolved photon counting detection then provides two simultaneous images resulting from selective two-photon excitation, as demonstrated in a live embryo. Although less versatile than programmable pulse-shaping devices, this novel arrangement significantly improves the performance of selective microscopy using broadband shaped pulses while simplifying the experimental setup.

Co-registered spectrally encoded confocal microscopy and optical frequency domain imaging system

Spectrally encoded confocal microscopy and optical frequency domain imaging are two non-contact optical imaging technologies that provide images of tissue cellular and architectural morphology, which are both used for histopathological diagnosis. Although spectrally encoded confocal microscopy has better transverse resolution than optical frequency domain imaging, optical frequency domain imaging can penetrate deeper into tissues, which potentially enables the visualization of different morphologic features. We have developed a co-registered spectrally encoded confocal microscopy and optical frequency domain imaging system and have obtained preliminary images from human oesophageal biopsy samples to compare the capabilities of these imaging techniques for diagnosing oesophageal pathology.

High-velocity-flow imaging with real-time Doppler optical coherence tomography

We present a real-time time-domain Doppler optical coherence tomography (OCT) system based on the zero-crossing method for velocity measurements of fluid flows with attainable velocities up to 10 m/s. In the current implementation, one-dimensional and two-dimensional velocity profiles of fluid flows ranging from 1 cm/s to more than 3 m/s were obtained for both laminar and turbulent flows. The line rate was approximately 500 Hz, and the images were treated in real time. This approach has the advantage of providing reliable velocity maps free from phase aliasing or other artifacts common to several OCT systems. The system is particularly well suited for investigating complex velocity profiles, especially in the presence of steep velocity gradients.

Rapid spectrally encoded fluorescence imaging using a wavelength-swept source

We present rapid imaging of fluorescent samples using spectral encoding (SE). A near-IR wavelength-swept source in used to preserve the SE of the position, despite Stokes shifts. To validate this approach, we imaged fluorescent PbS quantum dot solutions at concentrations down to 0.5+/-0.1micromol/L. This simple configuration allowed acquisition rates of up to 9920 lines of 1024 pixels per second to create high-resolution images. This spectrally encoded setup could be easily miniaturized for endoscopy, thus combining high-resolution fluorescence with confocal reflectance imaging at unmatched acquisition speed.

Double-clad fiber coupler for endoscopy

We present a double-clad fiber coupler (DCFC) for use in endoscopy to reduce speckle contrast, increase signal collection and depth of field. The DCFC is made by fusing and tapering two all silica double-clad fiber (DCF) and allows achromatic transmission of >95% of core illumination (1265nm - 1325nm) as well as collection of >42% of inner cladding diffuse light. Its potential for endoscopy is demonstrated in a spectrally encoded imaging setup which shows speckle reduction by a factor 5, increased signal collection by a factor 9 and enhanced depth of field by 1.8 times. Separation by the DCFC of single- and multi-mode signals allows combining low-speckle reflectance images (25.5 fps) with interferometrically measured depth profiles (post-processed) for of small three-dimensional (3D) features through an all-fiber low loss instrument.

Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy

BACKGROUND

Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique that has the potential to be used for acquiring comprehensive images of the entire distal esophagus endoscopically with subcellular resolution.

OBJECTIVE

The goal of this study was to demonstrate large-area SECM in upper GI tissues and to determine whether the images contain microstructural information that is useful for pathologic diagnosis.

DESIGN

A feasibility study.

SETTING

Gastrointestinal Unit, Massachusetts General Hospital.

PATIENTS

Fifty biopsy samples from 36 patients undergoing routine EGD were imaged by SECM, in their entirety, immediately after their removal.

RESULTS

The microstructure seen in the SECM images was similar to that seen by histopathology. Gastric cardia mucosa was clearly differentiated from squamous mucosa. Gastric fundic/body type mucosa showed more tightly packed glands than gastric cardia mucosa. Fundic gland polyps showed cystically dilated glands lined with cuboidal epithelium. The presence of intraepithelial eosinophils was detected with the cells demonstrating a characteristic bilobed nucleus. Specialized intestinal metaplasia was identified by columnar epithelium and the presence of goblet cells. Barrett's esophagus (BE) with dysplasia was differentiated from specialized intestinal metaplasia by the loss of nuclear polarity and disorganized glandular architecture.

LIMITATIONS

Ex vivo, descriptive study.

CONCLUSIONS

Large-area SECM images of gastroesophageal biopsy samples enabled the visualization of both subcellular and architectural features of various upper GI mucosal types and were similar to the corresponding histopathologic slides. These results suggest that the development of an endoscopic SECM probe is merited.

Towards a handheld probe based on optical coherence tomography for minimally invasive spine surgeries

Minimally invasive surgical (MIS) techniques for the correction of scoliosis are under development. The installation of fusionless implants targeting the vertebral growth plate requires precise identification of spinal micro-structures. During ex vivo studies, we demonstrate that optical coherence tomography (OCT) allows visualization of spinal tissues including the growth plate, the intervertebral disc and the vertebral body. This study aims at designing a handheld probe using OCT and assessing its potential for use in MIS. An OCT handheld probe was built which satisfies criteria for resolution, penetration and field of view required for spinal MIS techniques. Ex vivo images of rat tail and porcine vertebrae enabled differentiating musculoskeletal tissues of the spine (growth plate, intervertebral disc and vertebral body). Pending in vivo studies on porcine models, we evaluated the probe on a human finger and demonstrated its ability to image human tissues at video rate (25 fps) with proper imaging depth and resolution. These preliminary results showed the potential of the OCT probe for dynamic and precise imaging of spinal tissues.

Multiplexed two-photon microscopy of dynamic biological samples with shaped broadband pulses

Coherent control can be used to selectively enhance or cancel concurrent multiphoton processes, and has been suggested as a means to achieve nonlinear microscopy of multiple signals. Here we report multiplexed two-photon imaging in vivo with fast pixel rates and micrometer resolution. We control broadband laser pulses with a shaping scheme combining diffraction on an optically-addressed spatial light modulator and a scanning mirror allowing to switch between programmable shapes at kiloHertz rates. Using coherent control of the two-photon excited fluorescence, it was possible to perform selective microscopy of GFP and endogenous fluorescence in developing Drosophila embryos. This study establishes that broadband pulse shaping is a viable means for achieving multiplexed nonlinear imaging of biological tissues.

Multimodality optical imaging of embryonic heart microstructure

Study of developmental heart defects requires the visualization of the microstructure and function of the embryonic myocardium, ideally with minimal alterations to the specimen. We demonstrate multiple endogenous contrast optical techniques for imaging the Xenopus laevis tadpole heart. Each technique provides distinct and complementary imaging capabilities, including: 1. 3-D coherence microscopy with subcellular (1 to 2 microm) resolution in fixed embryos, 2. real-time reflectance confocal microscopy with large penetration depth in vivo, and 3. ultra-high speed (up to 900 frames per second) that enables real-time 4-D high resolution imaging in vivo. These imaging modalities can provide a comprehensive picture of the morphologic and dynamic phenotype of the embryonic heart. The potential of endogenous-contrast optical microscopy is demonstrated for investigation of the teratogenic effects of ethanol. Microstructural abnormalities associated with high levels of ethanol exposure are observed, including compromised heart looping and loss of ventricular trabecular mass.

Large area confocal microscopy

Imaging large tissue areas with microscopic resolution in vivo may offer an alternative to random excisional biopsy. We present an approach for performing confocal imaging of large tissue surface areas using spectrally encoded confocal microscopy (SECM). We demonstrate a single-optical-fiber SECM apparatus, designed for imaging luminal organs, that is capable of imaging with a transverse resolution of 2.1 microm over a subsurface area of 16 cm2 in less than 1 min. Due to the unique probe configuration and scanning geometry, the speed and resolution of this new imaging technology are sufficient for comprehensively imaging large tissues areas at a microscopic scale in times that are appropriate for clinical use.

Rapid wavelength-swept spectrally encoded confocal microscopy

Spectrally encoded confocal microscopy (SECM) is a technique that allows confocal microscopy to be performed through the confines of a narrow diameter optical fiber probe. We present a novel scheme for performing SECM in which a rapid wavelength swept source is used. The system allows large field of view images to be acquired at rates up to 30 frames/second. Images of resolution targets and tissue specimens acquired ex vivo demonstrate high lateral (1.4 mum) and axial (6 mum) resolution. Imaging of human skin was performed in vivo at depths of up to 350 mum, allowing cellular and sub-cellular details to be visualized in real time.

Extended-Cavity Semiconductor Wavelength-Swept Laser for Biomedical Imaging

We demonstrate a compact high-power rapidly swept wavelength tunable laser source based on a semiconductor optical amplifier and an extended-cavity grating filter. The laser produces excellent output characteristics for biomedical imaging, exhibiting >4-mW average output power, <0.06-nm instantaneous linewidth, and >80-dB noise extinction with its center wavelength swept over 100 nm at 1310 nm at variable repetition rates up to 500 Hz.

High-speed wavelength-swept semiconductor laser with a polygon-scanner-based wavelength filter

Ultrahigh-speed tuning of an extended-cavity semiconductor laser is demonstrated. The laser resonator comprises a unidirectional fiber-optic ring, a semiconductor optical amplifier as the gain medium, and a novel scanning filter based on a polygonal scanner. Variable tuning rates up to 1150 nm/ms (15.7-kHz repetition frequency) are demonstrated over a 70-nm wavelength span centered at 1.32 microm. This tuning rate is more than an order of magnitude faster than previously demonstrated and is facilitated in part by self-frequency shifting in the semiconductor optical amplifier. The instantaneous linewidth of the source is <0.1 nm for 9-mW cw output power and a low spontaneous-emission background of -80 dB.

Endovascular procedures under near-real-time magnetic resonance imaging guidance: an experimental feasibility study

PURPOSE

The purpose of this study was to assess the feasibility of insertion of endovascular stents and the precision of an open-field interventional magnetic resonance imaging (iMRI) system in an in vivo model.

METHODS

A feasibility study was undertaken at a university-affiliated hospital. Three male piglets with an average age of 6 months and a weight between 70 and 77 kg and two 3-month-old male piglets that weighed 40 to 44 kg were anesthetized. The five piglets underwent placement of nitinol stents inserted through the right femoral artery, under the guidance of a SIGNA-SP 0. 5T open-configuration iMRI unit. With a dedicated high-resolution near-real-time MRI sequence, the stent was guided and deployed onto a predefined target.

RESULTS

The main outcome measures were the duration of the procedure from the beginning of positioning to the end of deployment of the stent, the final position of the stent in relation to the target on the iMRI screen, and comparison with autopsy findings. Three stents were deployed within the aorta at the level of the renal arteries, and two were deployed within the right iliac artery just below the aortic trifurcation. The average duration of the endovascular deployment was 13 minutes. There was an agreement of 0.6 mm in the position of the stent as observed on iMR images and found at autopsy. When the piglets were sacrificed, the average distance between the stents and the predefined target was 7. 8 mm, mostly because of the migration of one stent. Axial views allowed for accurate determination of stent impaction on the vascular wall.

CONCLUSIONS

This study confirms the feasibility of stent deployment under near-real-time MRI guidance. It also emphasizes some inherent characteristics that hold promise with regard to other conventional techniques: stents and vascular structures are visualized in near-real-time in any desired plane, and the technique is performed without the potential adverse effects of ionizing radiations and iodinated contrast agents.