Imaging thermally damaged tissue by Polarization Sensitive Optical Coherence Tomography

Toward guidance of epicardial cardiac radiofrequency ablation therapy using optical coherence tomography

Radiofrequency ablation (RFA) is the standard of care to cure many cardiac arrhythmias. Epicardial ablation for the treatment of ventricular tachycardia has limited success rates due in part to the presence of epicardial fat, which prevents proper rf energy delivery, inadequate contact of ablation catheter with tissue, and increased likelihood of complications with energy delivery in close proximity to coronary vessels. A method to directly visualize the epicardial surface during RFA could potentially provide feedback to reduce complications and titrate rf energy dose by detecting critical structures, assessing probe contact, and confirming energy delivery by visualizing lesion formation. Currently, there is no technology available for direct visualization of the heart surface during epicardial RFA therapy. We demonstrate that optical coherence tomography (OCT) imaging has the potential to fill this unmet need. Spectral domain OCT at 1310 nm is employed to image the epicardial surface of freshly excised swine hearts using a microscope integrated bench-top scanner and a forward imaging catheter probe. OCT image features are observed that clearly distinguish untreated myocardium, ablation lesions, epicardial fat, and coronary vessels, and assess tissue contact with catheter-based imaging. These results support the potential for real-time guidance of epicardial RFA therapy using OCT imaging.

Biomechanical properties of in vivo human skin from dynamic optical coherence elastography

Dynamic optical coherence elastography is used to determine in vivo skin biomechanical properties based on mechanical surface wave propagation. Quantitative Young's moduli are measured on human skin from different sites, orientations, and frequencies. Skin thicknesses, including measurements from different layers, are also measured simultaneously. Experimental results show significant differences among measurements from different skin sites, between directions parallel and orthogonal to Langer's lines, and under different skin hydration states. Results also suggest surface waves with different driving frequencies represent skin biomechanical properties from different layers in depth. With features such as micrometer-scale resolution, noninvasive imaging, and real-time processing from the optical coherence tomography technology, this optical measurement technique has great potential for measuring skin biomechanical properties in dermatology.

Semi-Automated method of analysis of horizontal histological sections of skin for objective evaluation of fractional devices

BACKGROUND AND OBJECTIVE

The treatment of skin with fractional devices creates columns of micro-ablation or micro-denaturation depending on the device. Since the geometric profiles of thermal damage depend on the treatment parameters or physical properties of the treated tissue, the size of these columns may vary from a few microns to a few millimeters. For objective evaluation of the damage profiles generated by fractional devices, this report describes an innovative and efficient method of processing and evaluating horizontal sections of skin using a novel software program.

MATERIALS AND METHODS

Ex vivo porcine skin was treated with the Lux1540/10, Lux1540 Zoom and Lux2940 with 500 optics. Horizontal (radial) sections of biopsies were obtained and processed with H&E and NBTC staining. Digital images of the histologic sections were taken in either transmission or reflection illumination and were processed using the SAFHIR program.

RESULTS

NBTC- and H&E-stained horizontal sections of ex vivo skin treated with ablative and non-ablative fractional devices were obtained. Geometric parameters, such as depth, diameter, and width of the coagulated layer (if applicable), and micro-columns of thermal damage, were evaluated using the SAFHIR software. The feasibility of objective comparison of the performance of two different fractional devices was demonstrated.

CONCLUSION

The proposed methodology provides a comprehensive, objective, and efficient approach for the comparison of various fractional devices. Correlation of device settings with the objective dimensions of post-treatment damage profiles serve as a powerful tool for the prediction and modulation of clinical response.

In vitro characterization of cardiac radiofrequency ablation lesions using optical coherence tomography

Currently, cardiac radiofrequency ablation (RFA) is guided by indirect signals. We demonstrate optical coherence tomography (OCT) characterization of RFA lesions within swine ventricular wedges. Untreated tissue exhibited a consistent birefringence artifact within OCT images due to the organized myocardium, which was not present in treated tissue. Birefringence artifacts were detected by filtering with a Laplacian of Gaussian (LoG) to quantify gradient strength. The gradient strength distinguished RFA lesions from untreated sites (p=5.93 x 10(-15)) with a sensitivity and specificity of 94.5% and 86.7% respectively. This study demonstrates the potential of OCT for monitoring cardiac RFA, confirming lesion formation and providing feedback to avoid complications.

In vitro ovarian tumor growth and treatment response dynamics visualized with time-lapse OCT imaging

In vitro three-dimensional models for metastatic ovarian cancer have been useful for recapitulating the human disease. These spheroidal tumor cultures, however, can grow in excess of 1 mm in diameter, which are difficult to visualize without suitable imaging technology.Optical coherence tomography (OCT) is an ideal live imaging method for non-perturbatively visualizing these complex systems. OCT enabled detailed observations of the model at both nodular and cellular levels, revealing growth dynamics not previously observed. The development of a time-lapse OCT system, capable of automated, multidimensional acquisition, further provided insights into the growth and chemotherapeutic response of ovarian cancer.

Single-camera sequential-scan-based polarization-sensitive SDOCT for retinal imaging

A single-camera, high-speed, polarization-sensitive, spectral-domain optical-coherence-tomography system was developed to measure the polarization properties of the in vivo human retina. A novel phase-unwrapping method in birefringent media is described to extract the total reflectivity, accumulative retardance, and fast-axis orientation from a specially designed sequence of polarization states incident on the sample. A quarter-wave plate was employed to test the performance of the system. The average error and standard deviation of retardation measurements were 3.2 degrees and 2.3 degrees , respectively, and of the fast-axis orientation 1.2 degrees and 0.7 degrees over the range of 0 degrees -180 degrees . The depolarization properties of the retinal pigment epithelium were clearly observed in both retardance and fast-axis orientation image. A normalized standard deviation of the retardance and of the fast-axis orientation is introduced to segment the polarization-scrambling layer of the retinal pigment epithelium.

Quasi-holographic solution to polarization-sensitive optical coherence tomography acceptable to nonlaboratory applications

Experimental proof-of-concept is presented for a quasi-holographic solution to polarization-sensitive optical coherence tomography (PS OCT). Due to decoupling between the reference and sample beams by polarization, the solution seems acceptable to acquisition and communication of optical data in the nonlaboratory environment. The nonlab environment implies uncontrollable disturbances, e.g., temperature changes and mechanical effects happening under shop testing in industry or routine examinations in common clinics and hospitals. For mapping the collagen-related depolarization ratio of light backscattered from the human dermis, a phenomenological model is evolved from the theory of light depolarization in crystalline polymers. The model yielded a simplified intensity-based estimation algorithm. The design concept and the model rely on a submillimeter tumor thickness as a proofed prognostic factor and an important criterion for complementary functional diagnostics of skin cancers in their early phase. Choice of the model is inspired by similarity of structural and optical properties between liquid-crystal collagen fibers in the dermis and birefringent crystalline lamellae in some polymer materials. The model gives a plausible interpretation of a peculiarity of cumulative birefringence in the abnormal skin dermis. Following a top-down approach to design, the authors attempt to contribute to bridging the gap between practitioners' concerns and academic studies.

Autocalibration of spectral-domain optical coherence tomography spectrometers for in vivo quantitative retinal nerve fiber layer birefringence determination

Accurate wavelength assignment of each spectral element for spectral-domain optical coherence tomography (SD-OCT) and optical frequency domain imaging (OFDI) is required for proper construction of biological tissue cross-sectional images. This becomes more critical for functional extensions of these techniques, especially in polarization-sensitive optical coherence tomography (PS-OCT), where incorrect wavelength assignment between the two orthogonal polarization channels leads to polarization artifacts. We present an autocalibration method for wavelength assignment that does not require separate calibration measurements and that can be applied directly on actual data. Removal of the birefringence artifact is demonstrated in a PS-OCT system with picometer accuracy in the relative wavelength assignment, resulting in a residual phase error of 0.25 deg/100 microm. We also demonstrate, for the first time, a quantitative birefringence map of an in vivo human retinal nerve fiber layer.

Spectral domain polarization sensitive optical coherence tomography achieved by single camera detection

We present a spectral domain polarization sensitive optical coherence tomography (PSOCT) system that incorporates: 1) a spectrometer configured with a single line-scan camera for spectral interferogram detection, 2) a reference delay line assembly that provides a fixed optical pathlength delay between the lights of two orthogonal polarization states, and 3) a moving reference mirror that introduces a constant modulation frequency in the spatial spectral interferograms while the probe beam is scanned over the sample. The system utilizes the full range of complex Fourier plane for polarization sensitive imaging, where OCT images formed by the vertical and horizontal polarization beam components appear adjacent to each other. It is able to provide imaging of retardation, fast optic axis and backscattered intensity of the interrogated biological tissue. The system is experimentally demonstrated both in vitro and in vivo with an imaging rate at 10,000 A scans per second.

Polarization-sensitive optical coherence tomography for imaging human atherosclerosis

Polarization-sensitive optical coherence tomography (PS-OCT) combines the advantages of OCT with image contrast enhancement, which is based on its ability to detect phase retardation and the fast-axis angle. Both PS-OCT images and histopathology have demonstrated similar features that allowed differentiation of atherosclerotic structures (i.e., plaques) from normal tissue. Moreover, the picrosirius polarization method was used to confirm PS-OCT assessment of collagen in the fibrous cap of atherosclerotic plaques, and high-frequency (40 MHz) ultrasound images were used to identify calcium in the vessel wall. Our preliminary ex vivo investigation of human aortic specimens indicated that PS-OCT might help to identify atherosclerotic lesions.

Real-time microscopic visualization of tissue response to laser thermal therapy

We present methods for visualizing the dynamic response of biological samples to laser-induced heating. Our approach utilizes optical frequency-domain imaging to detect, spatially localize, and monitor unique dynamic signatures that arise within zones of active tissue denaturation. Since this information is precisely registered with high-resolution ( approximately 10 microm) cross sectional images, regions of thermally destroyed tissue can be mapped in relation to pre-existing morphology. Using porcine esophageal specimens ex vivo, we demonstrate that the extent and evolution of laser thermal damage can be assessed in real time.

Imaging of human aortic atherosclerotic plaques by polarization-sensitive optical coherence tomography

Optical coherence tomography (OCT) is analogous to ultrasound imaging except that it uses infrared light instead of sound. Polarization-sensitive optical coherence tomography (PS-OCT) combines the advantages of OCT and provides additional image contrast of the tested sample. We demonstrate this technique for imaging of back-reflected light, birefringence, and fast-axis orientation simultaneously in different kinds of atherosclerosis plaque. This in vitro study suggests birefringence changes in plaque are due to the prominent deposition of collagen or cholesterol by correlating PS-OCT images with histology. Thus the combination of high resolution structural imaging and birefringence detection make PS-OCT a potentially powerful tool for early assessment of atherosclerosis appearance and prediction of plaque rupture.

Multifunctional Imaging of Endogenous Contrast by Simultaneous Nonlinear and Optical Coherence Microscopy of Thick Tissues

A variety of high resolution optical microscopy techniques have been developed in recent years for basic and clinical studies of biological systems. We demonstrate a trimodal microscope combining optical coherence microscopy (OCM) with two forms of nonlinear microscopy, namely two-photon excited fluorescence (2PF) and second harmonic generation (SHG), for imaging turbid media. OCM combines the advantages of confocal detection and coherence gating for structural imaging in highly scattering tissues. Nonlinear microscopy enables the detection of biochemical species, such as elastin, NAD(P)H, and collagen. While 2PF arises from nonlinear excitation of fluorescent species, SHG is a form of nonlinear scattering observed in materials that lack a center of inversion symmetry, such as type I collagen. Characterization of the microscope showed nearly diffraction-limited spatial resolution in all modalities. Images were obtained in fish scales and excised human skin samples. The primary endogenous sources of contrast in the dermis were due to elastin autofluorescence and collagen SHG. Multimodal microscopy allows the simultaneous visualization of structural and functional information of biological systems.

Noninvasive assessment of cutaneous wound healing using ultrahigh-resolution optical coherence tomography

Ultrahigh-resolution optical coherence tomography (OCT) was used for noninvasive in vivo evaluation of the wound healing process. Cutaneous wounds were induced by 2.5-mm diameter full-thickness punch biopsies on the dorsal surface of seven mice. OCT imaging was performed to assess the structural characteristics associated with the healing process. The OCT results were compared to corresponding histology. Two automated quantitative analysis routines were implemented to identify the dermal-epidermal junction and segment the OCT images. Hallmarks of cutaneous wound healing such as wound size, epidermal migration, dermal-epidermal junction formation, and differences in wound composition were readily identified on the OCT images. Blister formation was also observed. Preliminary findings suggest OCT is a viable tool to noninvasively monitor wound healing in vivo.

Fiber-based polarization-sensitive Fourier domain optical coherence tomography using B-scan-oriented polarization modulation method

Fiber-based high-speed polarization-sensitive Fourier domain optical coherence tomography (PS-FD-OCT) is developed at 840 nm wavelength using polarization modulation method. The incident state of polarization is modulated along B-scan. The spectrometer has a polarizing beamsplitter and two line-CCD cameras operated at a line rate of 27.7 kHz. From the 0th and 1st orders of the spatial frequencies along the B-scanning, a depth-resolved Jones matrix can be derived. Since continuous polarization modulation along B-scan causes fringe washout, equivalent discrete polarization modulation is applied to biological measurements. For the demonstration, an in vitro chicken breast muscle, an in vivo finger pad, and an in vivo caries lesion of a human tooth are measured. Three dimensional phase retardation images show the potentials for applying the system to biological and medical studies.

Measurement of optical path length change following pulsed laser irradiation using differential phase optical coherence tomography

Differential phase optical coherence tomography (DPOCT) is introduced to measure optical path length changes in response to pulsed laser irradiation (585 nm). An analytical equation that includes thermoelastic surface displacement and thermorefractive index change is derived to predict optical path length change in response to pulsed laser irradiation for both "confined surface" and "free surface" model systems. The derived equation is tested by comparing predicted values with data recorded from experiments using two model systems. Thermorefractive index change and the thermal expansion coefficient are deduced from differential phase change (dDeltaphi) and temperature increase (DeltaT0) measurements. The measured n(T0)beta(T0)+dndT[=1.7410(-4)+/-1.710(-6) (1K)] in the free surface experiment matches with the National Institute of Standards and Technology (NIST) data value [=1.7710(-4) (1K)]. Exclusion of lateral thermal expansion in the analytical model for the confined surface experiment causes difference between the measured dndT[=-2.310(-4)+/-7.310(-6)(1K)] and the NIST value [=-9.4510(-5) (1K)]. In spite of the difference in the confined surface experiment, results of our studies indicate DPOCT can detect dynamic optical path length change in response to pulsed laser irradiation with high sensitivity, and applications to tissue diagnostics may be possible.

Automatic characterization and segmentation of human skin using three-dimensional optical coherence tomography

A set of fully automated algorithms that is specialized for analyzing a three-dimensional optical coherence tomography (OCT) volume of human skin is reported. The algorithm set first determines the skin surface of the OCT volume, and a depth-oriented algorithm provides the mean epidermal thickness, distribution map of the epidermis, and a segmented volume of the epidermis. Subsequently, an en face shadowgram is produced by an algorithm to visualize the infundibula in the skin with high contrast. The population and occupation ratio of the infundibula are provided by a histogram-based thresholding algorithm and a distance mapping algorithm. En face OCT slices at constant depths from the sample surface are extracted, and the histogram-based thresholding algorithm is again applied to these slices, yielding a three-dimensional segmented volume of the infundibula. The dermal attenuation coefficient is also calculated from the OCT volume in order to evaluate the skin texture. The algorithm set examines swept-source OCT volumes of the skins of several volunteers, and the results show the high stability, portability and reproducibility of the algorithm.

Optic axis determination accuracy for fiber-based polarization-sensitive optical coherence tomography

We present a generalized analysis of fiber-based polarization-sensitive optical coherence tomography with an emphasis on determination of sample optic axis orientation. The polarization properties of a fiber-based system can cause an overall rotation in a Poincaré sphere representation such that the plane of possible measured sample optic axes for linear birefringence and diattenuation no longer lies in the QU-plane. The optic axis orientation can be recovered as an angle on this rotated plane, subject to an offset and overall indeterminacy in sign such that only the magnitude, but not the direction, of a change in orientation can be determined. We discuss the accuracy of optic axis determination due to a fundamental limit on the accuracy with which a polarization state can be determined as a function of signal-to-noise ratio.

Comparison of histometric data obtained by optical coherence tomography and routine histology

There is a lack of systematic investigations comparing optical coherence tomography (OCT) with histology. OCT assessments were performed on the upper back of 16 healthy subjects. Epidermis thickness (ET) was assessed using three methods: first, peak-to-valley analysis of the A-scan (ET-OCT-V); second, manual measurements in the OCT images (ET-OCT-M); third, light microscopic determination using routine histology (ET-Histo). The relationship between the different methods was assessed by means of the Pearson correlation procedure and Bland and Altman plots. We observed a strong correlation between ET-Histo (79.4+/-21.9 microm) and ET-OCT-V (79.2+/-15.5 microm, r=0.77) and ET-OCT-M (82.9+/-15.8 microm, r=0.75), respectively. Bland and Altman plots revealed a bias of -0.19 microm (95% limits of agreement: -27.94 microm to 27.56 microm) for ET-OCT-V versus ET-Histo and a bias of 3.44 microm (95% limits of agreement: -24.9 microm to 31.78 microm) for ET-OCT-M versus ET-Histo. Despite the strong correlation and low bias observed, the 95% limits of agreement demonstrated an unsatisfactory numerical agreement between the two OCT methods and routine histology indicating that these methods cannot be employed interchangeably. Regarding practicability, precision, and indication spectrum, ET-OCT-V and ET-OCT-M are of different clinical value.

Characterization of dentin, enamel, and carious lesions by a polarization-sensitive optical coherence tomography system

Enamel and dentin are the primary components of human teeth. Both of them have a strong polarization effect. We designed a polarization-sensitive optical coherence tomography (PSOCT) system to study the spatially resolved scattering and polarization phenomena of teeth. The system is constructed in free space to avoid the complexity of polarization control in fiber-based PSOCT. The structural features of enamel were evaluated in five human teeth that had no visible evidence of caries. The teeth were subsequently sectioned in mesial distal orientation and coronal orientation. Then the structural aspects of dentin were evaluated. OCT images were made of the mantel dentin near the dentin-enamel junction. Five teeth with interproximal and occlusal caries were also studied. With two channel and phase-retardation images, PSOCT provided better functional contrast and more detailed structural information than conventional OCT. For a better description of the measured PSOCT data, we classify these features by two types, i.e., the local textural features and the global structural features. This study indicates that PSOCT has the potential to be a powerful tool for research of dental formation and caries diagnosis.

Jones matrix analysis for a polarization-sensitive optical coherence tomography system using fiber-optic components

We present an analysis for polarization-sensitive optical coherence tomography that facilitates the unrestricted use of fiber and fiber-optic components throughout an interferometer and yields sample birefringence, diattenuation, and relative optic axis orientation. We use a novel Jones matrix approach that compares the polarization states of light reflected from the sample surface with those reflected from within a biological sample for pairs of depth scans. The incident polarization alternated between two states that are perpendicular in a Poincaré sphere representation to ensure proper detection of tissue birefringence regardless of optical fiber contributions. The method was validated by comparing the calculated diattenuation of a polarizing sheet, chicken tendon, and muscle with that obtained by independent measurement. The relative importance of diattenuation versus birefringence to angular displacement of Stokes vectors on a Poincaré sphere was quantified.

Collagen denaturation can be quantified in burned human skin using polarization-sensitive optical coherence tomography

Quantifiable prognostic indicators are of considerable practical value following thermal injury. Collagen is a major component of the skin, and is known to undergo denaturation at the elevated temperatures associated with burns. The purpose of this study was to determine whether a recently developed, non-invasive imaging technique could detect and quantify collagen denaturation in burned human skin. Polarization-sensitive optical coherence tomography (PS-OCT) imaging was used to quantify collagen birefringence in normal human skin, and in skin excised from burn patients. Images were acquired and displayed in 1s, and demonstrated qualitative differences between normal and partial-thickness burned human skin. Birefringence loss due to thermal denaturation of collagen was quantified, with mean phase retardation rates for samples of 26 normal and 26 burned skin sites determined to be 0.401 +/- 0.020 and 0.249 +/- 0.017 degrees /microm, respectively (mean +/- S.E.M.), with this difference in sample means shown to be statistically significant (P < 0.000001). Analysis of the accuracy of the technique indicated that PS-OCT measurements may be made with resolution sufficient to distinguish between burns of varying severity. In conclusion, PS-OCT is capable of imaging and quantifying collagen denaturation in burned human skin, providing a new parameter against which post-injury outcome may be compared.

Advances in optical coherence tomography imaging for dermatology

Optical coherence tomography (OCT) is a non-invasive imaging technique, which has previously demonstrated potential for use in dermatology. The purpose of this study is to demonstrate how improvements in image quality, speed, and functionality enable qualitative and quantitative information to be obtained from in vivo human skin. We developed a portable fiber-optic based OCT imaging device that requires only 1 second to simultaneously provide high-resolution images of skin structure, collagen birefringence, and blood flow. Images of normal human skin were acquired in vivo, and features compared with clinical and histologic observations. The layered structure and appendages of skin were apparent in conventional OCT images, and correlated well with corresponding histology. Polarization-sensitive OCT images simultaneously revealed birefringent regions within the dermis corresponding to the location of collagen fibers, as confirmed with polarized light microscopy. Properties of collagen-rich tissues including tendon and scar tissues were quantified. Location of blood flow was also displayed alongside structural and polarization-sensitive images. Significant improvements in OCT technology have been made since its early application in dermatology. In particular, combining the previously described structural and Doppler imaging functions with polarization-sensitive imaging increases the utility of the technique for rapid, non-invasive investigations in the skin.

Differential phase optical coherence probe for depth-resolved detection of photothermal response in tissue

We describe a differential phase low-coherence interferometric probe for non-invasive, quantitative imaging of photothermal phenomena in biological materials. Our detection method utilizes principles of optical coherence tomography with differential phase measurement of interference fringe signals. A dual-channel optical low-coherence probe is used to analyse laser-induced thermoelastic and thermorefractive effects in tissue with micrometre axial resolution and nanometre sensitivity. We demonstrate an application of the technique using tissue phantoms and ex-vivo tissue specimens of rodent dorsal skin.

Three dimensional polarization sensitive OCT of human skin in vivo

We present three dimensional images of backscattered intensity, and to the best of our knowledge, the first 3D-images of retardation and fast axis orientation of human skin in vivo. The images were recorded with a phase resolved, polarization sensitive optical coherence tomography (OCT) system which is based on a fast transversal scanning of the sample. The three dimensional data sets were obtained by recording several en face images at different depths within the sample. Intensity and retardation images are combined to a 4 dimensional animation to enhance the visualization of the three dimensional data set. The three dimensional information enables a more accurate interpretation of the structural and birefringence information as compared to 2 dimensional B-scans. Birefringence properties of different skin regions are presented and discussed.

Optical coherence tomography for ultrahigh resolution in vivo imaging

Optical coherence tomography (OCT) is an emerging biomedical optical imaging technique that performs high-resolution, cross-sectional tomographic imaging of microstructure in biological systems. OCT can achieve image resolutions of 1-15 microm, one to two orders of magnitude finer than standard ultrasound. The image penetration depth of OCT is determined by the optical scattering and is up to 2-3 mm in tissue. OCT functions as a type of 'optical biopsy' to provide cross-sectional images of tissue structure on the micron scale. It is a promising imaging technology because it can provide images of tissue in situ and in real time, without the need for excision and processing of specimens.

Birefringence measurements in human skin using polarization-sensitive optical coherence tomography

Optical coherence tomography enables cross-sectional imaging of tissue structure to depths of around 1.5 mm, at high-resolution and in real time. Incorporation of polarization sensitivity (PS) provides an additional contrast mechanism which is complementary to images mapping backscattered intensity only. We present here polarization-sensitive optical coherence tomography (OCT) images of human skin in vivo, demonstrating the ability of the technique to visualize and quantify the birefringent properties of skin. Variation in normal skin birefringence according to anatomical location is demonstrated, and discussed in relation to collagen distribution at each location. From measurements on a sample of five human volunteers, mean double-pass phase retardation rates of 0.340+/-0.143, 0.250+/-0.076, and 0.592+/-0.142 deg/microm were obtained for the dorsal hand, temple, and lower back regions, respectively. We demonstrate how averaging the Stokes parameters of backscattered light over a range of axial and lateral dimensions results in a reduction of speckle-induced noise. Examples of PS-OCT images from skin sites following wound healing and repair are also presented and discussed.

Hand-held arthroscopic optical coherence tomography for in vivo high-resolution imaging of articular cartilage

We describe a novel hand-held polarization optical coherence tomographic (OCT) probe that can be inserted into mammalian joints to permit real-time cross-sectional imaging of articular cartilage. The transverse and axial resolutions of the arthroscopic OCT device are roughly 17 and 10 microm, respectively. Two-dimensional cross-sectional images of cartilage tissue with 500 x 1000 pixels covering an area 6 mm in length and 2.8 mm in depth can be acquired at nearly five frames/s and with over 100 dB of dynamic range. Design of an OCT as a hand-held device capable of providing such an optical biopsy of articular cartilage allows eventual in vivo detection of microstructural changes in articular cartilage that are not apparent using conventional arthroscopic cameras. The OCT probe can be easily incorporated in a conventional arthroscope for cartilage site guidance. The optical arrangement in the OCT scope minimizes specular back-reflection of the probe end face and absorption of body fluid in the path and ensures in-focus OCT imaging when it is in contact with the cartilage specimen to be examined. Successful application of in vivo arthroscopy to porcine articular cartilage demonstrates sufficient resolution and practicality for use in human joints.

Full-field birefringence imaging by thermal-light polarization-sensitive optical coherence tomography. I. Theory

A method for measuring birefringence by use of thermal-light polarization-sensitive optical coherence tomography is presented. The use of thermal light brings to polarization-sensitive optical coherence tomography a resolution in the micrometer range in three dimensions. The instrument is based on a Linnik interference microscope and makes use of achromatic quarter-wave plates. A mathematical representation of the instrument is presented here, and the detection scheme is described, together with a discussion of the validity domain of the equations used to evaluate the birefringence in the presence of white-light illumination.

Full-field birefringence imaging by thermal-light polarization-sensitive optical coherence tomography. II. Instrument and results

We describe an instrument for measuring the magnitude of birefringence of tomographic images and the principal directions of axes that use thermal-light polarization-sensitive optical coherence tomography. The instrument permits full-field measurements with an axial resolution of 1.5 microm and a transverse resolution limited by diffraction. We obtained a sensitivity of 84 dB, limited by shot noise, when we integrated the signal for 1 s. We verified the validity of the measurement by measuring the birefringence of a variable phase shifter. We present typical results obtained with optical samples.

Speckle reduction in optical coherence tomography by frequency compounding

We are investigating the possibility of a frequency compounding method for speckle reduction in optical coherence tomography. The method is based on incoherent summation of the magnitudes of two independent interferometric signals, which were recorded at two different center wavelengths simultaneously. We derive the corresponding statistics and compare the theoretical results with measurements obtained in a uniformly scattering sample. Finally we demonstrate our method by comparing images of human skin recorded in vivo with and without frequency compounding. The compounding method results in an increased contrast and improved image quality without loss of resolution.

Real-time multi-functional optical coherence tomography

We demonstrate real-time acquisition, processing, and display of tissue structure, birefringence, and blood flow in a multi-functional optical coherence tomography (MF-OCT) system. This is accomplished by efficient data processing of the phase-resolved inteference patterns without dedicated hardware or extensive modification to the high-speed fiber-based OCT system. The system acquires images of 2048 depth scans per second, covering an area of 5 mm in width x 1.2 mm in depth with real-time display updating images in a rolling manner 32 times each second. We present a video of the system display as images from the proximal nail fold of a human volunteer are taken.

Jones-matrix imaging of biological tissues with quadruple-channel optical coherence tomography

Two-dimensional depth-resolved Jones-matrix images of scattering biological tissues were measured with novel double-source double-detector polarization-sensitive optical coherence tomography (OCT). The Jones matrix can be determined in a single scan with this OCT system. The experimental results show that this system can be effectively applied to the measurement of soft tissues, which are less stable than hard tissues. Polarization parameters such as diattenuation, birefringence, and orientation of the fast axis can be extracted through decomposition of the measured Jones matrix. The Jones matrix of thermally treated porcine tendon showed a reduction of birefringence from thermal damage. The Jones matrices of porcine skin and bovine cartilage also revealed that the density and orientation of the collagen fibers in porcine skin and bovine cartilage are not distributed as uniformly as in porcine tendon. Birefringence is sensitive to changes in tissue because it is based on phase contrast.

In vivo burn depth determination by high-speed fiber-based polarization sensitive optical coherence tomography

We report the first application of high-speed fiber-based polarization sensitive optical coherence tomography (PS-OCT) to image burned tissue in vivo. Thermal injury denatures collagen in skin and PS-OCT can measure the reduction in collagen birefringence using depth resolved changes in the polarization state of light propagated in, and reflected from, the tissue. Stokes vectors were calculated for each point in a scan and birefringence relative to incident polarization determined using four incident polarization states. Using a high-speed fiber-based PS-OCT system on rat skin burned for varying periods of time, a correlation between birefringence and actual burn depth determined by histological analysis was established. In conclusion, PS-OCT has potential use for noninvasive assessment of burn depth.

Simplified method for polarization-sensitive optical coherence tomography

We report a method for extracting the birefringence properties of biological samples with micrometer-scale resolution in three dimensions, using a new form of polarization-sensitive optical coherence tomography. The method measures net retardance, net fast axis, and total reflectivity as a function of depth into the sample. Polarization sensing is accomplished by illumination of the sample with at least three separate polarization states during consecutive acquisitions of the same pixel, A scan, or B scan. The method can be implemented by use of non-polarization-maintaining fiber and a single detector. In a calibration test of the system, net retardance was measured with an average error of 7.5 degrees (standard deviation 2.2 degrees ) over the retardance range 0 degrees to 180 degrees , and a fast axis with average error of 4.8 degrees over the range 0 degrees to 180 degrees .

Er:YAG laser skin resurfacing using repetitive long-pulse exposure and cryogen spray cooling: I. Histological study

BACKGROUND AND OBJECTIVE

To evaluate histologically the characteristics of repetitive Er:YAG laser exposure of skin in combination with cryogen spray cooling (CSC), and its potential as a method of laser skin resurfacing.

STUDY DESIGN/MATERIALS AND METHODS

Rat skin was irradiated in vivo with sequences of 10 Er:YAG laser pulses (repetition rate 20 Hz, pulse duration 150 or 550 micros, single-pulse fluence 1.3-5.2 J/cm(2)). In some examples, CSC was applied to reduce epidermal injury. Histologic evaluation was performed 1 hour, 1 day, 5 days, and 4 weeks post-irradiation.

RESULTS

A sequence of ten 550-micros pulses with fluences around 2 J/cm(2) resulted in acute dermal collagen coagulation to a depth of approximately 250 microm, without complete epidermal ablation. CSC improved epidermal preservation, but also diminished the coagulation depth. Four weeks after irradiation, neo-collagen formation was observed to depths in excess of 100 microm.

CONCLUSIONS

Dermal collagen coagulation and neo-collagen formation to depths similar to those observed after CO(2) laser resurfacing can be achieved without complete ablation of the epidermis by rapidly stacking long Er:YAG laser pulses. Application of CSC does not offer significant epidermal protection for a given dermal coagulation depth.

Depth-resolved two-dimensional stokes vectors of backscattered light and mueller matrices of biological tissue measured with optical coherence tomography

Mueller matrices provide a complete characterization of the optical polarization properties of biological tissue. A polarization-sensitive optical coherence tomography (OCT) system was built and used to investigate the optical polarization properties of biological tissues and other turbid media. The apparent degree of polarization (DOP) of the backscattered light was measured with both liquid and solid scattering samples. The DOP maintains the value of unity within the detectable depth for the solid sample, whereas the DOP decreases with the optical depth for the liquid sample. Two-dimensional depth-resolved images of both the Stokes vectors of the backscattered light and the full Mueller matrices of biological tissue were measured with this system. These polarization measurements revealed some tissue structures that are not perceptible with standard OCT.

Optical coherence tomography of the rat cochlea

Optical coherence tomography (OCT) was used to image the internal structure of a rat cochlea (ex vivo). Immediately following sacrifice, the temporal bone of a Sprague-Dawley rat was harvested. Axial OCT cross sectional images (over regions of interest, 1x1 mm-2x8 mm) were obtained with a spatial resolution of 10-15 microm. The osseous borders of the lateral membranous labyrinth overlying the cochlea and the scala vestibuli, media, and tympani, which were well demarcated by the modiolus, Reissner's and the basilar membranes, were clearly identified. OCT can be used to image internal structures in the cochlea without violating the osseous labyrinth using simple surgical exposure of the promontory, and may potentially be used to diagnose inner ear pathology in vivo in both animal and human subjects labyrinth.

High-speed fiber based polarization-sensitive optical coherence tomography of in vivo human skin

A high-speed single-mode fiber-based polarization-sensitive optical coherence tomography (PS OCT) system was developed. With a polarization modulator, Stokes parameters of reflected flight for four input polarization states are measured as a function of depth. A phase modulator in the reference arm of a Michelson interferometer permits independent control of the axial scan rate and carrier frequency. In vivo PS OCT images of human skin are presented, showing subsurface structures that are not discernible in conventional OCT images. A phase retardation image in tissue is calculated based on the reflected Stokes parameters of the four input polarization states.

Quantifying the properties of two-layer turbid media with frequency-domain diffuse reflectance

Noncontact, frequency-domain measurements of diffusely reflected light are used to quantify optical properties of two-layer tissuelike turbid media. The irradiating source is a sinusoidal intensity-modulated plane wave, with modulation frequencies ranging from 10 to 1500 MHz. Frequency-dependent phase and amplitude of diffusely reflected photon density waves are simultaneously fitted to a diffusion-based two-layer model to quantify absorption (mu(a)) and reduced scattering (mu(s)') parameters of each layer as well as the upper-layer thickness (l). Study results indicate that the optical properties of two-layer media can be determined with a percent accuracy of the order of +/-9% and +/-5% for mu(a) and mu(s)', respectively. The accuracy of upper-layer thickness (l) estimation is as good as +/-6% when optical properties of upper and lower layers are known. Optical property and layer thickness prediction accuracy degrade significantly when more than three free parameters are extracted from data fits. Problems with convergence are encountered when all five free parameters (mu(a) and mu(s)' of upper and lower layers and thickness l) must be deduced.

Polarization Effects in Optical Coherence Tomography of Various Biological Tissues

Polarization sensitive optical coherence tomography (PS-OCT) was used to obtain spatially resolved ex vivo images of polarization changes in skeletal muscle, bone, skin and brain. Through coherent detection of two orthogonal polarization states of the signal formed by interference of light reflected from the biological sample and a mirror in the reference arm of a Michelson interferometer, the depth resolved change in polarization was measured. Inasmuch as any fibrous structure will influence the polarization of light, PS-OCT is a potentially powerful technique investigating tissue structural properties. In addition, the effects of single polarization state detection on OCT image formation is demonstrated.

Polarization Effects in Optical Coherence Tomography of Various Biological Tissues

Polarization sensitive optical coherence tomography (PS-OCT) was used to obtain spatially resolved ex vivo images of polarization changes in skeletal muscle, bone, skin and brain. Through coherent detection of two orthogonal polarization states of the signal formed by interference of light reflected from the biological sample and a mirror in the reference arm of a Michelson interferometer, the depth resolved change in polarization was measured. Inasmuch as any fibrous structure will influence the polarization of light, PS-OCT is a potentially powerful technique investigating tissue structural properties. In addition, the effects of single polarization state detection on OCT image formation is demonstrated.

Determination of the depth-resolved Stokes parameters of light backscattered from turbid media by use of polarization-sensitive optical coherence tomography

Polarization-sensitive optical coherence tomography (PS-OCT) was used to characterize completely the polarization state of light backscattered from turbid media. Using a low-coherence light source, one can determine the Stokes parameters of backscattered light as a function of optical path in turbid media. To demonstrate the application of this technique we determined the birefringence and the optical axis in fibrous tissue (rodent muscle) and in vivo rodent skin. PS-OCT has potentially useful applications in biomedical optics by imaging simultaneously the structural properties of turbid biological materials and their effects on the polarization state of backscattered light. This method may also find applications in material science for investigation of polarization properties (e.g., birefringence) in opaque media such as ceramics and crystals.