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Wijesinghe RE, Kahatapitiya NS, Lee C, Han S, Kim S, Saleah SA, Seong D, Silva BN, Wijenayake U, Ravichandran NK, Jeon M, Kim J. Growing Trend to Adopt Speckle Variance Optical Coherence Tomography for Biological Tissue Assessments in Pre-Clinical Applications. MICROMACHINES 2024; 15:564. [PMID: 38793137 PMCID: PMC11122893 DOI: 10.3390/mi15050564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
Speckle patterns are a generic feature in coherent imaging techniques like optical coherence tomography (OCT). Although speckles are granular like noise texture, which degrades the image, they carry information that can be benefited by processing and thereby furnishing crucial information of sample structures, which can serve to provide significant important structural details of samples in in vivo longitudinal pre-clinical monitoring and assessments. Since the motions of tissue molecules are indicated through speckle patterns, speckle variance OCT (SV-OCT) can be well-utilized for quantitative assessments of speckle variance (SV) in biological tissues. SV-OCT has been acknowledged as a promising method for mapping microvasculature in transverse-directional blood vessels with high resolution in micrometers in both the transverse and depth directions. The fundamental scope of this article reviews the state-of-the-art and clinical benefits of SV-OCT to assess biological tissues for pre-clinical applications. In particular, focus on precise quantifications of in vivo vascular response, therapy assessments, and real-time temporal vascular effects of SV-OCT are primarily emphasized. Finally, SV-OCT-incorporating pre-clinical techniques with high potential are presented for future biomedical applications.
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Affiliation(s)
- Ruchire Eranga Wijesinghe
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Sri Lanka Institute of Information Technology, Malabe 10115, Sri Lanka;
- Center for Excellence in Intelligent Informatics, Electronics & Transmission (CIET), Sri Lanka Institute of Information Technology, Malabe 10115, Sri Lanka
| | - Nipun Shantha Kahatapitiya
- Department of Computer Engineering, Faculty of Engineering, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (N.S.K.); (U.W.)
| | - Changho Lee
- Department of Artificial Intelligence Convergence, Chonnam National University, Gwangju 61186, Republic of Korea
- Department of Nuclear Medicine, Chonnam National University Medical School & Hwasun Hospital, 264, Seoyang-ro, Hwasun 58128, Republic of Korea
| | - Sangyeob Han
- ICT Convergence Research Center, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Shinheon Kim
- ICT Convergence Research Center, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Sm Abu Saleah
- ICT Convergence Research Center, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Daewoon Seong
- School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Bhagya Nathali Silva
- Center for Excellence in Intelligent Informatics, Electronics & Transmission (CIET), Sri Lanka Institute of Information Technology, Malabe 10115, Sri Lanka
- Faculty of Computing, Sri Lanka Institute of Information Technology, Malabe 10115, Sri Lanka
| | - Udaya Wijenayake
- Department of Computer Engineering, Faculty of Engineering, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (N.S.K.); (U.W.)
| | - Naresh Kumar Ravichandran
- Center for Scientific Instrumentation, Korea Basic Science Institute, 169-148, Gwahak-ro, Yuseong-gu, Daejeon 34133, Republic of Korea
| | - Mansik Jeon
- School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Jeehyun Kim
- School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
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Wang Q, Gong P, Afsharan H, Joo C, Morellini N, Fear M, Wood F, Ho H, Silva D, Cense B. In vivo burn scar assessment with speckle decorrelation and joint spectral and time domain optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:126001. [PMID: 38074217 PMCID: PMC10704265 DOI: 10.1117/1.jbo.28.12.126001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/07/2023] [Accepted: 10/12/2023] [Indexed: 12/18/2023]
Abstract
Significance Post-burn scars and scar contractures present significant challenges in burn injury management, necessitating accurate evaluation of the wound healing process to prevent or minimize complications. Non-invasive and accurate assessment of burn scar vascularity can offer valuable insights for evaluations of wound healing. Optical coherence tomography (OCT) and OCT angiography (OCTA) are promising imaging techniques that may enhance patient-centered care and satisfaction by providing detailed analyses of the healing process. Aim Our study investigates the capabilities of OCT and OCTA for acquiring information on blood vessels in burn scars and evaluates the feasibility of utilizing this information to assess burn scars. Approach Healthy skin and neighboring scar data from nine burn patients were obtained using OCT and processed with speckle decorrelation, Doppler OCT, and an enhanced technique based on joint spectral and time domain OCT. These methods facilitated the assessment of vascular structure and blood flow velocity in both healthy skin and scar tissues. Analyzing these parameters allowed for objective comparisons between normal skin and burn scars. Results Our study found that blood vessel distribution in burn scars significantly differs from that in healthy skin. Burn scars exhibit increased vascularization, featuring less uniformity and lacking the intricate branching network found in healthy tissue. Specifically, the density of the vessels in burn scars is 67% higher than in healthy tissue, while axial flow velocity in burn scar vessels is 25% faster than in healthy tissue. Conclusions Our research demonstrates the feasibility of OCT and OCTA as burn scar assessment tools. By implementing these technologies, we can distinguish between scar and healthy tissue based on its vascular structure, providing evidence of their practicality in evaluating burn scar severity and progression.
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Affiliation(s)
- Qiang Wang
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, Perth, Western Australia, Australia
| | - Peijun Gong
- Harry Perkins Institute of Medical Research, BRITElab, QEII Medical Centre, Nedlands, Western Australia, Australia
- The University of Western Australia, Centre for Medical Research, Perth, Western Australia, Australia
- The University of Western Australia, School of Engineering, Department of Electrical, Electronic & Computer Engineering, Perth, Western Australia, Australia
| | - Hadi Afsharan
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, Perth, Western Australia, Australia
- The University of Western Australia, Centre for Medical Research, Perth, Western Australia, Australia
| | - Chulmin Joo
- Yonsei University, Department of Mechanical Engineering, Seoul, Republic of Korea
| | - Natalie Morellini
- The University of Western Australia, Burn Injury Research Unit, School of Biomedical Sciences, Perth, Western Australia, Australia
- Fiona Stanley Hospital, Fiona Wood Foundation, Murdoch, Western Australia, Australia
| | - Mark Fear
- The University of Western Australia, Burn Injury Research Unit, School of Biomedical Sciences, Perth, Western Australia, Australia
- Fiona Stanley Hospital, Fiona Wood Foundation, Murdoch, Western Australia, Australia
| | - Fiona Wood
- The University of Western Australia, Burn Injury Research Unit, School of Biomedical Sciences, Perth, Western Australia, Australia
- Fiona Stanley Hospital, Fiona Wood Foundation, Murdoch, Western Australia, Australia
- Fiona Stanley Hospital, Burns Service of Western Australia, Western Australia Department of Health, Murdoch, Western Australia, Australia
| | - Hao Ho
- Harry Perkins Institute of Medical Research, BRITElab, QEII Medical Centre, Nedlands, Western Australia, Australia
- The University of Western Australia, Centre for Medical Research, Perth, Western Australia, Australia
- The University of Western Australia, School of Engineering, Department of Electrical, Electronic & Computer Engineering, Perth, Western Australia, Australia
| | - Dilusha Silva
- The University of Western Australia, Department of Electrical, Electronic and Computer Engineering, Microelectronics Research Group, Perth, Western Australia, Australia
| | - Barry Cense
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, Perth, Western Australia, Australia
- Yonsei University, Department of Mechanical Engineering, Seoul, Republic of Korea
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Pan M, Wang Y, Gong P, Wang Q, Cense B. Feasibility of deep learning-based polarization-sensitive optical coherence tomography angiography for imaging cutaneous microvasculature. BIOMEDICAL OPTICS EXPRESS 2023; 14:3856-3870. [PMID: 37799704 PMCID: PMC10549757 DOI: 10.1364/boe.488822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/09/2023] [Accepted: 06/05/2023] [Indexed: 10/07/2023]
Abstract
Polarization-sensitive optical coherence tomography (PS-OCT) measures the polarization states of the backscattered light from tissue that can improve angiography based on conventional optical coherence tomography (OCT). We present a feasibility study on PS-OCT integrated with deep learning for PS-OCT angiography (PS-OCTA) imaging of human cutaneous microvasculature. Two neural networks were assessed for PS-OCTA, including the residual dense network (RDN), which previously showed superior performance for angiography with conventional OCT and the upgraded grouped RDN (GRDN). We also investigated different protocols to process the multiple signal channels provided by the Jones matrices from the PS-OCT system to achieve optimal PS-OCTA performance. The training and testing of the deep learning-based PS-OCTA were performed using PS-OCT scans collected from 18 skin locations comprising 16,600 B-scan pairs. The results demonstrated a moderately improved performance of GRDN over RDN, and of the use of the combined signal from the Jones matrix elements over the separate use of the elements, as well as a similar image quality to that provided by speckle decorrelation angiography. GRDN-based PS-OCTA also showed ∼2-3 times faster processing and improved mitigation of tissue motion as compared to speckle decorrelation angiography, and enabled fully automatic processing. Deep learning-based PS-OCTA can be used for imaging cutaneous microvasculature, which may enable easy adoption of PS-OCTA for preclinical and clinical applications.
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Affiliation(s)
- Moning Pan
- Key Laboratory for Biomedical Engineering of Ministry of Education, Embedded System Engineering Research Center of Ministry of Education and Zhejiang Provincial Key Laboratory for Network Multimedia Technologies, Zhejiang University, Hangzhou, 310027, China
| | - Yuxing Wang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Embedded System Engineering Research Center of Ministry of Education and Zhejiang Provincial Key Laboratory for Network Multimedia Technologies, Zhejiang University, Hangzhou, 310027, China
| | - Peijun Gong
- Key Laboratory for Biomedical Engineering of Ministry of Education, Embedded System Engineering Research Center of Ministry of Education and Zhejiang Provincial Key Laboratory for Network Multimedia Technologies, Zhejiang University, Hangzhou, 310027, China
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research,
The University of Western Australia, Perth, WA 6009, Australia
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Qiang Wang
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Barry Cense
- Department of Electrical, Electronic & Computer Engineering, School of Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Department of Mechanical Engineering, Yonsei University, Seoul, 03722, Republic of Korea
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Untracht GR, Dikaios N, Durrani AK, Bapir M, Sarunic MV, Sampson DD, Heiss C, Sampson DM. Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people. Sci Rep 2023; 13:1122. [PMID: 36670141 PMCID: PMC9853488 DOI: 10.1038/s41598-022-26871-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023] Open
Abstract
Optical coherence tomography angiography (OCTA) is a non-invasive, high-resolution imaging modality with growing application in dermatology and microvascular assessment. Accepted reference values for OCTA-derived microvascular parameters in skin do not yet exist but need to be established to drive OCTA into the clinic. In this pilot study, we assess a range of OCTA microvascular metrics at rest and after post-occlusive reactive hyperaemia (PORH) in the hands and feet of 52 healthy people and 11 people with well-controlled type 2 diabetes mellitus (T2DM). We calculate each metric, measure test-retest repeatability, and evaluate correlation with demographic risk factors. Our study delivers extremity-specific, age-dependent reference values and coefficients of repeatability of nine microvascular metrics at baseline and at the maximum of PORH. Significant differences are not seen for age-dependent microvascular metrics in hand, but they are present for several metrics in the foot. Significant differences are observed between hand and foot, both at baseline and maximum PORH, for most of the microvascular metrics with generally higher values in the hand. Despite a large variability over a range of individuals, as is expected based on heterogeneous ageing phenotypes of the population, the test-retest repeatability is 3.5% to 18% of the mean value for all metrics, which highlights the opportunities for OCTA-based studies in larger cohorts, for longitudinal monitoring, and for assessing the efficacy of interventions. Additionally, branchpoint density in the hand and foot and changes in vessel diameter in response to PORH stood out as good discriminators between healthy and T2DM groups, which indicates their potential value as biomarkers. This study, building on our previous work, represents a further step towards standardised OCTA in clinical practice and research.
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Affiliation(s)
- Gavrielle R Untracht
- Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, 6009, Australia
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
| | - Nikolaos Dikaios
- Mathematics Research Centre, Academy of Athens, Athens, 10679, Greece
| | - Abdullah K Durrani
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
- School of Physics, Advanced Technology Institute, The University of Surrey, Guildford, GU27XH, UK
| | - Mariam Bapir
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
| | - Marinko V Sarunic
- Institute of Ophthalmology, University College London, London, EC1V 2PD, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, WC1E 6BT, UK
| | - David D Sampson
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
- School of Physics, Advanced Technology Institute, The University of Surrey, Guildford, GU27XH, UK
| | - Christian Heiss
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK
- East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, RH15RH, UK
| | - Danuta M Sampson
- School of Biosciences and Medicine, The University of Surrey, Guildford, GU27XH, UK.
- Institute of Ophthalmology, University College London, London, EC1V 2PD, UK.
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Shi Y, Lu J, Le N, Wang RK. Integrating a pressure sensor with an OCT handheld probe to facilitate imaging of microvascular information in skin tissue beds. BIOMEDICAL OPTICS EXPRESS 2022; 13:6153-6166. [PMID: 36733756 PMCID: PMC9872897 DOI: 10.1364/boe.473013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 05/05/2023]
Abstract
Optical coherence tomography (OCT) and OCT angiography (OCTA) have been increasingly applied in skin imaging applications in dermatology, where the imaging is often performed with the OCT probe in contact with the skin surface. However, this contact mode imaging can introduce uncontrollable mechanical stress applied to the skin, inevitably complicating the interpretation of OCT/OCTA imaging results. There remains a need for a strategy for assessing local pressure applied on the skin during imaging acquisition. This study reports a handheld scanning probe integrated with built-in pressure sensors, allowing the operator to control the mechanical stress applied to the skin in real-time. With real time feedback information, the operator can easily determine whether the pressure applied to the skin would affect the imaging quality so as to obtain repeatable and reliable OCTA images for a more accurate investigation of skin conditions. Using this probe, imaging of palm skin was used in this study to demonstrate how the OCTA imaging would have been affected by different mechanical pressures ranging from 0 to 69 kPa. The results showed that OCTA imaging is relatively stable when the pressure is less than 11 kPa, and within this range, the change of vascular area density calculated from the OCTA imaging is below 0.13%. In addition, the probe was used to augment the OCT monitoring of blood flow changes during a reactive hyperemia experiment, in which the operator could properly control the amount of pressure applied to the skin surface and achieve full release after compression stimulation.
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Affiliation(s)
- Yaping Shi
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
- These authors contributed equally to this study
| | - Jie Lu
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
- These authors contributed equally to this study
| | - Nhan Le
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
- Department of Ophthalmology, University of Washington, Seattle, WA 98105, USA
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THE IMPORTANCE OF BIOMECHANICS AND THE KINETIC CHAINS OF HUMAN MOVEMENT IN THE DEVELOPMENT AND TREATMENT OF BURN SCARS – A NARRATIVE REVIEW WITH ILLUSTRATIVE CASES. Burns 2022; 49:707-715. [PMID: 36127224 DOI: 10.1016/j.burns.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Burn scars are a major clinical sequelae of severe burn wound healing. To effectively establish a successful treatment plan and achieve durable results, understanding the pathophysiology of scar development is of utmost importance. METHODS A narrative review of the principles of the kinematic chain of movement and the hypothesised effect on burn scar development based on properties of burn scars was performed. An examination of the literature supporting these concepts is presented in conjunction with illustrative cases, with a particular focus on the effect of combination treatments that include ablative fractional resurfacing with surgical contracture releases. DISCUSSION Ablative fractional resurfacing combined with the surgical release of contractures are an effective treatment modality for burn scar reconstruction. This treatment approach seems particularly effective because it is one of the only approaches where the principles of functional kinematics can be addressed when tailoring a reconstructive approach to an individual burn patient. The presented cases illustrate the importance of recognising and including the principles of functional kinematic chains in any reconstructive treatment approach for burn scars. Further, epifascial contracture bands are cord like structures which can be found underneath the subcutaneous fat of scar contractures which follow the principles of functional kinematics. Contractures can be more efficiently released if these structures are divided as well. CONCLUSION Ablative fractional resurfacing combined with local tissue re-arrangements is a promising approach to address the underlying forces leading to hypertrophic burn scarring. To achieve an optimal outcome, it is essential to recognise and address the origin of the pathology when treating burn scars. Ablative fractional laser resurfacing allows a different scar approach as it is not limited to one surgical site and thus enables for effective treatment at the cause of the pathology.
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Issler-Fisher AC, Fisher OM, Haertsch PA, Li Z, Maitz PKM. Effectiveness and safety of ablative fractional CO 2 laser for the treatment of burn scars: A case-control study. Burns 2021; 47:785-795. [PMID: 33121852 DOI: 10.1016/j.burns.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/14/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Burn scars are a major clinical challenge. The aim of this study was to determine the effectiveness and safety of one treatment with the ablative fractional CO2 laser (AFL-CO2) compared to standard burn scar treatment. METHOD From December 2014 to October 2018 patients were prospectively recruited and treatment effects analyzed by assessing various outcome parameters from the date of first consultation and after treatment. A case control study was conducted looking at the impact of one AFL-CO2 treatment compared to a cohort subjected to conventional conservative treatment. Adverse effects were noted at follow up. RESULTS 187 patients were included, with 167 in the AFL-CO2, and 20 in the control cohort. Baseline demographics and scar characteristics showed no significant differences. Ultrasound measured scar thickness as well as the Vancouver Scar Scale (VSS) revealed a significant reduction in the treatment cohort, but no significant improvement in the control group. The POSAS-O was significantly improved in both cohorts. Subjective parameters (POSAS-P, DN4-Pain, and modified D4Pruritus scores) decreased significantly in the AFL-CO2 cohort but remained unchanged in the control group. The BSHS-B quality of life score increased significantly in the AFL-CO2 group, but worsened at the follow up of the untreated patients. Sub-domain analyses found the biggest differences in Affect, Body Image, Heat Sensitivity, Treatment and Work. Complications occurred in 5 patients (2.9%). CONCLUSIONS This study demonstrates that AFL-CO2 is an effective and safe treatment modality for burn scars improving thickness, symptoms and quality of life of burn survivors when compared to conventional scar treatment.
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Affiliation(s)
- Andrea C Issler-Fisher
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia.
| | - Oliver M Fisher
- School of Medicine, University of Notre Dame, Sydney, NSW 2010, Australia; University of New South Wales Department of Surgery, St George Hospital, Kogarah, Australia
| | - Peter A Haertsch
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia
| | - Zhe Li
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia
| | - Peter K M Maitz
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia
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da Costa PTL, Echevarría-Guanilo ME, Gonçalves N, Girondi JBR, Gonçalves ADC. Subjective Tools for Burn Scar Assessment: An Integrative Review. Adv Skin Wound Care 2021; 34:1-10. [PMID: 33979826 DOI: 10.1097/01.asw.0000749732.09228.a9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the clinical and scientific literature on the subjective ways of assessing burn scars and describe their main characteristics. DATA SOURCES The Latin American, Caribbean Health Sciences Literature, Nursing Database, PubMed, CINAHL, and Scopus and Web of Science databases were used to search for studies published between 2014 and 2018 using descriptors in Portuguese, Spanish, and English. STUDY SELECTION After establishing the research question and the location and definition of the studies, as well as accounting for differences among databases and application of filters based on inclusion and exclusion criteria, 886 references remained. DATA EXTRACTION Investigators reviewed the titles and abstracts of the sample and selected 188 relevant studies for full review. DATA SYNTHESIS Twenty-six subjective forms of assessment were found; most research concerned the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. CONCLUSIONS The Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale are the most common scales for assessing burn scars and have similar evaluation points such as vascularization, pliability, pigmentation, and height, which are the main parameters that contribute to the general assessment and severity of a scar. There is a need to improve instructions for application of the scales to facilitate better understanding and improve agreement among evaluators.
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Affiliation(s)
- Pollyana Thays Lameira da Costa
- At the Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, Brazil, Pollyana Thays Lameira da Costa, MSN, RN, is a Doctorate Student and Maria Elena Echevarría Guanilo, DNP, RN; Natália Gonçalves, PhD, RN; and Juliana Balbinot Reis Girondi, PhD, RN, are Professors. Adriana da Costa Gonçalves, PhD, is Professor of Physical Therapy, Centro Universitário Barão de Mauá de Ribeirão Preto, Brazil. Acknowledgment: This study was completed as part of a scholarship funded by the Higher Education Personnel Improvement Coordination (Coordenação Aperfeiçoamento Pessoal do Nível Superior). The authors have disclosed no other financial relationships related to this article. Submitted September 3, 2020; accepted in revised form November 5, 2020
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Imaging Motion: A Comprehensive Review of Optical Coherence Tomography Angiography. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1310:343-365. [PMID: 33834441 DOI: 10.1007/978-981-33-6064-8_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Optical coherence tomography (OCT) is a three-dimensional (3-D) optical imaging technology that provides noninvasive, micrometer resolution images of structural interiors within biological samples with an approximately 1 ~ 2 mm penetration depth. Over the last decades, advances in OCT have revolutionized biomedical imaging by demonstrating a potential of optical biopsy in preclinical and clinical settings. Recently, functional OCT imaging has shown a promise as angiography to visualize cell-perfused vasculatures in the tissue bed in vivo without requiring any exogenous contrast agents. This new technology termed OCT angiography (OCTA) possesses a unique imaging capability of delineating tissue morphology and blood or lymphatic vessels down to capillaries at real-time acquisition rates. For the past 10 years since 2007, OCTA has been proven to be a useful tool to identify disorder or dysfunction in tissue microcirculation from both experimental animal studies and clinical studies in ophthalmology and dermatology. In this section, we overview about OCTA including a basic principle of OCTA explained with simple optical physics, and its scan protocols and post-processing algorithms for acquisition of angiography. Then, potential and challenge of OCTA for clinical settings are shown with outcomes of human studies.
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Wan B, Ganier C, Du-Harpur X, Harun N, Watt FM, Patalay R, Lynch MD. Applications and future directions for optical coherence tomography in dermatology. Br J Dermatol 2020; 184:1014-1022. [PMID: 32974943 DOI: 10.1111/bjd.19553] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/24/2022]
Abstract
Optical coherence tomography (OCT) is a noninvasive optical imaging method that can generate high-resolution en face and cross-sectional images of the skin in vivo to a maximum depth of 2 mm. While OCT holds considerable potential for noninvasive diagnosis and disease monitoring, it is poorly understood by many dermatologists. Here we aim to equip the practising dermatologist with an understanding of the principles of skin OCT and the potential clinical indications. We begin with an introduction to the technology and discuss the different modalities of OCT including angiographic (dynamic) OCT, which can image cutaneous blood vessels at high resolution. Next we review clinical applications. OCT has been most extensively investigated in the diagnosis of keratinocyte carcinomas, particularly basal cell carcinoma. To date, OCT has not proven sufficiently accurate for the robust diagnosis of malignant melanoma; however, the evaluation of abnormal vasculature with angiographic OCT is an area of active investigation. OCT, and in particular angiographic OCT, also shows promise in monitoring the response to therapy of inflammatory dermatoses, such as psoriasis and connective tissues disease. We additionally discuss a potential role for artificial intelligence in improving the accuracy of interpretation of OCT imaging data.
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Affiliation(s)
- B Wan
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - C Ganier
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - X Du-Harpur
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK.,The Francis Crick Institute, 1 Midland Road, London, UK
| | - N Harun
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - F M Watt
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - R Patalay
- St John's Institute of Dermatology, King's College London, London, UK
| | - M D Lynch
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK.,St John's Institute of Dermatology, King's College London, London, UK
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Gong P, Li Q, Wang Q, Karnowski K, Sampson DD. Jones matrix-based speckle-decorrelation angiography using polarization-sensitive optical coherence tomography. JOURNAL OF BIOPHOTONICS 2020; 13:e202000007. [PMID: 32418315 DOI: 10.1002/jbio.202000007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/19/2020] [Accepted: 05/13/2020] [Indexed: 05/18/2023]
Abstract
We show that polarization-sensitive optical coherence tomography angiography (PS-OCTA) based on full Jones matrix assessment of speckle decorrelation offers improved contrast and depth of vessel imaging over conventional OCTA. We determine how best to combine the individual Jones matrix elements and compare the resulting image quality to that of a conventional OCT scanner by co-locating and imaging the same skin locations with closely matched scanning setups. Vessel projection images from finger and forearm skin demonstrate the benefits of Jones matrix-based PS-OCTA. Our study provides a promising starting point and a useful reference for future pre-clinical and clinical applications of Jones matrix-based PS-OCTA.
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Affiliation(s)
- Peijun Gong
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
| | - Qingyun Li
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
| | - Qiang Wang
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
| | - Karol Karnowski
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
- Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland
| | - David D Sampson
- Surrey Biophotonics, Advanced Technology Institute and School of Biosciences and Medicine, University of Surrey, Surrey, UK
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12
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Gong P, Heiss C, Sampson DM, Wang Q, Yuan Z, Sampson DD. Detection of localized pulsatile motion in cutaneous microcirculation by speckle decorrelation optical coherence tomography angiography. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200112R. [PMID: 32935499 PMCID: PMC7490763 DOI: 10.1117/1.jbo.25.9.095004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/18/2020] [Indexed: 05/21/2023]
Abstract
SIGNIFICANCE Pulsatility is a vital characteristic of the cardiovascular system. Characterization of the pulsatility pattern locally in the peripheral microvasculature is currently not readily available and would provide an additional source of information, which may prove important in understanding the pathophysiology of arterial stiffening, vascular ageing, and their linkage with cardiovascular disease development. AIM We aim to confirm the suitability of speckle decorrelation optical coherence tomography angiography (OCTA) under various noncontact/contact scanning protocols for the visualization of pulsatility patterns in vessel-free tissue and in the microvasculature of peripheral human skin. RESULTS Results from five healthy subjects show distinct pulsatile patterns both in vessel-free tissue with either noncontact or contact imaging and in individual microvessels with contact imaging. Respectively, these patterns are likely caused by the pulsatile pressure and pulsatile blood flow. The pulse rates show good agreement with those from pulse oximetry, confirming that the pulsatile signatures reflect pulsatile hemodynamics. CONCLUSIONS This study demonstrates the potential of speckle decorrelation OCTA for measuring localized peripheral cutaneous pulsatility and defines scanning protocols necessary to undertake such measurements. Noncontact imaging should be used for the study of pulsatility in vessel-free tissue and contact imaging with strong mechanical coupling in individual microvessels. Further studies of microcirculation based upon this method and protocols are warranted.
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Affiliation(s)
- Peijun Gong
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic, and Computer Engineering, Perth, Western Australia, Australia
- Address all correspondence to Peijun Gong, E-mail:
| | - Christian Heiss
- The University of Surrey, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, Guildford, Surrey, United Kingdom
- Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom
| | - Danuta M. Sampson
- The University of Surrey, Centre for Vision, Speech, and Signal Processing, Surrey Biophotonics, Guildford, Surrey, United Kingdom
- The University of Surrey, School of Biosciences and Medicine, Surrey Biophotonics, Guildford, Surrey, United Kingdom
| | - Qiang Wang
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic, and Computer Engineering, Perth, Western Australia, Australia
| | - Zhihong Yuan
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic, and Computer Engineering, Perth, Western Australia, Australia
| | - David D. Sampson
- The University of Surrey, School of Biosciences and Medicine, Surrey Biophotonics, Guildford, Surrey, United Kingdom
- The University of Surrey, Advanced Technology Institute, School of Physics, Surrey Biophotonics, Guildford, Surrey, United Kingdom
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13
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Maltais-Tariant R, Boudoux C, Uribe-Patarroyo N. Real-time co-localized OCT surveillance of laser therapy using motion corrected speckle decorrelation. BIOMEDICAL OPTICS EXPRESS 2020; 11:2925-2950. [PMID: 32637233 PMCID: PMC7316020 DOI: 10.1364/boe.385654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/19/2020] [Accepted: 04/09/2020] [Indexed: 05/27/2023]
Abstract
We present a system capable of real-time delivery and monitoring of laser therapy by imaging with optical coherence tomography (OCT) through a double-clad fiber (DCF). A double-clad fiber coupler is used to inject and collect OCT light into the core of a DCF and inject the therapy light into its larger inner cladding, allowing for both imaging and therapy to be perfectly coregistered. Monitoring of treatment depth is achieved by calculating the speckle intensity decorrelation occurring during tissue coagulation. Furthermore, an analytical noise correction was used on the correlation to extend the maximum monitoring depth. We also present a method for correcting motion-induced decorrelation using a lookup table. Using the value of the noise- and motion-corrected correlation coefficient in a novel approach, our system is capable of identifying the depth of thermal coagulation in real time and automatically shut the therapy laser off when the targeted depth is reached. The process is demonstrated ex vivo in rat tongue and abdominal muscles for depths ranging from 500 µm to 1000 µm with induced motion in real time.
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Affiliation(s)
- Raphaël Maltais-Tariant
- Polytechnique Montréal, Department of Engineering Physics, 2900 Boulevard Edouard-Montpetit, Montreal, Qc, Canada
| | - Caroline Boudoux
- Polytechnique Montréal, Department of Engineering Physics, 2900 Boulevard Edouard-Montpetit, Montreal, Qc, Canada
- Castor Optics Inc., 361 Boul Montpellier, St-Laurent, Qc, Canada
| | - Néstor Uribe-Patarroyo
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114, USA
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14
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Sirotkina MA, Gubarkova EV, Plekhanov AA, Sovetsky AA, Elagin VV, Matveyev AL, Matveev LA, Kuznetsov SS, Zagaynova EV, Gladkova ND, Zaitsev VY. In vivo assessment of functional and morphological alterations in tumors under treatment using OCT-angiography combined with OCT-elastography. BIOMEDICAL OPTICS EXPRESS 2020; 11:1365-1382. [PMID: 32206416 PMCID: PMC7075625 DOI: 10.1364/boe.386419] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/08/2020] [Accepted: 02/09/2020] [Indexed: 05/13/2023]
Abstract
Emerging methods of anti-tumor therapies require new approaches to tumor response evaluation, especially enabling label-free diagnostics and in vivo utilization. Here, to assess the tumor early reaction and predict its long-term response, for the first time we apply in combination the recently developed OCT extensions - optical coherence angiography (OCA) and compressional optical coherence elastography (OCE), thus enabling complementary functional/microstructural tumor characterization. We study two vascular-targeted therapies of different types, (1) anti-angiogenic chemotherapy (ChT) and (2) photodynamic therapy (PDT), aimed to indirectly kill tumor cells through blood supply injury. Despite different mechanisms of anti-angiogenic action for ChT and PDT, in both cases OCA demonstrated high sensitivity to blood perfusion cessation. The new method of OCE-based morphological segmentation revealed very similar histological structure alterations. The OCE results showed high correlation with conventional histology in evaluating percentages of necrotic and viable tumor zones. Such possibilities make OCE an attractive tool enabling previously inaccessible in vivo monitoring of individual tumor response to therapies without taking multiple biopsies.
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Affiliation(s)
| | | | | | | | - Vadim V. Elagin
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | | | - Lev A. Matveev
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
| | - Sergey S. Kuznetsov
- N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia
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15
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Use of Optical Coherence Tomography (OCT) in Aesthetic Skin Assessment—A Short Review. Lasers Surg Med 2020; 52:699-704. [DOI: 10.1002/lsm.23219] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2020] [Indexed: 12/28/2022]
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16
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Zhang C, Yin K, Shen YM. Efficacy of fractional carbon dioxide laser therapy for burn scars: a meta-analysis. J DERMATOL TREAT 2019; 32:845-850. [PMID: 31865824 DOI: 10.1080/09546634.2019.1704679] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Cong Zhang
- Department of Burn, Beijing Jishuitan Hospital, Beijing, China
| | - Kai Yin
- Department of Burn, Beijing Jishuitan Hospital, Beijing, China
| | - Yu-ming Shen
- Department of Burn, Beijing Jishuitan Hospital, Beijing, China
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17
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Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women. BMC Pregnancy Childbirth 2019; 19:445. [PMID: 31775663 PMCID: PMC6882006 DOI: 10.1186/s12884-019-2604-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 11/14/2019] [Indexed: 11/26/2022] Open
Abstract
Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.
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18
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Casper MJ, Glahn J, Evers M, Schulz-Hildebrandt H, Kositratna G, Birngruber R, Hüttmann G, Manstein D. Capillary Refill-The Key to Assessing Dermal Capillary Capacity and Pathology in Optical Coherence Tomography Angiography. Lasers Surg Med 2019; 52:653-658. [PMID: 31755127 PMCID: PMC7496142 DOI: 10.1002/lsm.23188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2019] [Indexed: 12/12/2022]
Abstract
Background/Objectives Standard optical coherence tomography angiography (OCTA) has been limited to imaging blood vessels actively undergoing perfusion, providing a temporary picture of surface microvasculature. Capillary perfusion in the skin is dynamic and changes in response to the surrounding tissue's respiratory, nutritional, and thermoregulatory needs. Hence, OCTA often represents a given perfusion state without depicting the actual extent of the vascular network. Here we present a method for obtaining a more accurate anatomic representation of the surface capillary network in human skin using OCTA, along with proposing a new parameter, the Relative Capillary Capacity (RCC), a quantifiable proxy for assessing capillary dilation potential and permeability. Methods OCTA images were captured at baseline and after compression of the skin. Baseline images display ambient capillary perfusion, while images taken upon capillary refill display the network of existing capillaries at full capacity. An optimization‐based automated vessel segmentation method was used to automatically analyze and compare OCTA image sequences obtained from two volunteers. RCC was then compared with visual impressions of capillary viability. Results Our OCTA imaging sequence provides a method for mapping cutaneous capillary networks independent of ambient perfusion. Differences between baseline and refill images clearly demonstrate the shortcomings of standard OCTA imaging and produce the RCC biometric as a quantifiable proxy for assessing capillary dilation potential and permeability. Conclusion Future dermatological OCTA diagnostic studies should implement the Capillary Refill Methods over standard imaging techniques and further explore the relevance of RCC to differential diagnosis and dermatopathology. Lasers Surg. Med. © The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
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Affiliation(s)
- M J Casper
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129.,Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany
| | - J Glahn
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129
| | - M Evers
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129.,Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany
| | - H Schulz-Hildebrandt
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Medical Laser Center Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany
| | - G Kositratna
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129
| | - R Birngruber
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Medical Laser Center Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - G Hüttmann
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Medical Laser Center Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Airway Research Center North (ARCN), Member of the German Center of Lung Research (DZL), Gießen, Germany
| | - D Manstein
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129
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19
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Hua Z, Wu M. Spontaneous rupture of the uterus following salpingectomy: a case report and literature review. J Int Med Res 2019; 47:5328-5336. [PMID: 31554449 PMCID: PMC6833417 DOI: 10.1177/0300060519874903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Laparoscopic salpingectomy (LPSC) is the main treatment for ectopic pregnancy, which leads to spontaneous uterine rupture (UR) during pregnancy. We report the characteristics of a woman who had spontaneous UR during pregnancy with a history of salpingectomy. We experienced a 31-year-old woman with a UR in pregnancy with a history of LPSC twice. The patient had a successful pregnancy. We also performed a literature review including cases with spontaneous UR after LPSC. Twenty-seven case reports of 48 women were included in our review. Thirty-five (83.33%, 35/42) women previously received LPSC and 15 (31.25%) developed interstitial pregnancies. The interval between pregnancy and the last surgery did not affect the frequency of interstitial pregnancy and gestational age. Fetal outcomes in patients with UR at the third trimester were better than those at the first and second trimesters. We suggest that close observation and timely treatment by experienced clinicians lead to good outcomes of pregnant women with suspected UR.
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Affiliation(s)
- Zhifen Hua
- Department of Obstetrics, Changning Maternity & Infant Health Hospital of Shanghai, Shanghai, China
| | - Minjun Wu
- Department of Obstetrics, Changning Maternity & Infant Health Hospital of Shanghai, Shanghai, China
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20
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Liu M, Drexler W. Optical coherence tomography angiography and photoacoustic imaging in dermatology. Photochem Photobiol Sci 2019; 18:945-962. [PMID: 30735220 DOI: 10.1039/c8pp00471d] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Optical coherence tomography angiography (OCTA) is a relatively novel functional extension of the widely accepted ophthalmic imaging tool named optical coherence tomography (OCT). Since OCTA's debut in ophthalmology, researchers have also been trying to expand its translational application in dermatology. The ability of OCTA to resolve microvasculature has shown promising results in imaging skin diseases. Meanwhile, photoacoustic imaging (PAI), which uses laser pulse induced ultrasound waves as the signal, has been studied to differentiate human skin layers and to help in skin disease diagnosis. This perspective article gives a short review of OCTA and PAI in the field of photodermatology. After an introduction to the principles of OCTA and PAI, we describe the most updated results of skin disease imaging using these two optical imaging modalities. We also place emphasis on dual modality imaging combining OCTA and photoacoustic tomography (PAT) for dermatological applications. In the end, the challenges and prospects of these two imaging modalities in dermatology are discussed.
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Affiliation(s)
- Mengyang Liu
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
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21
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Wang Q, Gong P, Cense B, Sampson DD. Short-time series optical coherence tomography angiography and its application to cutaneous microvasculature. BIOMEDICAL OPTICS EXPRESS 2019; 10:293-307. [PMID: 30775101 PMCID: PMC6363186 DOI: 10.1364/boe.10.000293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/14/2018] [Accepted: 11/28/2018] [Indexed: 05/25/2023]
Abstract
We present a new optical coherence tomography (OCT) angiography method for imaging tissue microvasculature in vivo based on the characteristic frequency-domain flow signature in a short time series of a single voxel. The angiography signal is generated by Fourier transforming the OCT signal time series from a given voxel in multiple acquisitions and computing the average magnitude of non-zero (high-pass) frequency components. Larger temporal variations of the OCT signal caused by blood flow result in higher values of the average magnitude in the frequency domain compared to those from static tissue. Weighting of the signal by the inverse of the zero-frequency component (i.e., the sum of the OCT signal time series) improves vessel contrast in flow regions of low OCT signal. The method is demonstrated on a fabricated flow phantom and on human skin in vivo and, at only 5 time points per voxel, shows enhanced vessel contrast in comparison to conventional correlation mapping/speckle decorrelation and speckle variance methods.
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Affiliation(s)
- Qiang Wang
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth WA 6009, Australia
| | - Peijun Gong
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth WA 6009, Australia
| | - Barry Cense
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth WA 6009, Australia
| | - David D. Sampson
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth WA 6009, Australia
- University of Surrey, Guildford, Surrey, GU2 7XH, UK
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22
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Ramakonar H, Quirk BC, Kirk RW, Li J, Jacques A, Lind CRP, McLaughlin RA. Intraoperative detection of blood vessels with an imaging needle during neurosurgery in humans. SCIENCE ADVANCES 2018; 4:eaav4992. [PMID: 30585293 PMCID: PMC6300404 DOI: 10.1126/sciadv.aav4992] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/20/2018] [Indexed: 05/05/2023]
Abstract
Intracranial hemorrhage can be a devastating complication associated with needle biopsies of the brain. Hemorrhage can occur to vessels located adjacent to the biopsy needle as tissue is aspirated into the needle and removed. No intraoperative technology exists to reliably identify blood vessels that are at risk of damage. To address this problem, we developed an "imaging needle" that can visualize nearby blood vessels in real time. The imaging needle contains a miniaturized optical coherence tomography probe that allows differentiation of blood flow and tissue. In 11 patients, we were able to intraoperatively detect blood vessels (diameter, >500 μm) with a sensitivity of 91.2% and a specificity of 97.7%. This is the first reported use of an optical coherence tomography needle probe in human brain in vivo. These results suggest that imaging needles may serve as a valuable tool in a range of neurosurgical needle interventions.
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Affiliation(s)
- Hari Ramakonar
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Bryden C. Quirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Rodney W. Kirk
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Jiawen Li
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Angela Jacques
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Christopher R. P. Lind
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Robert A. McLaughlin
- ARC Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
- Corresponding author.
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Li Q, Karnowski K, Noble PB, Cairncross A, James A, Villiger M, Sampson DD. Robust reconstruction of local optic axis orientation with fiber-based polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2018; 9:5437-5455. [PMID: 30460138 PMCID: PMC6238922 DOI: 10.1364/boe.9.005437] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 05/19/2023]
Abstract
It is challenging to recover local optic axis orientation from samples probed with fiber-based polarization-sensitive optical coherence tomography (PS-OCT). In addition to the effect of preceding tissue layers, the transmission through fiber and system elements, and imperfect system alignment, need to be compensated. Here, we present a method to retrieve the required correction factors from measurements with depth-multiplexed PS-OCT, which accurately measures the full Jones matrix. The correction considers both retardation and diattenuation and is applied in the wavenumber domain, preserving the axial resolution of the system. The robustness of the method is validated by measuring a birefringence phantom with a misaligned system. Imaging ex-vivo lamb trachea and human bronchus demonstrates the utility of reconstructing the local optic axis orientation to assess smooth muscle, which is expected to be useful in the assessment of airway smooth muscle thickness in asthma, amongst other fiber-based applications.
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Affiliation(s)
- Qingyun Li
- Optical + Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA 6009,
Australia
| | - Karol Karnowski
- Optical + Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA 6009,
Australia
| | - Peter B. Noble
- School of Human Sciences, The University of Western Australia, Perth, WA 6009,
Australia
| | - Alvenia Cairncross
- School of Human Sciences, The University of Western Australia, Perth, WA 6009,
Australia
| | - Alan James
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth,
Australia
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA,
USA
| | - David D. Sampson
- Optical + Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA 6009,
Australia
- University of Surrey, Guildford, GU2 7XH, Surrey,
United Kingdom
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24
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Classification of burn injury using Raman spectroscopy and optical coherence tomography: An ex-vivo study on porcine skin. Burns 2018; 45:659-670. [PMID: 30385061 DOI: 10.1016/j.burns.2018.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/16/2018] [Accepted: 10/04/2018] [Indexed: 11/20/2022]
Abstract
Accurate depth assessment of burn wounds is a critical task to provide the right treatment and care. Currently, laser Doppler imaging is able to provide better accuracy compared to the standard clinical evaluation. However, its clinical applicability is limited by factors like scanning distance, time, and cost. Precise diagnosis of burns requires adequate structural and functional details. In this work, we evaluated the combined potential of two non-invasive optical modalities, optical coherence tomography (OCT) and Raman spectroscopy (RS), to identify degrees of burn wounds (superficial partial-thickness (SPT), deep partial-thickness (DPT), and full-thickness (FT)). OCT provides morphological information, whereas, RS provides biochemical aspects. OCT images and Raman spectra were obtained from burns created on ex-vivo porcine skin. Algorithms were developed to segment skin region and extract textural features from OCT images, and derive spectral wave features from RS. These computed features were fed into machine learning classifiers for categorization of burns. Histological results obtained from trichrome staining were used as ground-truth. The combined performance of RS-OCT reported an overall average accuracy of 85% and ROC-AUC=0.94, in distinguishing the burn wounds. The significant performance on ex vivo skin motivates to assess the feasibility of combined RS-OCT in in vivo models.
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Moiseev A, Ksenofontov S, Sirotkina M, Kiseleva E, Gorozhantseva M, Shakhova N, Matveev L, Zaitsev V, Matveyev A, Zagaynova E, Gelikonov V, Gladkova N, Vitkin A, Gelikonov G. Optical coherence tomography-based angiography device with real-time angiography B-scans visualization and hand-held probe for everyday clinical use. JOURNAL OF BIOPHOTONICS 2018; 11:e201700292. [PMID: 29737042 DOI: 10.1002/jbio.201700292] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 05/04/2018] [Indexed: 05/18/2023]
Abstract
This work is dedicated to the development of the OCT system with angiography for everyday clinical use. Two major problems were solved during the development: compensation of specific natural tissue displacements, induced by contact scanning mode and physiological motion of patients (eg, respiratory and cardiac motions) and online visualization of vessel cross-sections to provide feedback for the system operator.
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Affiliation(s)
- Alexander Moiseev
- Nano-optics and highly sensitive optical measurement department, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
| | - Sergey Ksenofontov
- Nano-optics and highly sensitive optical measurement department, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Marina Sirotkina
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
| | - Elena Kiseleva
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
| | - Maria Gorozhantseva
- Department for radiophysical methods in medicine, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Natalia Shakhova
- Department for radiophysical methods in medicine, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Lev Matveev
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
- Department of nonlinear geophysical processes, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Vladimir Zaitsev
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
- Department of nonlinear geophysical processes, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander Matveyev
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
- Department of nonlinear geophysical processes, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Elena Zagaynova
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
| | - Valentin Gelikonov
- Nano-optics and highly sensitive optical measurement department, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
| | - Natalia Gladkova
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
| | - Alex Vitkin
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
- Department of Medical Biophysics & Radiation Oncology, University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Grigory Gelikonov
- Nano-optics and highly sensitive optical measurement department, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Institute of Biomedical Technologies, Laboratory of Optical Coherence Tomography, Nizhny Novgorod, Russia
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26
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Gong P, Yu DY, Wang Q, Yu PK, Karnowski K, Heisler M, Francke A, An D, Sarunic MV, Sampson DD. Label-free volumetric imaging of conjunctival collecting lymphatics ex vivo by optical coherence tomography lymphangiography. JOURNAL OF BIOPHOTONICS 2018; 11:e201800070. [PMID: 29920959 DOI: 10.1002/jbio.201800070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/14/2018] [Indexed: 05/08/2023]
Abstract
We employ optical coherence tomography (OCT) and optical coherence microscopy (OCM) to study conjunctival lymphatics in porcine eyes ex vivo. This study is a precursor to the development of in vivo imaging of the collecting lymphatics for potentially guiding and monitoring glaucoma filtration surgery. OCT scans at 1300 nm and higher-resolution OCM scans at 785 nm reveal the lymphatic vessels via their optical transparency. Equivalent signal characteristics are also observed from blood vessels largely free of blood (and devoid of flow) in the ex vivo conjunctiva. In our lymphangiography, vessel networks were segmented by compensating the depth attenuation in the volumetric OCT/OCM signal, projecting the minimum intensity in two dimensions and thresholding to generate a three-dimensional vessel volume. Vessel segmentation from multiple locations of a range of porcine eyes (n = 21) enables visualization of the vessel networks and indicates the varying spatial distribution of patent lymphatics. Such visualization provides a new tool to investigate conjunctival vessels in tissue ex vivo without need for histological tissue processing and a valuable reference on vessel morphology for the in vivo label-free imaging studies of lymphatics to follow.
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Affiliation(s)
- Peijun Gong
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
| | - Dao-Yi Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia
- Lions Eye Institute, Nedlands, WA, Australia
| | - Qiang Wang
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
| | - Paula K Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia
- Lions Eye Institute, Nedlands, WA, Australia
| | - Karol Karnowski
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
| | - Morgan Heisler
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Ashley Francke
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Dong An
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia
- Lions Eye Institute, Nedlands, WA, Australia
| | - Marinko V Sarunic
- Biomedical Optics Research Group, School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - David D Sampson
- Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth, WA, Australia
- University of Surrey, Guildford, Surrey, UK
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27
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Jansen SM, Almasian M, Wilk LS, de Bruin DM, van Berge Henegouwen MI, Strackee SD, Bloemen PR, Meijer SL, Gisbertz SS, van Leeuwen TG. Feasibility of Optical Coherence Tomography (OCT) for Intra-Operative Detection of Blood Flow during Gastric Tube Reconstruction. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1331. [PMID: 29693606 PMCID: PMC5982600 DOI: 10.3390/s18051331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/15/2018] [Accepted: 04/21/2018] [Indexed: 01/09/2023]
Abstract
In this study; an OCT-based intra-operative imaging method for blood flow detection during esophagectomy with gastric tube reconstruction is investigated. Change in perfusion of the gastric tube tissue can lead to ischemia; with a high morbidity and mortality as a result. Anastomotic leakage (incidence 5⁻20%) is one of the most severe complications after esophagectomy with gastric tube reconstruction. Optical imaging techniques provide for minimal-invasive and real-time visualization tools that can be used in intraoperative settings. By implementing an optical technique for blood flow detection during surgery; perfusion can be imaged and quantified and; if needed; perfusion can be improved by either a surgical intervention or the administration of medication. The feasibility of imaging gastric microcirculation in vivo using optical coherence tomography (OCT) during surgery of patients with esophageal cancer by visualizing blood flow based on the speckle contrast from M-mode OCT images is studied. The percentage of pixels exhibiting a speckle contrast value indicative of flow was quantified to serve as an objective parameter to assess blood flow at 4 locations on the reconstructed gastric tube. Here; it was shown that OCT can be used for direct blood flow imaging during surgery and may therefore aid in improving surgical outcomes for patients.
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Affiliation(s)
- Sanne M Jansen
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
- Department of Plastic, Reconstructive & Hand Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Mitra Almasian
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Leah S Wilk
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Daniel M de Bruin
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Mark I van Berge Henegouwen
- Department of Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Simon D Strackee
- Department of Plastic, Reconstructive & Hand Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Paul R Bloemen
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Sybren L Meijer
- Department of Pathology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Suzanne S Gisbertz
- Department of Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
| | - Ton G van Leeuwen
- Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
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28
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Chen Z, Rank E, Meiburger KM, Sinz C, Hodul A, Zhang E, Hoover E, Minneman M, Ensher J, Beard PC, Kittler H, Leitgeb RA, Drexler W, Liu M. Non-invasive multimodal optical coherence and photoacoustic tomography for human skin imaging. Sci Rep 2017; 7:17975. [PMID: 29269886 PMCID: PMC5740114 DOI: 10.1038/s41598-017-18331-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/08/2017] [Indexed: 12/29/2022] Open
Abstract
The cutaneous vasculature is involved in many diseases. Current clinical examination techniques, however, cannot resolve the human vasculature with all plexus in a non-invasive manner. By combining an optical coherence tomography system with angiography extension and an all optical photoacoustic tomography system, we can resolve in 3D the blood vessels in human skin for all plexus non-invasively. With a customized imaging unit that permits access to various parts of patients' bodies, we applied our multimodality imaging system to investigate several different types of skin conditions. Quantitative vascular analysis is given for each of the dermatological conditions to show the potential diagnostic value of our system in non-invasive examination of diseases and physiological processes. Improved performance of our system over its previous generation is also demonstrated with an updated characterization.
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Affiliation(s)
- Zhe Chen
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH 4L, 1090, Vienna, Austria
| | - Elisabet Rank
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH 4L, 1090, Vienna, Austria
| | - Kristen M Meiburger
- Dipartimento di Elettronica e Telecomunicazioni, Biolab, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Torino, Italy
| | - Christoph Sinz
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, AKH 7J, 1090, Vienna, Austria
| | - Andreas Hodul
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH 4L, 1090, Vienna, Austria
| | - Edward Zhang
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK
| | - Erich Hoover
- Insight Photonic Solutions, Inc., 2650 Crescent Drive, Number 201, Lafayette, CO, 80026, USA
| | - Micheal Minneman
- Insight Photonic Solutions, Inc., 2650 Crescent Drive, Number 201, Lafayette, CO, 80026, USA
| | - Jason Ensher
- Insight Photonic Solutions, Inc., 2650 Crescent Drive, Number 201, Lafayette, CO, 80026, USA
| | - Paul C Beard
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, WC1E 6BT, London, UK
| | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, AKH 7J, 1090, Vienna, Austria
| | - Rainer A Leitgeb
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH 4L, 1090, Vienna, Austria
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH 4L, 1090, Vienna, Austria
| | - Mengyang Liu
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, AKH 4L, 1090, Vienna, Austria.
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Fan S, Ung BSY, Parrott EPJ, Wallace VP, Pickwell-MacPherson E. In vivo terahertz reflection imaging of human scars during and after the healing process. JOURNAL OF BIOPHOTONICS 2017; 10:1143-1151. [PMID: 27804226 DOI: 10.1002/jbio.201600171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/03/2016] [Indexed: 05/18/2023]
Abstract
We use terahertz imaging to measure four human skin scars in vivo. Clear contrast between the refractive index of the scar and surrounding tissue was observed for all of the scars, despite some being difficult to see with the naked eye. Additionally, we monitored the healing process of a hypertrophic scar. We found that the contrast in the absorption coefficient became less prominent after a few months post-injury, but that the contrast in the refractive index was still significant even months post-injury. Our results demonstrate the capability of terahertz imaging to quantitatively measure subtle changes in skin properties and this may be useful for improving scar treatment and management.
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Affiliation(s)
- Shuting Fan
- School of Physics (M013), University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Benjamin S Y Ung
- Department of Electronic Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Edward P J Parrott
- Department of Electronic Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Vincent P Wallace
- School of Physics (M013), University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Emma Pickwell-MacPherson
- Department of Electronic Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
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30
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Men SJ, Chen CL, Wei W, Lai TY, Song SZ, Wang RK. Repeatability of vessel density measurement in human skin by OCT-based microangiography. Skin Res Technol 2017; 23:607-612. [PMID: 28514014 DOI: 10.1111/srt.12379] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 12/26/2022]
Abstract
PURPOSE To investigate the repeatability of vessel density measurement at human arm skin in healthy subjects with OCT-based microangiography (OMAG). METHODS Four locations including volar wrist, volar forearm, shoulder, and volar upper arm were scanned using an optimized swept source OCT system, working at center wavelength of 1300 nm and A-line rate of 100 kHz. Three scans were acquired at each location at the same visit. Vascular images of papillary dermis, reticular dermis, and the whole dermis layer were generated with OMAG processing and automatic segmentation algorithms. The vessel density (VD) of each layer was calculated based on vascular images, and the repeatability of the VD at the same physiological location was thereafter assessed. RESULTS Fifteen healthy volunteers were included. High repeatability of VD was found for wrist, forearm, shoulder, and upper arm (coefficient of variation (CV)=2.4, 2.7, 2.7, 2.0, and intraclass correlation coefficient (ICC)=0.906, 0.854, 0.943, 0.916 respectively). The VD measurements showed no significant difference between the four locations in any of the three layers, ie papillary layer (P=.1063), reticular layer (P=.3371), and whole dermis layer (P=.3233). CONCLUSION Quantification of VD by using OCT/OMAG is repeatable when imaging skin tissue beds in healthy individuals.
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Affiliation(s)
- S J Men
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - C-L Chen
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - W Wei
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - T-Y Lai
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - S Z Song
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - R K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
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31
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Es’haghian S, Kennedy KM, Gong P, Li Q, Chin L, Wijesinghe P, Sampson DD, McLaughlin RA, Kennedy BF. In vivo volumetric quantitative micro-elastography of human skin. BIOMEDICAL OPTICS EXPRESS 2017; 8:2458-2471. [PMID: 28663884 PMCID: PMC5480491 DOI: 10.1364/boe.8.002458] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 05/17/2023]
Abstract
In this paper, we demonstrate in vivo volumetric quantitative micro-elastography of human skin. Elasticity is estimated at each point in the captured volume by combining local axial strain measured in the skin with local axial stress estimated at the skin surface. This is achieved by utilizing phase-sensitive detection to measure axial displacements resulting from compressive loading of the skin and an overlying, compliant, transparent layer with known stress/strain behavior. We use an imaging probe head that provides optical coherence tomography imaging and compression from the same direction. We demonstrate our technique on a tissue phantom containing a rigid inclusion, and present in vivo elastograms acquired from locations on the hand, wrist, forearm and leg of human volunteers.
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Affiliation(s)
- Shaghayegh Es’haghian
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Kelsey M. Kennedy
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - Peijun Gong
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Qingyun Li
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Lixin Chin
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Philip Wijesinghe
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, Australia
| | - David D. Sampson
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- Centre for Microscopy, Characterisation & Analysis, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Robert A. McLaughlin
- Optical+Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
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Es'haghian S, Gong P, Chin L, Harms KA, Murray A, Rea S, Kennedy BF, Wood FM, Sampson DD, McLaughlin RA. Investigation of optical attenuation imaging using optical coherence tomography for monitoring of scars undergoing fractional laser treatment. JOURNAL OF BIOPHOTONICS 2017; 10:511-522. [PMID: 27243584 DOI: 10.1002/jbio.201500342] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/17/2016] [Accepted: 04/26/2016] [Indexed: 05/08/2023]
Abstract
We demonstrate the use of the near-infrared attenuation coefficient, measured using optical coherence tomography (OCT), in longitudinal assessment of hypertrophic burn scars undergoing fractional laser treatment. The measurement method incorporates blood vessel detection by speckle decorrelation and masking, and a robust regression estimator to produce 2D en face parametric images of the attenuation coefficient of the dermis. Through reliable co-location of the field of view across pre- and post-treatment imaging sessions, the study was able to quantify changes in the attenuation coefficient of the dermis over a period of ∼20 weeks in seven patients. Minimal variation was observed in the mean attenuation coefficient of normal skin and control (untreated) mature scars, as expected. However, a significant decrease (13 ± 5%, mean ± standard deviation) was observed in the treated mature scars, resulting in a greater distinction from normal skin in response to localized damage from the laser treatment. By contrast, we observed an increase in the mean attenuation coefficient of treated (31 ± 27%) and control (27 ± 20%) immature scars, with numerical values incrementally approaching normal skin as the healing progressed. This pilot study supports conducting a more extensive investigation of OCT attenuation imaging for quantitative longitudinal monitoring of scars. En face 2D OCT attenuation coefficient map of a treated immature scar derived from the pre-treatment (top) and the post-treatment (bottom) scans. (Vasculature (black) is masked out.) The scale bars are 0.5 mm.
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Affiliation(s)
- Shaghayegh Es'haghian
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Peijun Gong
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Lixin Chin
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009
| | - Karl-Anton Harms
- Burns Service of Western Australia, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia
| | - Alexandra Murray
- Burns Service of Western Australia, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia
| | - Suzanne Rea
- Burns Service of Western Australia, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Brendan F Kennedy
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009
| | - Fiona M Wood
- Burns Service of Western Australia, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - David D Sampson
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- Centre for Microscopy, Characterisation & Analysis, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Robert A McLaughlin
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
- ARC Centre of Excellence for Nanoscale BioPhotonics, School of Medicine, The University of Adelaide, Adelaide, SA 5005, Australia
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Gong P, Es’haghian S, Harms KA, Murray A, Rea S, Wood FM, Sampson DD, McLaughlin RA. In vivo label-free lymphangiography of cutaneous lymphatic vessels in human burn scars using optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2016; 7:4886-4898. [PMID: 28018713 PMCID: PMC5175539 DOI: 10.1364/boe.7.004886] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/16/2016] [Accepted: 10/17/2016] [Indexed: 05/08/2023]
Abstract
We present an automated, label-free method for lymphangiography of cutaneous lymphatic vessels in humans in vivo using optical coherence tomography (OCT). This method corrects for the variation in OCT signal due to the confocal function and sensitivity fall-off of a spectral-domain OCT system and utilizes a single-scattering model to compensate for A-scan signal attenuation to enable reliable thresholding of lymphatic vessels. A segment-joining algorithm is then incorporated into the method to mitigate partial-volume effects with small vessels. The lymphatic vessel images are augmented with images of the blood vessel network, acquired from the speckle decorrelation with additional weighting to differentiate blood vessels from the observed high decorrelation in lymphatic vessels. We demonstrate the method with longitudinal scans of human burn scar patients undergoing ablative fractional laser treatment, showing the visualization of the cutaneous lymphatic and blood vessel networks.
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Affiliation(s)
- Peijun Gong
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Shaghayegh Es’haghian
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Karl-Anton Harms
- Burns Service of Western Australia, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Alexandra Murray
- Burns Service of Western Australia, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Suzanne Rea
- Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Perth, WA 6009, Australia
| | - Fiona M. Wood
- Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Perth, WA 6009, Australia
| | - David D. Sampson
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Centre for Microscopy, Characterisation & Analysis, The University of Western Australia, Perth, WA 6009, Australia
| | - Robert A. McLaughlin
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, School of Medicine, The University of Adelaide, Adelaide, SA 5005, Australia
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Carter HH, Gong P, Kirk RW, Es'haghian S, Atkinson CL, Sampson DD, Green DJ, McLaughlin RA. Optical coherence tomography in the assessment of acute changes in cutaneous vascular diameter induced by heat stress. J Appl Physiol (1985) 2016; 121:965-972. [PMID: 27586840 DOI: 10.1152/japplphysiol.00918.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 08/25/2016] [Indexed: 11/22/2022] Open
Abstract
There are limited imaging technologies available that can accurately assess or provide surrogate markers of the in vivo cutaneous microvessel network in humans. In this study, we establish the use of optical coherence tomography (OCT) as a novel imaging technique to assess acute changes in cutaneous microvessel area density and diameter in humans. OCT speckle decorrelation images of the skin on the ventral side of the forearm up to a depth of 500 μm were obtained prior to and following 20-25 min of lower limb heating in eight healthy men [30.3 ± 7.6 (SD) yr]. Skin red blood cell flux was also collected using laser Doppler flowmetry probes immediately adjacent to the OCT skin sites, along with skin temperature. OCT speckle decorrelation images were obtained at both baseline and heating time points. Forearm skin flux increased significantly (0.20 ± 0.15 to 1.75 ± 0.38 cutaneous vascular conductance, P < 0.01), along with forearm skin temperature (32.0 ± 1.2 to 34.3 ± 1.0°C, P < 0.01). Quantitative differences in the automated calculation of vascular area densities (26 ± 9 to 49 ± 19%, P < 0.01) and individual microvessel diameters (68 ± 17 to 105 ± 25 μm, P < 0.01) were evident following the heating session. This is the first in vivo within-subject assessment of acute changes in the cutaneous microvasculature in response to heating in humans and highlights the use of OCT as an exciting new imaging approach for skin physiology and clinical research.
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Affiliation(s)
- Howard H Carter
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Peijun Gong
- School of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, The University of Western Australia, Crawley, Western Australia, Australia
| | - Rodney W Kirk
- School of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, The University of Western Australia, Crawley, Western Australia, Australia.,Australian Research Council Centre of Excellence for Nanoscale Biophotonics, School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Shaghayegh Es'haghian
- School of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ceri L Atkinson
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - David D Sampson
- School of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, The University of Western Australia, Crawley, Western Australia, Australia.,Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Crawley, Western Australia, Australia; and
| | - Daniel J Green
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Robert A McLaughlin
- School of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, The University of Western Australia, Crawley, Western Australia, Australia; .,Australian Research Council Centre of Excellence for Nanoscale Biophotonics, School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Gong P, Es'haghian S, Wood FM, Sampson DD, McLaughlin RA. Optical coherence tomography angiography for longitudinal monitoring of vascular changes in human cutaneous burns. Exp Dermatol 2016; 25:722-4. [DOI: 10.1111/exd.13053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Peijun Gong
- Optical+Biomedical Engineering Laboratory; School of Electrical; Electronic & Computer Engineering; The University of Western Australia; Perth WA Australia
| | - Shaghayegh Es'haghian
- Optical+Biomedical Engineering Laboratory; School of Electrical; Electronic & Computer Engineering; The University of Western Australia; Perth WA Australia
| | - Fiona M. Wood
- Burns Service of Western Australia; Fiona Stanley Hospital; Murdoch WA Australia
- Burn Injury Research Unit; School of Surgery; The University of Western Australia; Perth WA Australia
| | - David D. Sampson
- Optical+Biomedical Engineering Laboratory; School of Electrical; Electronic & Computer Engineering; The University of Western Australia; Perth WA Australia
- Centre for Microscopy; Characterisation & Analysis; The University of Western Australia; Perth WA Australia
| | - Robert A. McLaughlin
- Optical+Biomedical Engineering Laboratory; School of Electrical; Electronic & Computer Engineering; The University of Western Australia; Perth WA Australia
- Centre for Nanoscale Biophotonics; The University of Adelaide; Adelaide SA Australia
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