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Malone JD, El-Haddad MT, Yerramreddy SS, Oguz I, Tao YK. Handheld spectrally encoded coherence tomography and reflectometry for motion-corrected ophthalmic optical coherence tomography and optical coherence tomography angiography. NEUROPHOTONICS 2019; 6:041102. [PMID: 32042852 PMCID: PMC6991137 DOI: 10.1117/1.nph.6.4.041102] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/12/2019] [Indexed: 05/05/2023]
Abstract
Optical coherence tomography (OCT) is the gold standard for quantitative ophthalmic imaging. The majority of commercial and research systems require patients to fixate and be imaged in a seated upright position, which limits the ability to perform ophthalmic imaging in bedridden or pediatric patients. Handheld OCT devices overcome this limitation, but image quality often suffers due to a lack of real-time aiming and patient eye and photographer motion. We describe a handheld spectrally encoded coherence tomography and reflectometry (SECTR) system that enables simultaneous en face reflectance and cross-sectional OCT imaging. The handheld probe utilizes a custom double-pass scan lens for fully telecentric OCT scanning with a compact optomechanical design and a rapid-prototyped enclosure to reduce the overall system size and weight. We also introduce a variable velocity scan waveform that allows for simultaneous acquisition of densely sampled OCT angiography (OCTA) volumes and widefield reflectance images, which enables high-resolution vascular imaging with precision motion-tracking for volumetric motion correction and multivolumetric mosaicking. Finally, we demonstrate in vivo human retinal OCT and OCT angiography (OCTA) imaging using handheld SECTR on a healthy volunteer. Clinical translation of handheld SECTR will allow for high-speed, motion-corrected widefield OCT and OCTA imaging in bedridden and pediatric patients who may benefit ophthalmic disease diagnosis and monitoring.
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Affiliation(s)
- Joseph D. Malone
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Mohamed T. El-Haddad
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Suhaas S. Yerramreddy
- Vanderbilt University, Department of Electrical Engineering and Computer Science, Nashville, Tennessee, United States
| | - Ipek Oguz
- Vanderbilt University, Department of Electrical Engineering and Computer Science, Nashville, Tennessee, United States
| | - Yuankai K. Tao
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Address all correspondence to Yuankai K. Tao, E-mail:
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Kiseleva EB, Yashin KS, Moiseev AA, Timofeeva LB, Kudelkina VV, Alekseeva AI, Meshkova SV, Polozova AV, Gelikonov GV, Zagaynova EV, Gladkova ND. Optical coefficients as tools for increasing the optical coherence tomography contrast for normal brain visualization and glioblastoma detection. NEUROPHOTONICS 2019; 6:035003. [PMID: 31312669 PMCID: PMC6630098 DOI: 10.1117/1.nph.6.3.035003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 06/27/2019] [Indexed: 05/14/2023]
Abstract
The methods used for digital processing of optical coherence tomography (OCT) and crosspolarization (CP) OCT images are focused on improving the contrast ratio of native structural OCT images. Such advances are particularly important for the intraoperative detection of glioma margins where the visual assessment of OCT images can be difficult and lead to errors. The aim of the study was to investigate the application of optical coefficients obtained from CP OCT data for the differentiation of glial tumorous tissue from a normal brain. Pseudocolor en-face OCT maps based on two optical coefficients (the commonly used rate of attenuation in the cochannel, and in addition, the interchannel attenuation difference) were constructed for normal rat brain coronal cross sections and for brains with a 101.8 rat glioblastoma model. It was shown that the use of optical coefficients significantly increased the available information from the OCT data in comparison with unprocessed images. As a result, this allowed contrasting of the white matter from the gray matter and tumorous tissue ex vivo, and for this purpose, the interchannel attenuation difference worked better. The interchannel attenuation difference values of white matter were at least seven and two times higher than corresponding values of the cortex and tumorous tissue, whereas the same parameter for cochannel attenuation coefficient values of white matter are about 4 and 1.4. However, quantitative analysis shows that both coefficients are suitable for the purpose of glioblastoma detection from normal brain tissue regardless of whether a necrotic component was present (in all compared groups p < 0.001 ).
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Affiliation(s)
- Elena B. Kiseleva
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
- Address all correspondence to Elena B. Kiseleva, E-mail:
| | | | - Alexander A. Moiseev
- Russian Academy of Sciences, Institute of Applied Physics, Nizhny Novgorod, Russia
| | | | | | | | | | | | - Grigory V. Gelikonov
- Russian Academy of Sciences, Institute of Applied Physics, Nizhny Novgorod, Russia
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Schaefer JM, Barth CW, Davis SC, Gibbs SL. Diagnostic performance of receptor-specific surgical specimen staining correlates with receptor expression level. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-9. [PMID: 30737910 PMCID: PMC6988447 DOI: 10.1117/1.jbo.24.2.026002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/11/2019] [Indexed: 05/19/2023]
Abstract
Intraoperative margin assessment is imperative to cancer cure but is a continued challenge to successful surgery. Breast conserving surgery is a relevant example, where a cosmetically improved outcome is gained over mastectomy, but re-excision is required in >25 % of cases due to positive or closely involved margins. Clinical translation of margin assessment modalities that must directly contact the patient or required administered contrast agents are time consuming and costly to move from bench to bedside. Tumor resections provide a unique surgical opportunity to deploy margin assessment technologies including contrast agents on the resected tissues, substantially shortening the path to the clinic. However, staining of resected tissues is plagued by nonspecific uptake. A ratiometric imaging approach where matched targeted and untargeted probes are used for staining has demonstrated substantially improved biomarker quantification over staining with conventional targeted contrast agents alone. Our group has developed an antibody-based ratiometric imaging technology using fluorescently labeled, spectrally distinct targeted and untargeted antibody probes termed dual-stain difference specimen imaging (DDSI). Herein, the targeted biomarker expression level and pattern are evaluated for their effects on DDSI diagnostic potential. Epidermal growth factor receptor expression level was correlated to DDSI diagnostic potential, which was found to be robust to spatial pattern expression variation. These results highlight the utility of DDSI for accurate margin assessment of freshly resected tumor specimens.
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MESH Headings
- Adipose Tissue/diagnostic imaging
- Adipose Tissue/pathology
- Animals
- Biomarkers, Tumor/metabolism
- Breast/surgery
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Carcinoma, Squamous Cell/diagnostic imaging
- Carcinoma, Squamous Cell/pathology
- Cell Line, Tumor
- False Positive Reactions
- Female
- Flow Cytometry
- Fluorescent Dyes/pharmacology
- Humans
- Image Processing, Computer-Assisted/methods
- Margins of Excision
- Mastectomy, Segmental
- Mice
- Mice, Nude
- Microscopy, Fluorescence
- Neoplasm Transplantation
- Neoplasms, Experimental/diagnostic imaging
- Neoplasms, Experimental/pathology
- Pancreatic Neoplasms/diagnostic imaging
- Pancreatic Neoplasms/pathology
- ROC Curve
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Affiliation(s)
- Jasmin M. Schaefer
- Oregon Health and Science University, Department of Biomedical Engineering, Portland, Oregon, United States
| | - Connor W. Barth
- Oregon Health and Science University, Department of Biomedical Engineering, Portland, Oregon, United States
| | - Scott C. Davis
- Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, United States
- Address all correspondence to Scott C. Davis, E-mail: ; Summer L. Gibbs, E-mail:
| | - Summer L. Gibbs
- Oregon Health and Science University, Department of Biomedical Engineering, Portland, Oregon, United States
- Oregon Health and Science University, Knight Cancer Institute, Portland, Oregon, United States
- Oregon Health and Science University, OHSU Center for Spatial Systems Biomedicine, Portland, Oregon, United States
- Address all correspondence to Scott C. Davis, E-mail: ; Summer L. Gibbs, E-mail:
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House BJ, Schaefer JM, Barth CW, Davis SC, Gibbs SL. Diagnostic Performance of Receptor-Specific Surgical Specimen Staining Correlate with Receptor Expression Level. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2019; 10862. [PMID: 32273644 DOI: 10.1117/12.2510625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Identification of tumor margins in the operating room in real time is a critical challenge for surgical procedures that serve as cancer cure. Breast conserving surgery (BCS) is particularly affected by this problem, with current re-excision rates above 25%. Due to a lack of clinically available methodologies for detection of involved or close tumor margins, much effort is focused on developing intraoperative margin assessment modalities that can aid in addressing this unmet clinical need. BCS provides a unique opportunity to design contrast-based technologies that are able to assess tumor margins independent from the patient, providing a rapid pathway from bench to bedside at a much lower cost. Since resected tissue is removed from the patient's blood supply, non-specific contrast agent uptake becomes a challenge due to the lack of clearance. Therefore, a dual probe, ratiometric fluorescence imaging approach was taken in an effort to reduce non-specific signal, and provide a modality that could demonstrate rapid, robust margin assessment on resected patient samples. Termed, dual-stain difference specimen imaging (DDSI), DDSI includes the use of spectrally unique, and fluorescently labeled target-specific, as well as non-specific biomarkers. In the present study, we have applied epidermal growth factor receptor (EGFR) targeted DDSI to tumor xenografts with variable EGFR expression levels using a previously optimized staining protocol, allowing for a quantitative assessment of the predictive power of the technique under biologically relevant conditions. Due to the presence of necrosis in the model tumors, ring analysis was employed to characterize diagnostic accuracy as measured by receiver operator characteristic (ROC) curve analysis. Our findings demonstrate the robust nature of the DDSI technique even in the presence of variable biomarker expression and spatial patterns. These results support the continued development of this technology as a robust diagnostic tool for tumor margin assessment in resected specimens during BCS.
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Affiliation(s)
- Broderick J House
- Biomedical Engineering Department, Oregon Health & Science University, Portland, OR 97201
| | - Jasmin M Schaefer
- Biomedical Engineering Department, Oregon Health & Science University, Portland, OR 97201
| | - Connor W Barth
- Biomedical Engineering Department, Oregon Health & Science University, Portland, OR 97201
| | - Scott C Davis
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755
| | - Summer L Gibbs
- Biomedical Engineering Department, Oregon Health & Science University, Portland, OR 97201.,Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97201.,OHSU Center for Spatial Systems Biomedicine, Oregon Health & Science University, Portland, OR 97201
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