Miniature probe for mapping mechanical properties of vascular lesions using acoustic radiation force optical coherence elastography

Learning-based distortion correction enables proximal-scanning endoscopic OCT elastography

Proximal rotary scanning is predominantly used in the clinical practice of endoscopic and intravascular OCT, mainly because of the much lower manufacturing cost of the probe compared to distal scanning. However, proximal scanning causes severe beam stability issues (also known as non-uniform rotational distortion, NURD), which hinders the extension of its applications to functional imaging, such as OCT elastography (OCE). In this work, we demonstrate the abilities of learning-based NURD correction methods to enable the imaging stability required for intensity-based OCE. Compared with the previous learning-based NURD correction methods that use pseudo distortion vectors for model training, we propose a method to extract real distortion vectors from a specific endoscopic OCT system, and validate its superiority in accuracy under both convolutional-neural-network- and transformer-based learning architectures. We further verify its effectiveness in elastography calculations (digital image correlation and optical flow) and the advantages of our method over other NURD correction methods. Using the air pressure of a balloon catheter as a mechanical stimulus, our proximal-scanning endoscopic OCE could effectively differentiate between areas of varying stiffness of atherosclerotic vascular phantoms. Compared with the existing endoscopic OCE methods that measure only in the radial direction, our method could achieve 2D displacement/strain distribution in both radial and circumferential directions.

In vivo endoscopic optical coherence elastography based on a miniature probe

Optical coherence elastography (OCE) is a functional extension of optical coherence tomography (OCT). It offers high-resolution elasticity assessment with nanoscale tissue displacement sensitivity and high quantification accuracy, promising to enhance diagnostic precision. However, in vivo endoscopic OCE imaging has not been demonstrated yet, which needs to overcome key challenges related to probe miniaturization, high excitation efficiency and speed. This study presents a novel endoscopic OCE system, achieving the first endoscopic OCE imaging in vivo. The system features the smallest integrated OCE probe with an outer diameter of only 0.9 mm (with a 1.2-mm protective tube during imaging). Utilizing a single 38-MHz high-frequency ultrasound transducer, the system induced rapid deformation in tissues with enhanced excitation efficiency. In phantom studies, the OCE quantification results match well with compression testing results, showing the system's high accuracy. The in vivo imaging of the rat vagina demonstrated the system's capability to detect changes in tissue elasticity continually and distinguish between normal tissue, hematomas, and tissue with increased collagen fibers precisely. This research narrows the gap for the clinical implementation of the endoscopic OCE system, offering the potential for the early diagnosis of intraluminal diseases.

Optical coherence elastography and its applications for the biomechanical characterization of tissues

The biomechanical characterization of the tissues provides significant evidence for determining the pathological status and assessing the disease treatment. Incorporating elastography with optical coherence tomography (OCT), optical coherence elastography (OCE) can map the spatial elasticity distribution of biological tissue with high resolution. After the excitation with the external or inherent force, the tissue response of the deformation or vibration is detected by OCT imaging. The elastogram is assessed by stress-strain analysis, vibration amplitude measurements, and quantification of elastic wave velocities. OCE has been used for elasticity measurements in ophthalmology, endoscopy, and oncology, improving the precision of diagnosis and treatment of disease. In this article, we review the OCE methods for biomechanical characterization and summarize current OCE applications in biomedicine. The limitations and future development of OCE are also discussed during its translation to the clinic.

A Miniature Dual-Fiber Probe for Quantitative Optical Coherence Elastography

OBJECTIVE

Optical coherence elastography (OCE) allows for high resolution analysis of elastic tissue properties. However, due to the limited penetration of light into tissue, miniature probes are required to reach structures inside the body, e.g., vessel walls. Shear wave elastography relates shear wave velocities to quantitative estimates of elasticity. Generally, this is achieved by measuring the runtime of waves between two or multiple points. For miniature probes, optical fibers have been integrated and the runtime between the point of excitation and a single measurement point has been considered. This approach requires precise temporal synchronization and spatial calibration between excitation and imaging.

METHODS

We present a miniaturized dual-fiber OCE probe of 1 mm diameter allowing for robust shear wave elastography. Shear wave velocity is estimated between two optics and hence independent of wave propagation between excitation and imaging. We quantify the wave propagation by evaluating either a single or two measurement points. Particularly, we compare both approaches to ultrasound elastography.

RESULTS

Our experimental results demonstrate that quantification of local tissue elasticities is feasible. For homogeneous soft tissue phantoms, we obtain mean deviations of 0.15 ms-1 and 0.02 ms-1 for single-fiber and dual-fiber OCE, respectively. In inhomogeneous phantoms, we measure mean deviations of up to 0.54 ms-1 and 0.03 ms-1 for single-fiber and dual-fiber OCE, respectively.

CONCLUSION

We present a dual-fiber OCE approach that is much more robust in inhomogeneous tissues. Moreover, we demonstrate the feasibility of elasticity quantification in ex-vivo coronary arteries.

SIGNIFICANCE

This study introduces an approach for robust elasticity quantification from within the tissue.

Recent advances in optical elastography and emerging opportunities in the basic sciences and translational medicine [Invited]

Optical elastography offers a rich body of imaging capabilities that can serve as a bridge between organ-level medical elastography and single-molecule biophysics. We review the methodologies and recent developments in optical coherence elastography, Brillouin microscopy, optical microrheology, and photoacoustic elastography. With an outlook toward maximizing the basic science and translational clinical impact of optical elastography technologies, we discuss potential ways that these techniques can integrate not only with each other, but also with supporting technologies and capabilities in other biomedical fields. By embracing cross-modality and cross-disciplinary interactions with these parallel fields, optical elastography can greatly increase its potential to drive new discoveries in the biomedical sciences as well as the development of novel biomechanics-based clinical diagnostics and therapeutics.

Intravascular optical coherence elastography

Optical coherence elastography (OCE), a functional extension of optical coherence tomography (OCT), visualizes tissue strain to deduce the tissue's biomechanical properties. In this study, we demonstrate intravascular OCE using a 1.1 mm motorized catheter and a 1.6 MHz Fourier domain mode-locked OCT system. We induced an intraluminal pressure change by varying the infusion rate from the proximal end of the catheter. We analysed the pixel-matched phase change between two different frames to yield the radial strain. Imaging experiments were carried out in a phantom and in human coronary arteries in vitro. At an imaging speed of 3019 frames/s, we were able to capture the dynamic strain. Stiff inclusions in the phantom and calcification in atherosclerotic plaques are associated with low strain values and can be distinguished from the surrounding soft material, which exhibits elevated strain. For the first time, circumferential intravascular OCE images are provided side by side with conventional OCT images, simultaneously mapping both the tissue structure and stiffness.

Advances in Endoscopic Photoacoustic Imaging

Photoacoustic (PA) imaging is able to provide extremely high molecular contrast while maintaining the superior imaging depth of ultrasound (US) imaging. Conventional microscopic PA imaging has limited access to deeper tissue due to strong light scattering and attenuation. Endoscopic PA technology enables direct delivery of excitation light into the interior of a hollow organ or cavity of the body for functional and molecular PA imaging of target tissue. Various endoscopic PA probes have been developed for different applications, including the intravascular imaging of lipids in atherosclerotic plaque and endoscopic imaging of colon cancer. In this paper, the authors review representative probe configurations and corresponding preclinical applications. In addition, the potential challenges and future directions of endoscopic PA imaging are discussed.

Introduction to optical coherence elastography: tutorial

Optical coherence elastography (OCE) has seen rapid growth since its introduction in 1998. The past few decades have seen tremendous advancements in the development of OCE technology and a wide range of applications, including the first clinical applications. This tutorial introduces the basics of solid mechanics, which form the foundation of all elastography methods. We then describe how OCE measurements of tissue motion can be used to quantify tissue biomechanical parameters. We also detail various types of excitation methods, imaging systems, acquisition schemes, and data processing algorithms and how various parameters associated with each step of OCE imaging can affect the final quantitation of biomechanical properties. Finally, we discuss the future of OCE, its potential, and the next steps required for OCE to become an established medical imaging technology.

Recent Development and Perspectives of Optimization Design Methods for Piezoelectric Ultrasonic Transducers

Apiezoelectric ultrasonic transducer (PUT) is widely used in nondestructive testing, medical imaging, and particle manipulation, etc., and the performance of the PUT determines its functional performance and effectiveness in these applications. The optimization design method of a PUT is very important for the fabrication of a high-performance PUT. In this paper, traditional and efficient optimization design methods for a PUT are presented. The traditional optimization design methods are mainly based on an analytical model, an equivalent circuit model, or a finite element model and the design parameters are adjusted by a trial-and-error method, which relies on the experience of experts and has a relatively low efficiency. Recently, by combining intelligent optimization algorithms, efficient optimization design methods for a PUT have been developed based on a traditional model or a data-driven model, which can effectively improve the design efficiency of a PUT and reduce its development cycle and cost. The advantages and disadvantages of the presented methods are compared and discussed. Finally, the optimization design methods for PUT are concluded, and their future perspectives are discussed.

Forward-Looking Multimodal Endoscopic System Based on Optical Multispectral and High-Frequency Ultrasound Imaging Techniques for Tumor Detection

We developed a forward-looking (FL) multimodal endoscopic system that offers color, spectral classified, high-frequency ultrasound (HFUS) B-mode, and integrated backscattering coefficient (IBC) images for tumor detection in situ. Examination of tumor distributions from the surface of the colon to deeper inside is essential for determining a treatment plan of cancer. For example, the submucosal invasion depth of tumors in addition to the tumor distributions on the colon surface is used as an indicator of whether the endoscopic dissection would be operated. Thus, we devised the FL multimodal endoscopic system to offer information on the tumor distribution from the surface to deep tissue with high accuracy. This system was evaluated with bilayer gelatin phantoms which have different properties at each layer of the phantom in a lateral direction. After evaluating the system with phantoms, it was employed to characterize forty human colon tissues excised from cancer patients. The proposed system could allow us to obtain highly resolved chemical, anatomical, and macro-molecular information on excised colon tissues including tumors, thus enhancing the detection of tumor distributions from the surface to deep tissue. These results suggest that the FL multimodal endoscopic system could be an innovative screening instrument for quantitative tumor characterization.

Ultrahigh-sensitive optical coherence elastography

The phase stability of an optical coherence elastography (OCE) system is the key determining factor for achieving a precise elasticity measurement, and it can be affected by the signal-to-noise ratio (SNR), timing jitters in the signal acquisition process, and fluctuations in the optical path difference (OPD) between the sample and reference arms. In this study, we developed an OCE system based on swept-source optical coherence tomography (SS-OCT) with a common-path configuration (SS-OCECP). Our system has a phase stability of 4.2 mrad without external stabilization or extensive post-processing, such as averaging. This phase stability allows us to detect a displacement as small as ~300 pm. A common-path interferometer was incorporated by integrating a 3-mm wedged window into the SS-OCT system to provide intrinsic compensation for polarization and dispersion mismatch, as well as to minimize phase fluctuations caused by the OPD variation. The wedged window generates two reference signals that produce two OCT images, allowing for averaging to improve the SNR. Furthermore, the electrical components are optimized to minimize the timing jitters and prevent edge collisions by adjusting the delays between the trigger, k-clock, and signal, utilizing a high-speed waveform digitizer, and incorporating a high-bandwidth balanced photodetector. We validated the SS-OCECP performance in a tissue-mimicking phantom and an in vivo rabbit model, and the results demonstrated a significantly improved phase stability compared to that of the conventional SS-OCE. To the best of our knowledge, we demonstrated the first SS-OCECP system, which possesses high-phase stability and can be utilized to significantly improve the sensitivity of elastography.

Cylindrical Transducer for Intravascular ARFI Imaging: Design and Feasibility

Intravascular acoustic radiation force impulse (IV-ARFI) imaging has the potential to identify vulnerable atherosclerotic plaques and improve clinical treatment decisions and outcomes for patients with coronary heart disease. Our long-term goal is to develop a thin, flexible catheter probe that does not require mechanical rotation to achieve high-resolution IV-ARFI imaging. In this work, we propose a novel cylindrical transducer array design for IV-ARFI imaging and investigate the feasibility of this approach. We present the construction of a 2.2-mm-long, 4.6-Fr cylindrical prototype transducer to demonstrate generating large ARFI displacements from a small toroidal beam, and we also present simulations of the proposed IV-ARFI cylindrical array design using Field II and a cylindrical finite-element model of vascular tissues and soft plaques. The prototype transducer was found to generate peak radial displacements of over [Formula: see text] in soft gelatin phantoms, and simulations demonstrate the ability of the array design to obtain ARFI images and distinguish soft plaque targets from surrounding, stiffer vessel wall tissue. These results suggest that high-resolution IV-ARFI imaging is possible using a cylindrical transducer array.

Spatial mapping of tracheal ciliary beat frequency using real time phase-resolved Doppler spectrally encoded interferometric microscopy

Ciliary motion in the upper airway is the primary mechanism by which the body transports foreign particulates out of the respiratory system in order to maintain proper respiratory function. The ciliary beating frequency (CBF) is often disrupted with the onset of disease as well as other conditions, such as changes in temperature or in response to drug administration. Current imaging of ciliary motion relies on microscopy and high-speed cameras, which cannot be easily adapted to in-vivo imaging. M-mode optical coherence tomography (OCT) imaging is capable of visualization of ciliary activity, but the field of view is limited. We report on the development of a spectrally encoded interferometric microscopy (SEIM) system using a phase-resolved Doppler (PRD) algorithm to measure and map the ciliary beating frequency within an en face region. This novel high speed, high resolution system allows for visualization of both temporal and spatial ciliary motion patterns as well as propagation of metachronal wave. Rabbit tracheal CBF ranging from 9 to 13 Hz has been observed under different temperature conditions, and the effects of using lidocaine and albuterol have also been measured. This study is the stepping stone to in-vivo studies and the translation of imaging spatial CBF to clinics.

Multimodal intravascular imaging technology for characterization of atherosclerosis

Early detection of vulnerable plaques is the critical step in the prevention of acute coronary events. Morphology, composition, and mechanical property of a coronary artery have been demonstrated to be the key characteristics for the identification of vulnerable plaques. Several intravascular multimodal imaging technologies providing co-registered simultaneous images have been developed and applied in clinical studies to improve the characterization of atherosclerosis. In this paper, the authors review the present system and probe designs of representative intravascular multimodal techniques. In addition, the scientific innovations, potential limitations, and future directions of these technologies are also discussed.

Advances in Doppler optical coherence tomography and angiography

Since the first demonstration of Doppler optical coherence tomography (OCT) in 1997, several functional extensions of Doppler OCT have been developed, including velocimetry, angiogram, and optical coherence elastography. These functional techniques have been widely used in research and clinical applications, particularly in ophthalmology. Here, we review the principles, representative methods, and applications of different Doppler OCT techniques, followed by discussion on the innovations, limitations, and future directions of each of these techniques.

Viscosity monitoring during hemodiluted blood coagulation using optical coherence elastography

Rapid and accurate clot diagnostic systems are needed for the assessment of hemodiluted blood coagulation. We develop a real-time optical coherence elastography (OCE) system, which measures the attenuation coefficient of a compressional wave induced by a piezoelectric transducer (PZT) in a drop of blood using optical coherence tomography (OCT), for the determination of viscous properties during the dynamic whole blood coagulation process. Changes in the viscous properties increase the attenuation coefficient of the sample. Consequently, dynamic blood coagulation status can be monitored by relating changes of the attenuation coefficient to clinically relevant coagulation metrics, including the initial coagulation time and the clot formation rate. This system was used to characterize the influence of activator kaolin and the influence of hemodilution with either NaCl 0.9% or hydroxyethyl starch (HES) 6% on blood coagulation. The results show that PZT-OCE is sensitive to coagulation abnormalities and is able to characterize blood coagulation status based on viscosity-related attenuation coefficient measurements. PZT-OCE can be used for point-of-care testing for diagnosis of coagulation disorders and monitoring of therapies.

Confocal Shear Wave Acoustic Radiation Force Optical Coherence Elastography for Imaging and Quantification of the In Vivo Posterior Eye

Retinal diseases, such as age-related macular degeneration (AMD), are the leading cause of blindness in the elderly population. Since no known cures are currently present, it is crucial to diagnose the condition in its early stages so that disease progression is monitored. Recent advances show that the mechanical elasticity of the posterior eye changes with the onset of AMD. In this work, we present a quantitative method of mapping the mechanical elasticity of the posterior eye using confocal shear wave acoustic radiation force optical coherence elastography (SW-ARF-OCE). This technique has been developed and validated with both an ex-vivo porcine tissue model and a customized in-vivo rabbit model, which both showed the quantified elasticity variations between different layers. This study verifies the feasibility of using this technology for the quantification and diagnosis of retinal diseases from the in-vivo posterior eye.

Acoustic radiation force optical coherence elastography for elasticity assessment of soft tissues

Biomechanical properties of soft tissues are important indicators of tissue functions which can be used for clinical diagnosis and disease monitoring. Elastography, incorporating the principles of elasticity measurements into imaging modalities, provides quantitative assessment of elastic properties of biological tissues. Benefiting from high-resolution, noninvasive and three-dimensional optical coherence tomography (OCT), optical coherence elastography (OCE) is an emerging optical imaging modality to characterize and map biomechanical properties of soft tissues. Recently, acoustic radiation force (ARF) OCE has been developed for elasticity measurements of ocular tissues, detection of vascular lesions and monitoring of blood coagulation based on remote and noninvasive ARF excitation to both internal and superficial tissues. Here, we describe the advantages of the ARF-OCE technique, the measurement methods in ARF-OCE, the applications in biomedical detection, current challenges and advances. ARF-OCE technology has the potential to become a powerful tool for in vivo elasticity assessment of biological samples in a non-contact, non-invasive and high-resolution nature.

High-Speed Integrated Endoscopic Photoacoustic and Ultrasound Imaging System

Endoscopic integrated photoacoustic and ultrasound imaging has the potential for early detection of the cancer in the gastrointestinal tract. Currently, slow imaging speed is one of the limitations for clinical translation. Here, we developed a high speed integrated endoscopic PA and US imaging system, which is able to perform PA and US imaging simultaneously up to 50 frames per second. Using this system, the architectural morphology and vasculature of the rectum wall were visualized from a Sprague Dawley rat in-vivo.

Coaxial excitation longitudinal shear wave measurement for quantitative elasticity assessment using phase-resolved optical coherence elastography

Optical coherence elastography (OCE) is an emerging imaging modality for the assessment of mechanical properties in soft tissues. Transverse shear wave measurements using OCE can quantify the elastic moduli perpendicular to the force direction, however, missing the elastic information along the force direction. In this study, we developed coaxial excitation longitudinal shear wave measurements for quantification of elastic moduli along the force direction using M-scans. Incorporating Rayleigh wave measurements using non-coaxial lateral scans into longitudinal shear wave measurements, directionally dependent elastic properties can be quantified along the force direction and perpendicular to the force direction. Therefore, the reported system has the capability to image elasticity of anisotropic biological tissues.

Multimodality endoscopic optical coherence tomography and fluorescence imaging technology for visualization of layered architecture and subsurface microvasculature

Endoscopic imaging technologies, such as endoscopic optical coherence tomography (OCT) and near-infrared fluorescence, have been used to investigate vascular and morphological changes as hallmarks of early cancer in the gastrointestinal tract. Here we developed a high-speed multimodality endoscopic OCT and fluorescence imaging system. Using this system, the architectural morphology and vasculature of the rectum wall were obtained simultaneously from a Sprague Dawley rat in vivo. This multimodality imaging strategy in a single imaging system permits the use of a single imaging probe, thereby improving prognosis by early detection and reducing costs.

A Multimodal Biomicroscopic System based on High-frequency Acoustic Radiation Force Impulse and Multispectral Imaging Techniques for Tumor Characterization Ex vivo

We report a multimodal biomicroscopic system which offers high-frequency ultrasound B-mode, acoustic radiation force impulse (ARFI), and multispectral imaging for qualitative tumor characterization ex vivo. Examinations of resected tissues from diseased regions such as tumors are crucial procedures during surgical operations to treat cancer. Particularly, if tiny tumors remain at surgical sites after tumor resection, such tumors can result in unwanted outcomes, such as cancer recurrence or metastasis to other organs. To avoid this, accurate characterizations of tumors resected during surgery are necessary. To this end, we devised a multimodal biomicroscopic system including high-frequency ultrasound B-mode, ARFI, and multispectral imaging modalities to examine resected tumors with high levels of accuracy. This system was evaluated with tissue-mimicking phantoms with different mechanical properties. In addition, colorectal tumors excised from cancer patients were examined. The proposed system offers highly resolved anatomical, mechanical, chemical information pertaining to tumors, thus allowing the detection of tumor regions from the surface to deep inside tissues. These results therefore suggest that the multimodal biomicroscopic system has the potential to undertake qualitative characterizations of excised tumors ex vivo.