1
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Zarghami A, Mirmalek SA. Differentiating Primary and Recurrent Lesions in Patients with a History of Breast Cancer: A Comprehensive Review. Galen Med J 2024; 13:1-18. [PMID: 39224544 PMCID: PMC11368482 DOI: 10.31661/gmj.v13i.3340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Indexed: 09/04/2024] Open
Abstract
Breast cancer (BC) recurrence remains a concerning issue, requiring accurate identification and differentiation from primary lesions for optimal patient management. This comprehensive review aims to summarize and evaluate the current evidence on methods to distinguish primary breast tumors from recurrent lesions in patients with a history of BC. Also, we provide a comprehensive understanding of the different imaging techniques, including mammography, ultrasound, magnetic resonance imaging, and positron emission tomography, highlighting their diagnostic accuracy, limitations, and potential integration. In addition, the role of various biopsy modalities and molecular markers was explored. Furthermore, the potential role of liquid biopsy, circulating tumor cells, and circulating tumor DNA in differentiating between primary and recurrent BC was emphasized. Finally, it addresses emerging diagnostic modalities, such as radiomic analysis and artificial intelligence, which show promising potential in enhancing diagnostic accuracy. Through comprehensive analysis and review of the available literature, the current study provides an up-to-date understanding of the current state of knowledge, challenges, and future directions in accurately distinguishing between primary and recurrent breast lesions in patients with a history of BC.
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Affiliation(s)
- Anita Zarghami
- Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Mirmalek
- Department of Surgery, Tehran Medical Sciences, Islamic Azad University, Tehran,
Iran
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2
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Nguyen VP, Hu J, Zhe J, Ramasamy S, Ahmed U, Paulus YM. Advanced nanomaterials for imaging of eye diseases. ADMET AND DMPK 2024; 12:269-298. [PMID: 38720929 PMCID: PMC11075159 DOI: 10.5599/admet.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/16/2024] [Indexed: 05/12/2024] Open
Abstract
Background and purpose Vision impairment and blindness present significant global challenges, with common causes including age-related macular degeneration, diabetes, retinitis pigmentosa, and glaucoma. Advanced imaging tools, such as optical coherence tomography, fundus photography, photoacoustic microscopy, and fluorescence imaging, play a crucial role in improving therapeutic interventions and diagnostic methods. Contrast agents are often employed with these tools to enhance image clarity and signal detection. This review aims to explore the commonly used contrast agents in ocular disease imaging. Experimental approach The first section of the review delves into advanced ophthalmic imaging techniques, outlining their importance in addressing vision-related issues. The emphasis is on the efficacy of therapeutic interventions and diagnostic methods, establishing a foundation for the subsequent exploration of contrast agents. Key results This review focuses on the role of contrast agents, with a specific emphasis on gold nanoparticles, particularly gold nanorods. The discussion highlights how these contrast agents optimize imaging in ocular disease diagnosis and monitoring, emphasizing their unique properties that enhance signal detection and imaging precision. Conclusion The final section, we explores both organic and inorganic contrast agents and their applications in specific conditions such as choroidal neovascularization, retinal neovascularization, and stem cell tracking. The review concludes by addressing the limitations of current contrast agent usage and discussing potential future clinical applications. This comprehensive exploration contributes to advancing our understanding of contrast agents in ocular disease imaging and sets the stage for further research and development in the field.
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Affiliation(s)
- Van Phuc Nguyen
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Justin Hu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Josh Zhe
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Sanjay Ramasamy
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Umayr Ahmed
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Yannis M. Paulus
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48105, USA
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3
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Pavone M, Spiridon IA, Lecointre L, Seeliger B, Scambia G, Venkatasamy A, Querleu D. Full-field optical coherence tomography imaging for intraoperative microscopic extemporaneous lymph node assessment. Int J Gynecol Cancer 2023; 33:1985-1987. [PMID: 37945058 DOI: 10.1136/ijgc-2023-005050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Affiliation(s)
- Matteo Pavone
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Irene A Spiridon
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Morpho-Functional Sciences I-Pathology, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Lise Lecointre
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Gynecologic Surgery, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Barbara Seeliger
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - Giovanni Scambia
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Aïna Venkatasamy
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
| | - Denis Querleu
- Institut Hospitalo-Universitaire (IHU) Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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4
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Papadoliopoulou M, Matiatou M, Koutsoumpos S, Mulita F, Giannios P, Margaris I, Moutzouris K, Arkadopoulos N, Michalopoulos NV. Optical Imaging in Human Lymph Node Specimens for Detecting Breast Cancer Metastases: A Review. Cancers (Basel) 2023; 15:5438. [PMID: 38001697 PMCID: PMC10670418 DOI: 10.3390/cancers15225438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Assessment of regional lymph node status in breast cancer is of important staging and prognostic value. Even though formal histological examination is the currently accepted standard of care, optical imaging techniques have shown promising results in disease diagnosis. In the present article, we review six spectroscopic techniques and focus on their use as alternative tools for breast cancer lymph node assessment. Elastic scattering spectroscopy (ESS) seems to offer a simple, cost-effective, and reproducible method for intraoperative diagnosis of breast cancer lymph node metastasis. Optical coherence tomography (OCT) provides high-resolution tissue scanning, along with a short data acquisition time. However, it is relatively costly and experimentally complex. Raman spectroscopy proves to be a highly accurate method for the identification of malignant axillary lymph nodes, and it has been further validated in the setting of head and neck cancers. Still, it remains time-consuming. Near-infrared fluorescence imaging (NIRF) and diffuse reflectance spectroscopy (DFS) are related to significant advantages, such as deep tissue penetration and efficiency. Fourier-transform infrared spectroscopy (FTIR) is a promising method but has significant drawbacks. Nonetheless, only anecdotal reports exist on their clinical use for cancerous lymph node detection. Our results indicate that optical imaging methods can create informative and rapid tools to effectively guide surgical decision-making.
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Affiliation(s)
- Maria Papadoliopoulou
- 4th Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 12462 Athens, Greece (N.V.M.)
| | - Maria Matiatou
- Laboratory of Electronic Devices and Materials, Department of Electrical & Electronic Engineering, University of West Attica, 12244 Egaleo, Greece
| | - Spyridon Koutsoumpos
- Laboratory of Electronic Devices and Materials, Department of Electrical & Electronic Engineering, University of West Attica, 12244 Egaleo, Greece
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, 26504 Rio, Greece
| | - Panagiotis Giannios
- Barcelona Institute of Science and Technology, Institute for Research in Biomedicine, IRB Barcelona, 08028 Barcelona, Spain
| | - Ioannis Margaris
- 4th Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 12462 Athens, Greece (N.V.M.)
| | - Konstantinos Moutzouris
- Laboratory of Electronic Devices and Materials, Department of Electrical & Electronic Engineering, University of West Attica, 12244 Egaleo, Greece
| | - Nikolaos Arkadopoulos
- 4th Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 12462 Athens, Greece (N.V.M.)
| | - Nikolaos V. Michalopoulos
- 4th Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 12462 Athens, Greece (N.V.M.)
- 1st Propaedeutic Department of Surgery, Hippocration General Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece
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5
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Song Cho DM, Jerome MJ, Hendon CP. Compressed sensing of human breast optical coherence 3-D image volume data using predictive coding. BIOMEDICAL OPTICS EXPRESS 2023; 14:5720-5734. [PMID: 38021138 PMCID: PMC10659800 DOI: 10.1364/boe.502851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023]
Abstract
There are clinical needs for optical coherence tomography (OCT) of large areas within a short period of time, such as imaging resected breast tissue for the evaluation of cancer. We report on the use of denoising predictive coding (DN-PC), a novel compressed sensing (CS) algorithm for reconstruction of OCT volumes of human normal breast and breast cancer tissue. The DN-PC algorithm has been rewritten to allow for computational parallelization and efficient memory transfer, resulting in a net reduction of computation time by a factor of 20. We compress image volumes at decreasing A-line sampling rates to evaluate a relation between reconstruction behavior and image features of breast tissue.
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Affiliation(s)
- Diego M. Song Cho
- Department of Biomedical Engineering, Columbia University, 500 W 120th Street, New York, NY 10027, USA
| | - Manuel J. Jerome
- Department of Electrical Engineering, Columbia University, 500 W 120th Street, New York, NY 10027, USA
| | - Christine P. Hendon
- Department of Electrical Engineering, Columbia University, 500 W 120th Street, New York, NY 10027, USA
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6
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Wąż P, Zorena K, Murawska A, Bielińska-Wąż D. Classification Maps: A New Mathematical Tool Supporting the Diagnosis of Age-Related Macular Degeneration. J Pers Med 2023; 13:1074. [PMID: 37511686 PMCID: PMC10381320 DOI: 10.3390/jpm13071074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE A new diagnostic graphical tool-classification maps-supporting the detection of Age-Related Macular Degeneration (AMD) has been constructed. METHODS The classification maps are constructed using the ordinal regression model. In the ordinal regression model, the ordinal variable (the dependent variable) is the degree of the advancement of AMD. The other variables, such as CRT (Central Retinal Thickness), GCC (Ganglion Cell Complex), MPOD (Macular Pigment Optical Density), ETDRS (Early Treatment Diabetic Retinopathy Study), Snellen and Age have also been used in the analysis and are represented on the axes of the maps. RESULTS Here, 132 eyes were examined and classified to the AMD advancement level according to the four-point Age-Related Eye Disease Scale (AREDS): AREDS 1, AREDS 2, AREDS 3 and AREDS 4. These data were used for the creation of two-dimensional classification maps for each of the four stages of AMD. CONCLUSIONS The maps allow us to perform the classification of the patient's eyes to particular stages of AMD. The pairs of the variables represented on the axes of the maps can be treated as diagnostic identifiers necessary for the classification to particular stages of AMD.
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Affiliation(s)
- Piotr Wąż
- Department of Nuclear Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Anna Murawska
- Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Dorota Bielińska-Wąż
- Department of Radiological Informatics and Statistics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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7
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Huang Z, Zhao X, Ziv O, Laurita KR, Rollins AM, Hendon CP. Automated analysis framework for in vivo cardiac ablation therapy monitoring with optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:1228-1242. [PMID: 36950243 PMCID: PMC10026573 DOI: 10.1364/boe.480943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/12/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Radiofrequency ablation (RFA) is a minimally invasive procedure that is commonly used for the treatment of atrial fibrillation. However, it is associated with a significant risk of arrhythmia recurrence and complications owing to the lack of direct visualization of cardiac substrates and real-time feedback on ablation lesion transmurality. Within this manuscript, we present an automated deep learning framework for in vivo intracardiac optical coherence tomography (OCT) analysis of swine left atria. Our model can accurately identify cardiac substrates, monitor catheter-tissue contact stability, and assess lesion transmurality on both OCT intensity and polarization-sensitive OCT data. To the best of our knowledge, we have developed the first automatic framework for in vivo cardiac OCT analysis, which holds promise for real-time monitoring and guidance of cardiac RFA therapy..
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Affiliation(s)
- Ziyi Huang
- Department of Electrical Engineering, Columbia University, New York, NY, USA
| | - Xiaowei Zhao
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Ohad Ziv
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Heart and Vascular Research Center, MetroHealth Campus, Case Western Reserve University, Cleveland, OH, USA
| | - Kenneth R. Laurita
- Heart and Vascular Research Center, MetroHealth Campus, Case Western Reserve University, Cleveland, OH, USA
| | - Andrew M. Rollins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Christine P. Hendon
- Department of Electrical Engineering, Columbia University, New York, NY, USA
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8
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Lin SE, Chang WW, Hsiao PK, Hsieh MC, Chen WY, Fang CL, Tsai CC. Feasibility of Breast Cancer Metastasis Assessment of Ex Vivo Sentinel Lymph Nodes through a p-H&E Optical Coherence Microscopic Imaging System. Cancers (Basel) 2022; 14:cancers14246081. [PMID: 36551567 PMCID: PMC9776820 DOI: 10.3390/cancers14246081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/21/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Frozen-sectioned hematoxylin-eosin (H&E) image evaluation is the current method for intraoperative breast cancer metastasis assessment through ex vivo sentinel lymph nodes (SLNs). After frozen sectioning, the sliced fatty region of the frozen-sectioned specimen is easily dropped because of different freezing points for fatty tissues and other tissues. Optical-sectioned H&E images provide a nondestructive method for obtaining the insight en face image near the attached surface of the dissected specimen, preventing the freezing problem of fatty tissue. Specimens from 29 patients at Wanfang Hospital were collected after excision and were analyzed at the pathology laboratory, and a fluorescence-in-built optical coherence microscopic imaging system (OCMIS) was then used to visualize the pseudo-H&E (p-H&E) images of the SLNs for intraoperative breast cancer metastasis assessment, and the specificity, sensitivity, and accuracy were 100%, 88.9%, and 98.8% (n = 83), respectively. Compared with gold-standard paraffin-sectioned H&E images, the specificity, sensitivity, and accuracy obtained with the frozen-sectioned H&E images (n = 85) of the specimens were the same as those obtained with the p-H&E images (n = 95). Thus, OCMIS is a useful noninvasive image-assisted tool for breast cancer metastasis assessment based on SLN images.
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Affiliation(s)
- Sey-En Lin
- Department of Anatomic Pathology, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan
- Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei 11031, Taiwan
- Department of Pathology, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Wei-Wen Chang
- Division of General Surgery, Department of Surgery, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Ping-Kun Hsiao
- Division of General Surgery, Department of Surgery, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Mao-Chih Hsieh
- Division of General Surgery, Department of Surgery, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Wei-Yu Chen
- Department of Pathology, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chia-Lang Fang
- Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei 11031, Taiwan
- Department of Pathology, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chien-Chung Tsai
- AcuSolutions Inc., 3F., No. 2, Ln. 263, Chongyang Rd., Nangang Dist., Taipei 11573, Taiwan
- Correspondence: ; Tel.: +886-2-2558-9611
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Bareja R, Mojahed D, Hibshoosh H, Hendon C. Classifying breast cancer in ultrahigh-resolution optical coherence tomography images using convolutional neural networks. APPLIED OPTICS 2022; 61:4458-4462. [PMID: 36256284 DOI: 10.1364/ao.455626] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/29/2022] [Indexed: 06/16/2023]
Abstract
Optical coherence tomography (OCT) is being investigated in breast cancer diagnostics as a real-time histology evaluation tool. We present a customized deep convolutional neural network (CNN) for classification of breast tissues in OCT B-scans. Images of human breast samples from mastectomies and breast reductions were acquired using a custom ultrahigh-resolution OCT system with 2.72 µm axial resolution and 5.52 µm lateral resolution. The network achieved 96.7% accuracy, 92% sensitivity, and 99.7% specificity on a dataset of 23 patients. The usage of deep learning will be important for the practical integration of OCT into clinical practice.
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10
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Yaari Z, Horoszko CP, Antman-Passig M, Kim M, Nguyen FT, Heller DA. Emerging technologies in cancer detection. Cancer Biomark 2022. [DOI: 10.1016/b978-0-12-824302-2.00011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Barkur S, Notingher I, Rakha E. Intra-operative assessment of sentinel lymph nodes for breast cancer surgery: An update. Surg Oncol 2021; 40:101678. [PMID: 34844070 DOI: 10.1016/j.suronc.2021.101678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/26/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022]
Abstract
Lymph node (LN) involvement is the strongest prognostic factor in operable breast cancer (BC). Therefore, accurate assessment of LN status is essential for management of BC patients. The introduction of sentinel LN approach reduced the need for extensive axillary surgery to achieve accurate staging. However, positive sentinel LN as determined on postoperative histological examination often leads to a second axillary operation to ensure an accurate staging and that positive non-sentinel LNs are removed. Although preoperative assessment of LN has improved significantly, its accuracy remains insufficient to avoid further axillary surgery and is not sufficient to predict the status of the LN. Therefore, intraoperative evaluation of the sentinel LN to determine the need for completing lymph node dissection in case of metastasis can provide an important approach to guide BC management decision making. This article reviews the techniques available and under development for intraoperative detection of sentinel LN metastasis in BC surgery. The key features of each technique are described in detail, emphasising the benefits offered by label-free optical techniques: minimal sample preparation, high spatial resolution, and immediate on-site implementation. Optical techniques have the potential to provide a cost-effective and accurate intraoperative platform for the assessment of SLN within the operating theatre.
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Affiliation(s)
- Surekha Barkur
- School of Physics and Astronomy, University of Nottingham, University Park, NG7 2RD, UK
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, University Park, NG7 2RD, UK.
| | - Emad Rakha
- Division of Oncology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK.
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12
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Tung ET, Yim KHC, Li CL, Cheung CY, Chan YC. Optical coherence tomography in peripheral arterial disease: A systematic review. Int J Clin Pract 2021; 75:e14628. [PMID: 34258814 DOI: 10.1111/ijcp.14628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/01/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Optical coherence tomography (OCT) is a novel adjunct in the field of medicine. The objective of this systematic review was to evaluate the role of OCT in the field of contemporary endovascular surgery in terms of its utility in diagnostics and interventions in peripheral arterial disease (PAD). METHOD A systematic search of literature published from 1st January 2009 to 1st August 2019 was identified from PubMed, Ovid and Cochrane library database with reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The pre-defined selection inclusion criteria were clinical applications of OCT in vascular surgery in relation to diagnostics and interventions. Keywords used included OCT, PAD, endovascular procedures and atherectomy. RESULTS From an initial search of 310 articles, 27 articles were included in this systematic review: 15 articles were related to diagnostics: peripheral arterial disease was the most studied condition (n = 8), other conditions included in-stent restenosis (n = 4), fibromuscular dysplasia (n = 2) and acute limb ischaemia (n = 1); 12 articles were related to intervention: an OCT-guided crossing catheter was the most used assisting device (n = 10), with an OCT-guided atherectomy device used in four of these studies. CONCLUSION Although there is currently no level 1 evidence to suggest routine use of OCT in the diagnosis and treatment of PAD, current literature suggests that the use of OCT is safe and effective. The OCT real-time vessel wall structural images clearly distinguish normal anatomy from plaque pathology, and are of great advantage both in the accurate diagnosis and treatment of target lesion, especially in reducing the amount of radiation in the endovascular procedure.
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Affiliation(s)
- Ernest T Tung
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
| | - Kristy H C Yim
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
| | - Calston L Li
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
| | - Chun Yiu Cheung
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
| | - Yiu Che Chan
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
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13
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Mueller CG, Gaiddon C, Venkatasamy A. Current Clinical and Pre-Clinical Imaging Approaches to Study the Cancer-Associated Immune System. Front Immunol 2021; 12:716860. [PMID: 34539653 PMCID: PMC8446654 DOI: 10.3389/fimmu.2021.716860] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/16/2021] [Indexed: 02/01/2023] Open
Abstract
In the light of the success and the expected growth of its arsenal, immuno-therapy may become the standard neoadjuvant procedure for many cancers in the near future. However, aspects such as the identity, organization and the activation status of the peri- and intra-tumoral immune cells would represent important elements to weigh in the decision for the appropriate treatment. While important progress in non-invasive imaging of immune cells has been made over the last decades, it falls yet short of entering the clinics, let alone becoming a standard procedure. Here, we provide an overview of the different intra-vital imaging approaches in the clinics and in pre-clinical settings and discuss their benefits and drawbacks for assessing the activity of the immune system, globally and on a cellular level. Stimulated by further research, the future is likely to see many technological advances both on signal detection and emission as well as image specificity and resolution to tackle current hurdles. We anticipate that the ability to precisely determine an immune stage of cancer will capture the attention of the oncologist and will create a change in paradigm for cancer therapy.
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Affiliation(s)
- Christopher G Mueller
- CNRS UPR 3572, University of Strasbourg, Immunologie-Immunopathologie-Chimie Thérapeutique, Strasbourg, France
| | - Christian Gaiddon
- Inserm UMR_S 1113, University of Strasbourg, Interface de Recherche Fondamentale et Appliquée en Cancérologie (IRFAC), Strasbourg, France
| | - Aïna Venkatasamy
- Inserm UMR_S 1113, University of Strasbourg, Interface de Recherche Fondamentale et Appliquée en Cancérologie (IRFAC), Strasbourg, France.,IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
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14
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Blessing K, Schirmer J, Sharma G, Singh K. Novel input polarisation independent endoscopic cross-polarised optical coherence tomography probe. JOURNAL OF BIOPHOTONICS 2020; 13:e202000134. [PMID: 32738024 DOI: 10.1002/jbio.202000134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
Lead by the original idea to perform noninvasive optical biopsies of various tissues, optical coherence tomography found numerous medical applications within the last two decades. The interference based imaging technique opens the possibility to visualise subcellular morphology up to an imaging depth of 3 mm and up to micron level axial and lateral resolution. The birefringence properties of the tissue are visualised with enhanced contrast using polarisation sensitive or cross-polarised optical coherence tomography (OCT) techniques. Although, it requires strict control over the polarisation states, resulting in several polarisation controlling elements. In this work, we propose a novel input-polarisation independent endoscopic system based on cross-polarised OCT. We tested the feasibility of our approach by measuring the polarisation change from a quarter-wave plate for different rotational angles. Further performance tests reveal a lateral resolution of 30 μm and a sensitivity of 103 dB. Images of the human nail bed and cow muscle tissue demonstrate the potential of the system to measure structural and birefringence properties of the tissue endoscopically.
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Affiliation(s)
- Katharina Blessing
- Research Group Singh, Max Planck Institute for the Science of Light, Erlangen, Germany
- Department of Physics, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Judith Schirmer
- Research Group Singh, Max Planck Institute for the Science of Light, Erlangen, Germany
- Department of Physics, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gargi Sharma
- Guck Division, Max Planck Institute for the Science of Light, Erlangen, Germany
| | - Kanwarpal Singh
- Research Group Singh, Max Planck Institute for the Science of Light, Erlangen, Germany
- Department of Physics, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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15
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Zaffino P, Moccia S, De Momi E, Spadea MF. A Review on Advances in Intra-operative Imaging for Surgery and Therapy: Imagining the Operating Room of the Future. Ann Biomed Eng 2020; 48:2171-2191. [PMID: 32601951 DOI: 10.1007/s10439-020-02553-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022]
Abstract
With the advent of Minimally Invasive Surgery (MIS), intra-operative imaging has become crucial for surgery and therapy guidance, allowing to partially compensate for the lack of information typical of MIS. This paper reviews the advancements in both classical (i.e. ultrasounds, X-ray, optical coherence tomography and magnetic resonance imaging) and more recent (i.e. multispectral, photoacoustic and Raman imaging) intra-operative imaging modalities. Each imaging modality was analyzed, focusing on benefits and disadvantages in terms of compatibility with the operating room, costs, acquisition time and image characteristics. Tables are included to summarize this information. New generation of hybrid surgical room and algorithms for real time/in room image processing were also investigated. Each imaging modality has its own (site- and procedure-specific) peculiarities in terms of spatial and temporal resolution, field of view and contrasted tissues. Besides the benefits that each technique offers for guidance, considerations about operators and patient risk, costs, and extra time required for surgical procedures have to be considered. The current trend is to equip surgical rooms with multimodal imaging systems, so as to integrate multiple information for real-time data extraction and computer-assisted processing. The future of surgery is to enhance surgeons eye to minimize intra- and after-surgery adverse events and provide surgeons with all possible support to objectify and optimize the care-delivery process.
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Affiliation(s)
- Paolo Zaffino
- Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy
| | - Sara Moccia
- Department of Information Engineering (DII), Universitá Politecnica delle Marche, via Brecce Bianche, 12, 60131, Ancona, AN, Italy.
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milano, MI, Italy
| | - Maria Francesca Spadea
- Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy
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16
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Posarelli C, Sartini F, Casini G, Passani A, Toro MD, Vella G, Figus M. What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review. J Clin Med 2020; 9:jcm9061682. [PMID: 32498222 PMCID: PMC7356858 DOI: 10.3390/jcm9061682] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 81 studies discussing MI-OCT applications in ophthalmology were included. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. Applications range from corneal transplant to macular surgery, including cataract surgery, glaucoma surgery, paediatric examination, proliferative diabetic retinopathy surgery, and retinal detachment surgery. Conclusion: The use of MI-OCT in ophthalmic surgery is becoming increasingly prevalent and has been applied in almost all procedures. However, there are still limitations to be overcome and the technology involved remains difficult to access and use.
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Affiliation(s)
- Chiara Posarelli
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy; (C.P.); (G.C.); (A.P.); (G.V.); (M.F.)
| | - Francesco Sartini
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy; (C.P.); (G.C.); (A.P.); (G.V.); (M.F.)
- Correspondence: ; Tel.: +39-050-997-675
| | - Giamberto Casini
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy; (C.P.); (G.C.); (A.P.); (G.V.); (M.F.)
| | - Andrea Passani
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy; (C.P.); (G.C.); (A.P.); (G.V.); (M.F.)
| | - Mario Damiano Toro
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
- Faculty of Medical Sciences, Collegium Medicum Cardinal Stefan Wyszyński University, 01815 Warsaw, Poland
| | - Giovanna Vella
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy; (C.P.); (G.C.); (A.P.); (G.V.); (M.F.)
| | - Michele Figus
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy; (C.P.); (G.C.); (A.P.); (G.V.); (M.F.)
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Ellebrecht DB, Latus S, Schlaefer A, Keck T, Gessert N. Towards an Optical Biopsy during Visceral Surgical Interventions. Visc Med 2020; 36:70-79. [PMID: 32355663 DOI: 10.1159/000505938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background Cancer will replace cardiovascular diseases as the most frequent cause of death. Therefore, the goals of cancer treatment are prevention strategies and early detection by cancer screening and ideal stage therapy. From an oncological point of view, complete tumor resection is a significant prognostic factor. Optical coherence tomography (OCT) and confocal laser microscopy (CLM) are two techniques that have the potential to complement intraoperative frozen section analysis as in vivo and real-time optical biopsies. Summary In this review we present both procedures and review the progress of evaluation for intraoperative application in visceral surgery. For visceral surgery, there are promising studies evaluating OCT and CLM; however, application during routine visceral surgical interventions is still lacking. Key Message OCT and CLM are not competing but complementary approaches of tissue analysis to intraoperative frozen section analysis. Although intraoperative application of OCT and CLM is at an early stage, they are two promising techniques of intraoperative in vivo and real-time tissue examination. Additionally, deep learning strategies provide a significant supplement for automated tissue detection.
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Affiliation(s)
- David Benjamin Ellebrecht
- LungenClinic Grosshansdorf, Department of Thoracic Surgery, Grosshansdorf, Germany.,University Medical Center Schleswig-Holstein, Campus Lübeck, Department of Surgery, Lübeck, Germany
| | - Sarah Latus
- Hamburg University of Technology, Institute of Medical Technology, Hamburg, Germany
| | - Alexander Schlaefer
- Hamburg University of Technology, Institute of Medical Technology, Hamburg, Germany
| | - Tobias Keck
- University Medical Center Schleswig-Holstein, Campus Lübeck, Department of Surgery, Lübeck, Germany
| | - Nils Gessert
- Hamburg University of Technology, Institute of Medical Technology, Hamburg, Germany
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18
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Schmidt H, Connolly C, Jaffer S, Oza T, Weltz CR, Port ER, Corben A. Evaluation of surgically excised breast tissue microstructure using wide-field optical coherence tomography. Breast J 2019; 26:917-923. [PMID: 31612563 DOI: 10.1111/tbj.13663] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Currently, positive margins at lumpectomy contribute to health care cost, patient anxiety, and treatment delay. Multiple technology solutions are being explored with the aim of lowering re-excision rates for breast-conserving surgery (BCS). We examined wide-field optical coherence tomography (WF-OCT), an innovative adjunct intraoperative imaging tool for tissue visualization of margins. METHODS This IRB-approved pilot study included women with invasive or in situ carcinoma scheduled for primary BCS. Lumpectomy specimens and any final/revised margins were imaged by optical coherence tomography immediately prior to standard histological processing. The optical coherence tomography used provided two-dimensional, cross-sectional, real-time depth visualization of the margin widths around excised specimens. A volume of images was captured for 10 × 10 cm tissue surface at high resolution (sub-30 μm) to a depth of 2 mm. Integrated interpretation was performed incorporating final pathology linked with the optical image data for correlation. RESULTS Wide-field optical coherence tomography was performed on 185 tissue samples (50 lumpectomy specimens and 135 additional margin shaves) in 50 subjects. Initial diagnosis was invasive ductal carcinoma (IDC) in 10, ductal carcinoma in situ (DCIS) in 14, IDC/DCIS in 22, invasive lobular carcinoma (ILC) in 2, ILC/DCIS in 1, and sarcoma in 1. Optical coherence tomography was concordant with final pathology in 178/185 tissue samples for overall accuracy of 86% and 96.2% (main specimen alone and main specimen + shave margins). Of seven samples that were discordant, 57% (4/7) were considered close (DCIS < 2 mm from margin) per final pathology. CONCLUSION Wide-field optical coherence tomography demonstrated concordance with histology at tissue margins, supporting its potential for use as a real-time adjunct intraoperative imaging tool for margin assessment. Further studies are needed for comprehensive evaluation in the intraoperative setting.
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Affiliation(s)
- Hank Schmidt
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
| | - Courtney Connolly
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
| | - Shabnam Jaffer
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
| | - Twisha Oza
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
| | - Christina R Weltz
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
| | - Elisa R Port
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
| | - Adriana Corben
- Dubin Breast Center of the Tisch Cancer Institute, Mount Sinai Hospital, New York, New York
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Li J, Lin P, Tan Y, Cheng JX. Volumetric stimulated Raman scattering imaging of cleared tissues towards three-dimensional chemical histopathology. BIOMEDICAL OPTICS EXPRESS 2019; 10:4329-4339. [PMID: 31453014 PMCID: PMC6701556 DOI: 10.1364/boe.10.004329] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/12/2019] [Accepted: 07/22/2019] [Indexed: 05/18/2023]
Abstract
Thin tissue slice based histology has been used as a gold standard for disease diagnosis since over a hundred years ago. However, histopathological evaluation on two-dimensional slides suffers from large variations due to limited sampling. To improve the diagnostic accuracy, three-dimensional (3D) histology is performed through serial sectioning, staining, imaging and reconstruction of individual slices, which is highly time-consuming and labor intensive. We developed a volumetric stimulated Raman scattering (SRS) imaging method, which provides histology-like information in 3D context without the need for staining with dyes. Using a small molecule clearing agent, formamide, we performed tissue clearing within 30 min and achieved an imaging depth up to 500 µm in highly scattered tissues, including brain, kidney, liver and lung. Through a two-color SRS imaging scheme, we obtained histology-like images in cleared brain tissue slices. Our method has the potential for 3D tissue histopathology to improve the accuracy of histopathological examination.
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Affiliation(s)
- Junjie Li
- Department of Electrical and Computer Engineering, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
| | - Peng Lin
- Department of Electrical and Computer Engineering, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
| | - Yuying Tan
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
| | - Ji-Xin Cheng
- Department of Electrical and Computer Engineering, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA 02215, USA
- Photonics Center, Boston University, 8 St. Mary’s St, Boston, MA 02215, USA
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20
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Abbaci M, Conversano A, De Leeuw F, Laplace-Builhé C, Mazouni C. Near-infrared fluorescence imaging for the prevention and management of breast cancer-related lymphedema: A systematic review. Eur J Surg Oncol 2019; 45:1778-1786. [PMID: 31221460 DOI: 10.1016/j.ejso.2019.06.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 02/07/2023] Open
Abstract
Sentinel lymph node identification by near infrared (NIR) fluorescence with indocyanine green (ICG) is recognized in the literature as a useful technique. NIR fluorescence technology could become key in the prevention and management of lymphedema after axillary dissection for breast cancer. Here, we conducted a systematic review focusing on ICG imaging to improve lymphedema prevention and treatment after axillary surgery. A systematic literature review was performed using MEDLINE and Embase to identify articles focused on ICG imaging for breast-cancer-related lymphedema (BCRL). Qualitative analysis was performed to summarize the characteristics of reported ICG procedures. In situ tissue identification and functionality assessment based on fluorescence signal were evaluated. Clinical outcomes were appraised when reported. Studies relating to axillary reverse mapping, lymphography and upper limb supermicrosurgery combined with ICG imaging were identified. We included a total of 33 relevant articles with a total of 2016 patients enrolled. ICG imaging for axillary reverse mapping was safe for all 951 included patients, with identification of arm nodes in 80%-88% of patients with axillary lymph nodes dissection. However, the papers discuss the oncologic safety of the approach and how - regardless of the contrast agent - concerns limit its adoption. ICG lymphography is openly supported in BCRL management, with 1065 patients undergoing this procedure in 26 articles. The technique is reported for lymphedema diagnosis, with high sensitivity and specificity, staging, intraoperative mapping and patency control in lymphaticovenular anastomosis. The substantial advantages/disadvantages of ICG imaging procedures are finally described.
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Affiliation(s)
- Muriel Abbaci
- Gustave Roussy, Plate-forme Imagerie et Cytométrie, UMS 23/3655, Université Paris-Saclay, Villejuif, F-94805, France; Univ Paris-Sud, UMR CNRS 8081- IR4M, Université Paris-Saclay, Orsay, F-91401, France.
| | - Angelica Conversano
- Gustave Roussy, Département de chirurgie, Université Paris-Saclay, Villejuif, F-94805, France
| | - Frederic De Leeuw
- Gustave Roussy, Plate-forme Imagerie et Cytométrie, UMS 23/3655, Université Paris-Saclay, Villejuif, F-94805, France
| | - Corinne Laplace-Builhé
- Gustave Roussy, Plate-forme Imagerie et Cytométrie, UMS 23/3655, Université Paris-Saclay, Villejuif, F-94805, France; Univ Paris-Sud, UMR CNRS 8081- IR4M, Université Paris-Saclay, Orsay, F-91401, France
| | - Chafika Mazouni
- Gustave Roussy, Département de chirurgie, Université Paris-Saclay, Villejuif, F-94805, France
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21
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Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy. J Bronchology Interv Pulmonol 2018; 25:189-197. [PMID: 29659420 DOI: 10.1097/lbr.0000000000000491] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Transbronchial needle aspiration (TBNA), often used to sample lymph nodes for lung cancer staging, is subject to sampling error even when performed with endobronchial ultrasound. Optical coherence tomography (OCT) is a high-resolution imaging modality that rapidly generates helical cross-sectional images. We aim to determine if needle-based OCT can provide microstructural information in lymph nodes that may be used to guide TBNA, and improve sampling error. METHODS We performed ex vivo needle-based OCT on thoracic lymph nodes from patients with and without known lung cancer. OCT imaging features were compared against matched histology. RESULTS OCT imaging was performed in 26 thoracic lymph nodes, including 6 lymph nodes containing metastatic carcinoma. OCT visualized lymphoid follicles, adipose tissue, pigment-laden histiocytes, and blood vessels. OCT features of metastatic carcinoma were distinct from benign lymph nodes, with microarchitectural features that reflected the morphology of the carcinoma subtype. OCT was also able to distinguish lymph node from adjacent airway wall. CONCLUSIONS Our results demonstrate that OCT provides critical microstructural information that may be useful to guide TBNA lymph node sampling, as a complement to endobronchial ultrasound. In vivo studies are needed to further evaluate the clinical utility of OCT in thoracic lymph node assessment.
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van Manen L, Dijkstra J, Boccara C, Benoit E, Vahrmeijer AL, Gora MJ, Mieog JSD. The clinical usefulness of optical coherence tomography during cancer interventions. J Cancer Res Clin Oncol 2018; 144:1967-1990. [PMID: 29926160 PMCID: PMC6153603 DOI: 10.1007/s00432-018-2690-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/16/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Tumor detection and visualization plays a key role in the clinical workflow of a patient with suspected cancer, both in the diagnosis and treatment. Several optical imaging techniques have been evaluated for guidance during oncological interventions. Optical coherence tomography (OCT) is a technique which has been widely evaluated during the past decades. This review aims to determine the clinical usefulness of OCT during cancer interventions focussing on qualitative features, quantitative features and the diagnostic value of OCT. METHODS A systematic literature search was performed for articles published before May 2018 using OCT in the field of surgical oncology. Based on these articles, an overview of the clinical usefulness of OCT was provided per tumor type. RESULTS A total of 785 articles were revealed by our search, of which a total of 136 original articles were available for analysis, which formed the basis of this review. OCT is currently utilised for both preoperative diagnosis and intraoperative detection of skin, oral, lung, breast, hepatobiliary, gastrointestinal, urological, and gynaecological malignancies. It showed promising results in tumor detection on a microscopic level, especially using higher resolution imaging techniques, such as high-definition OCT and full-field OCT. CONCLUSION In the near future, OCT could be used as an additional tool during bronchoscopic or endoscopic interventions and could also be implemented in margin assessment during (laparoscopic) cancer surgery if a laparoscopic or handheld OCT device will be further developed to make routine clinical use possible.
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Affiliation(s)
- Labrinus van Manen
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Alexander L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Michalina J Gora
- ICube Laboratory, CNRS, Strasbourg University, Strasbourg, France
| | - J Sven D Mieog
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
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Blatter C, Meijer EF, Padera TP, Vakoc BJ. Simultaneous measurements of lymphatic vessel contraction, flow and valve dynamics in multiple lymphangions using optical coherence tomography. JOURNAL OF BIOPHOTONICS 2018; 11:e201700017. [PMID: 28700145 PMCID: PMC5766440 DOI: 10.1002/jbio.201700017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/16/2017] [Accepted: 05/19/2017] [Indexed: 05/29/2023]
Abstract
Lymphatic dysfunction is involved in many diseases including lymphedema, hypertension, autoimmune responses, graft rejection, atherosclerosis, microbial infections, cancer and cancer metastasis. Expanding our knowledge of lymphatic system function can lead to a better understanding of these disease processes and improve treatment options. Here, optical coherence tomography (OCT) methods were used to reveal intraluminal valve dynamics in 3 dimensions, and measure lymph flow and vessel contraction simultaneously in 3 neighboring lymphangions of the afferent collecting lymphatic vessels to the popliteal lymph node in mice. Flow measurements were based on Doppler OCT techniques in combination with exogenous lymph labeling by Intralipid. Through these imaging methods, it is possible to study lymphatic function and pumping more comprehensively. These capabilities can lead to a better understanding of the regulation and dysregulation of lymphatic vessels in health and disease. The image depicts the dynamic measurements of lymphatic valves, lymphatic vessels cross-sectional area and lymph velocity simultaneously measured in vivo with optical coherence tomography.
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Affiliation(s)
- Cedric Blatter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Eelco F.J. Meijer
- Edwin L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Timothy P. Padera
- Edwin L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
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Ha R, Friedlander LC, Hibshoosh H, Hendon C, Feldman S, Ahn S, Schmidt H, Akens MK, Fitzmaurice M, Wilson BC, Mango VL. Optical Coherence Tomography: A Novel Imaging Method for Post-lumpectomy Breast Margin Assessment-A Multi-reader Study. Acad Radiol 2018; 25:279-287. [PMID: 29174226 DOI: 10.1016/j.acra.2017.09.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/12/2017] [Accepted: 09/18/2017] [Indexed: 01/08/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to assess whether different breast cancer subspecialty physicians can be trained to distinguish non-suspicious from suspicious areas of post-lumpectomy specimen margin in patients with breast cancer using optical coherence tomography (OCT) images (a near-infrared based imaging technique) with final histology as the reference standard. MATERIALS AND METHODS This institutional review board-exempt, Health Insurance Portability and Accountability Act-compliant study was performed on 63 surgically excised breast specimens from 35 female patients, creating a 90-case atlas containing both non-suspicious and suspicious areas for cancer. OCT images of the specimens were performed, providing 6.5-15 µm resolution with tissue visualization 1-2 mm subsurface. From the 90-case atlas, 40 cases were chosen for training and 40 were randomly selected for reader assessment. Three breast imaging radiologists, two pathologists, two breast surgeons, and one non-clinical reader were trained and assessed for ability to distinguish non-suspicious from suspicious findings blinded to clinical data and corresponding histology slides. Duration of training and assessment, sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve for each reader were calculated as well as averages by subspecialty. RESULTS The average training time was 3.4 hours (standard deviation, 1.2). The average assessment time was 1.9 hours (standard deviation, 0.7). The overall average reader sensitivity, specificity, and accuracy for detecting suspicious findings with histologic confirmation of cancer at the surgical margin for all eight readers were 80%, 87%, and 87%, respectively. Radiologists demonstrated the highest average among the disciplines, 85%, 93%, and 94%, followed by pathologists, 79%, 90%, and 84%, and surgeons, 76%, 84%, and 82% respectively. CONCLUSIONS With relatively short training (3.4 hours), readers from different medical specialties were able to distinguish suspicious from non-suspicious OCT imaging findings in ex vivo breast tissue as confirmed by histology. These results support the potential of OCT as a real-time intraoperative tool for post-lumpectomy specimen margin assessment.
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Affiliation(s)
- Richard Ha
- Columbia University Medical Center, New York, New York.
| | | | | | | | | | - Soojin Ahn
- Mount Sinai, New Icahn School of Medicine, New York, New York
| | - Hank Schmidt
- Mount Sinai, New Icahn School of Medicine, New York, New York
| | - Margaret K Akens
- Princess Margaret Cancer Centre/University Health Network, Toronto, ON, Canada
| | | | - Brian C Wilson
- Princess Margaret Cancer Centre/University Health Network, Toronto, ON, Canada
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Wang J, Xu Y, Boppart SA. Review of optical coherence tomography in oncology. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-23. [PMID: 29274145 PMCID: PMC5741100 DOI: 10.1117/1.jbo.22.12.121711] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/04/2017] [Indexed: 05/06/2023]
Abstract
The application of optical coherence tomography (OCT) in the field of oncology has been prospering over the past decade. OCT imaging has been used to image a broad spectrum of malignancies, including those arising in the breast, brain, bladder, the gastrointestinal, respiratory, and reproductive tracts, the skin, and oral cavity, among others. OCT imaging has initially been applied for guiding biopsies, for intraoperatively evaluating tumor margins and lymph nodes, and for the early detection of small lesions that would often not be visible on gross examination, tasks that align well with the clinical emphasis on early detection and intervention. Recently, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This paper reviews the evolution of OCT technologies for the clinical application of OCT in surgical and noninvasive interventional oncology procedures and concludes with a discussion of the future directions for OCT technologies, with particular emphasis on their applications in oncology.
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Affiliation(s)
- Jianfeng Wang
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Yang Xu
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
| | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana–Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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Monroy GL, Won J, Spillman DR, Dsouza R, Boppart SA. Clinical translation of handheld optical coherence tomography: practical considerations and recent advancements. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-30. [PMID: 29260539 PMCID: PMC5735247 DOI: 10.1117/1.jbo.22.12.121715] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/04/2017] [Indexed: 05/21/2023]
Abstract
Since the inception of optical coherence tomography (OCT), advancements in imaging system design and handheld probes have allowed for numerous advancements in disease diagnostics and characterization of the structural and optical properties of tissue. OCT system developers continue to reduce form factor and cost, while improving imaging performance (speed, resolution, etc.) and flexibility for applicability in a broad range of fields, and nearly every clinical specialty. An extensive array of components to construct customized systems has also become available, with a range of commercial entities that produce high-quality products, from single components to full systems, for clinical and research use. Many advancements in the development of these miniaturized and portable systems can be linked back to a specific challenge in academic research, or a clinical need in medicine or surgery. Handheld OCT systems are discussed and explored for various applications. Handheld systems are discussed in terms of their relative level of portability and form factor, with mention of the supporting technologies and surrounding ecosystem that bolstered their development. Additional insight from our efforts to implement systems in several clinical environments is provided. The trend toward well-designed, efficient, and compact handheld systems paves the way for more widespread adoption of OCT into point-of-care or point-of-procedure applications in both clinical and commercial settings.
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Affiliation(s)
- Guillermo L. Monroy
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Jungeun Won
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Darold R. Spillman
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Roshan Dsouza
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- Carle-Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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Singh K, Reddy R, Sharma G, Verma Y, Gardecki JA, Tearney G. In-line optical fiber metallic mirror reflector for monolithic common path optical coherence tomography probes. Lasers Surg Med 2017; 50:230-235. [DOI: 10.1002/lsm.22756] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Kanwarpal Singh
- Wellman Center for Photomedicine; Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
- Harvard Medical School; 25 Shattuck St Boston Massachusetts 02115
| | - Rohith Reddy
- Wellman Center for Photomedicine; Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
- Harvard Medical School; 25 Shattuck St Boston Massachusetts 02115
| | - Gargi Sharma
- Wellman Center for Photomedicine; Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
- Harvard Medical School; 25 Shattuck St Boston Massachusetts 02115
| | - Yogesh Verma
- Wellman Center for Photomedicine; Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
- Harvard Medical School; 25 Shattuck St Boston Massachusetts 02115
- Raja Ramanna Centre for Advanced Technology; Indore MP India
| | - Joseph A. Gardecki
- Wellman Center for Photomedicine; Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
- Harvard Medical School; 25 Shattuck St Boston Massachusetts 02115
| | - Guillermo Tearney
- Wellman Center for Photomedicine; Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
- Department of Pathology Massachusetts General Hospital; 55 Fruit Street Boston Massachusetts 02114
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Abstract
OBJECTIVE The objective of this article is to summarize the physical principles, technology features, and first clinical applications of optical imaging techniques to the breast. CONCLUSION Light-breast tissue interaction is expressed as absorption and scattering coefficients, allowing image reconstruction based on endogenous or exogenous contrast. Diffuse optical spectroscopy and imaging, fluorescence molecular tomography, photoacoustic imaging, and multiparametric infrared imaging show potential for clinical application, especially for lesion characterization, estimation of cancer probability, and monitoring the effect of neoadjuvant therapy.
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Carrasco-Zevallos OM, Viehland C, Keller B, Draelos M, Kuo AN, Toth CA, Izatt JA. Review of intraoperative optical coherence tomography: technology and applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:1607-1637. [PMID: 28663853 PMCID: PMC5480568 DOI: 10.1364/boe.8.001607] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/09/2017] [Accepted: 02/09/2017] [Indexed: 05/19/2023]
Abstract
During microsurgery, en face imaging of the surgical field through the operating microscope limits the surgeon's depth perception and visualization of instruments and sub-surface anatomy. Surgical procedures outside microsurgery, such as breast tumor resections, may also benefit from visualization of the sub-surface tissue structures. The widespread clinical adoption of optical coherence tomography (OCT) in ophthalmology and its growing prominence in other fields, such as cancer imaging, has motivated the development of intraoperative OCT for real-time tomographic visualization of surgical interventions. This article reviews key technological developments in intraoperative OCT and their applications in human surgery. We focus on handheld OCT probes, microscope-integrated OCT systems, and OCT-guided laser treatment platforms designed for intraoperative use. Moreover, we discuss intraoperative OCT adjuncts and processing techniques currently under development to optimize the surgical feedback derivable from OCT data. Lastly, we survey salient clinical studies of intraoperative OCT for human surgery.
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Affiliation(s)
| | - Christian Viehland
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Brenton Keller
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Mark Draelos
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Anthony N. Kuo
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
| | - Cynthia A. Toth
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
| | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
- Department of Ophthalmology, Duke University Medical Center, NC 27710, USA
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30
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Kennedy KM, Chin L, Wijesinghe P, McLaughlin RA, Latham B, Sampson DD, Saunders CM, Kennedy BF. Investigation of optical coherence micro-elastography as a method to visualize micro-architecture in human axillary lymph nodes. BMC Cancer 2016; 16:874. [PMID: 27829404 PMCID: PMC5103493 DOI: 10.1186/s12885-016-2911-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/27/2016] [Indexed: 01/21/2023] Open
Abstract
Background Evaluation of lymph node involvement is an important factor in detecting metastasis and deciding whether to perform axillary lymph node dissection (ALND) in breast cancer surgery. As ALND is associated with potentially severe long term morbidity, the accuracy of lymph node assessment is imperative in avoiding unnecessary ALND. The mechanical properties of malignant lymph nodes are often distinct from those of normal nodes. A method to image the micro-scale mechanical properties of lymph nodes could, thus, provide diagnostic information to aid in the assessment of lymph node involvement in metastatic cancer. In this study, we scan axillary lymph nodes, freshly excised from breast cancer patients, with optical coherence micro-elastography (OCME), a method of imaging micro-scale mechanical strain, to assess its potential for the intraoperative assessment of lymph node involvement. Methods Twenty-six fresh, unstained lymph nodes were imaged from 15 patients undergoing mastectomy or breast-conserving surgery with axillary clearance. Lymph node specimens were bisected to allow imaging of the internal face of each node. Co-located OCME and optical coherence tomography (OCT) scans were taken of each sample, and the results compared to standard post-operative hematoxylin-and-eosin-stained histology. Results The optical backscattering signal provided by OCT alone may not provide reliable differentiation by inspection between benign and malignant lymphoid tissue. Alternatively, OCME highlights local changes in tissue strain that correspond to malignancy and are distinct from strain patterns in benign lymphoid tissue. The mechanical contrast provided by OCME complements the optical contrast provided by OCT and aids in the differentiation of malignant tumor from uninvolved lymphoid tissue. Conclusion The combination of OCME and OCT images represents a promising method for the identification of malignant lymphoid tissue. This method shows potential to provide intraoperative assessment of lymph node involvement, thus, preventing unnecessary removal of uninvolved tissues and improving patient outcomes.
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Affiliation(s)
- 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
| | - 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 St, Nedlands, 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 St, Nedlands, 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, SA, 5005, Australia
| | - Bruce Latham
- PathWest, Fiona Stanley Hospital, Robin Warren Drive, Murdoch, WA, 6150, 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
| | - Christobel M Saunders
- School of Surgery, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia.,Breast Clinic, Royal Perth Hospital, 197 Wellington Street, Perth, WA, 6000, 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 St, Nedlands, Perth, WA, 6009, Australia
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31
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Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography. Sci Rep 2016; 6:31689. [PMID: 27538478 PMCID: PMC4990849 DOI: 10.1038/srep31689] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/25/2016] [Indexed: 02/07/2023] Open
Abstract
Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon’s capabilities.
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32
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Tunable Emission Wavelength Stacked InAs/GaAs Quantum Dots by Chemical Beam Epitaxy for Optical Coherence Tomography. MATERIALS 2016; 9:ma9070511. [PMID: 28773633 PMCID: PMC5456885 DOI: 10.3390/ma9070511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/26/2016] [Accepted: 06/17/2016] [Indexed: 11/25/2022]
Abstract
We report on Chemical Beam Epitaxy (CBE) growth of wavelength tunable InAs/GaAs quantum dots (QD) based superluminescent diode’s active layer suitable for Optical Coherence Tomography (OCT). The In-flush technique has been employed to fabricate QD with controllable heights, from 5 nm down to 2 nm, allowing a tunable emission band over 160 nm. The emission wavelength blueshift has been ensured by reducing both dots’ height and composition. A structure containing four vertically stacked height-engineered QDs have been fabricated, showing a room temperature broad emission band centered at 1.1 µm. The buried QD layers remain insensitive to the In-flush process of the subsequent layers, testifying the reliability of the process for broadband light sources required for high axial resolution OCT imaging.
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33
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Nolan RM, Adie SG, Marjanovic M, Chaney EJ, South FA, Monroy GL, Shemonski ND, Erickson-Bhatt SJ, Shelton RL, Bower AJ, Simpson DG, Cradock KA, Liu ZG, Ray PS, Boppart SA. Intraoperative optical coherence tomography for assessing human lymph nodes for metastatic cancer. BMC Cancer 2016; 16:144. [PMID: 26907742 PMCID: PMC4763478 DOI: 10.1186/s12885-016-2194-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 02/17/2016] [Indexed: 12/21/2022] Open
Abstract
Background Evaluation of lymph node (LN) status is an important factor for detecting metastasis and thereby staging breast cancer. Currently utilized clinical techniques involve the surgical disruption and resection of lymphatic structure, whether nodes or axillary contents, for histological examination. While reasonably effective at detection of macrometastasis, the majority of the resected lymph nodes are histologically negative. Improvements need to be made to better detect micrometastasis, minimize or eliminate lymphatic disruption complications, and provide immediate and accurate intraoperative feedback for in vivo cancer staging to better guide surgery. Methods We evaluated the use of optical coherence tomography (OCT), a high-resolution, real-time, label-free imaging modality for the intraoperative assessment of human LNs for metastatic disease in patients with breast cancer. We assessed the sensitivity and specificity of double-blinded trained readers who analyzed intraoperative OCT LN images for presence of metastatic disease, using co-registered post-operative histopathology as the gold standard. Results Our results suggest that intraoperative OCT examination of LNs is an appropriate real-time, label-free, non-destructive alternative to frozen-section analysis, potentially offering faster interpretation and results to empower superior intraoperative decision-making. Conclusions Intraoperative OCT has strong potential to supplement current post-operative histopathology with real-time in situ assessment of LNs to preserve both non-cancerous nodes and their lymphatic vessels, and thus reduce the associated risks and complications from surgical disruption of lymphoid structures following biopsy.
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Affiliation(s)
- Ryan M Nolan
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,PhotoniCare, Inc., Champaign, IL, USA.
| | - Steven G Adie
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
| | - Marina Marjanovic
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA.
| | - Eric J Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA.
| | - Fredrick A South
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Electrical and Computer Engineering, UIUC, Illinois, USA.
| | - Guillermo L Monroy
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Bioengineering, UIUC, Illinois, USA.
| | - Nathan D Shemonski
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Electrical and Computer Engineering, UIUC, Illinois, USA. .,Carl Zeiss Meditec, Inc., Dublin, CA, USA.
| | - Sarah J Erickson-Bhatt
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA.
| | - Ryan L Shelton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,PhotoniCare, Inc., Champaign, IL, USA.
| | - Andrew J Bower
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Electrical and Computer Engineering, UIUC, Illinois, USA.
| | - Douglas G Simpson
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Statistics, UIUC, Illinois, USA.
| | | | | | - Partha S Ray
- Carle Foundation Hospital, Urbana, IL, USA. .,Department of Surgery, University of Illinois College of Medicine at Urbana-Champaign and Carle Cancer Center, Urbana, IL, USA.
| | - Stephen A Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign (UIUC), 405 N. Mathews Ave., Urbana, IL, 61801, USA. .,Department of Electrical and Computer Engineering, UIUC, Illinois, USA. .,Department of Bioengineering, UIUC, Illinois, USA. .,Department of Internal Medicine, UIUC, Illinois, USA.
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Erickson-Bhatt SJ, Nolan RM, Shemonski ND, Adie SG, Putney J, Darga D, McCormick DT, Cittadine AJ, Zysk AM, Marjanovic M, Chaney EJ, Monroy GL, South FA, Cradock KA, Liu ZG, Sundaram M, Ray PS, Boppart SA. Real-time Imaging of the Resection Bed Using a Handheld Probe to Reduce Incidence of Microscopic Positive Margins in Cancer Surgery. Cancer Res 2016; 75:3706-12. [PMID: 26374464 DOI: 10.1158/0008-5472.can-15-0464] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Wide local excision (WLE) is a common surgical intervention for solid tumors such as those in melanoma, breast, pancreatic, and gastrointestinal cancer. However, adequate margin assessment during WLE remains a significant challenge, resulting in surgical reinterventions to achieve adequate local control. Currently, no label-free imaging method is available for surgeons to examine the resection bed in vivo for microscopic residual cancer. Optical coherence tomography (OCT) enables real-time high-resolution imaging of tissue microstructure. Previous studies have demonstrated that OCT analysis of excised tissue specimens can distinguish between normal and cancerous tissues by identifying the heterogeneous and disorganized microscopic tissue structures indicative of malignancy. In this translational study involving 35 patients, a handheld surgical OCT imaging probe was developed for in vivo use to assess margins both in the resection bed and on excised specimens for the microscopic presence of cancer. The image results from OCT showed structural differences between normal and cancerous tissue within the resection bed following WLE of the human breast. The ex vivo images were compared with standard postoperative histopathology to yield sensitivity of 91.7% [95% confidence interval (CI), 62.5%-100%] and specificity of 92.1% (95% CI, 78.4%-98%). This study demonstrates in vivo OCT imaging of the resection bed during WLE with the potential for real-time microscopic image-guided surgery.
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Affiliation(s)
- Sarah J Erickson-Bhatt
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Ryan M Nolan
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Nathan D Shemonski
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Steven G Adie
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | | | | | | | | | - Adam M Zysk
- Diagnostic Photonics, Inc., Chicago, Illinois
| | - Marina Marjanovic
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Eric J Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Guillermo L Monroy
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Fredrick A South
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | | | | | - Magesh Sundaram
- Carle Foundation Hospital, Urbana, Illinois. Department of Surgery, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Partha S Ray
- Carle Foundation Hospital, Urbana, Illinois. Department of Surgery, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Stephen A Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois. Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois. Diagnostic Photonics, Inc., Chicago, Illinois. Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois. Carle Foundation Hospital, Urbana, Illinois.
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35
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Grieve K, Mouslim K, Assayag O, Dalimier E, Harms F, Bruhat A, Boccara C, Antoine M. Assessment of Sentinel Node Biopsies With Full-Field Optical Coherence Tomography. Technol Cancer Res Treat 2015; 15:266-74. [DOI: 10.1177/1533034615575817] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 02/04/2015] [Indexed: 01/27/2023] Open
Abstract
Current techniques for the intraoperative analysis of sentinel lymph nodes during breast cancer surgery present drawbacks such as time and tissue consumption. Full-field optical coherence tomography is a novel noninvasive, high-resolution, fast imaging technique. This study investigated the use of full-field optical coherence tomography as an alternative technique for the intraoperative analysis of sentinel lymph nodes. Seventy-one axillary lymph nodes from 38 patients at Tenon Hospital were imaged minutes after excision with full-field optical coherence tomography in the pathology laboratory, before being handled for histological analysis. A pathologist performed a blind diagnosis (benign/malignant), based on the full-field optical coherence tomography images alone, which resulted in a sensitivity of 92% and a specificity of 83% (n = 65 samples). Regular feedback was given during the blind diagnosis, with thorough analysis of the images, such that features of normal and suspect nodes were identified in the images and compared with histology. A nonmedically trained imaging expert also performed a blind diagnosis aided by the reading criteria defined by the pathologist, which resulted in 85% sensitivity and 90% specificity (n = 71 samples). The number of false positives of the pathologist was reduced by 3 in a second blind reading a few months later. These results indicate that following adequate training, full-field optical coherence tomography can be an effective noninvasive diagnostic tool for extemporaneous sentinel node biopsy qualification.
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Affiliation(s)
| | - Karima Mouslim
- Hôpital Tenon, Service d’anatomie et cytologie pathologiques, Paris, France
| | | | | | - Fabrice Harms
- Institut Langevin, Paris, France
- LLTech SAS, Pépinière Paris Santé Cochin, Paris, France
| | - Alexis Bruhat
- LLTech SAS, Pépinière Paris Santé Cochin, Paris, France
| | - Claude Boccara
- Institut Langevin, Paris, France
- LLTech SAS, Pépinière Paris Santé Cochin, Paris, France
| | - Martine Antoine
- Hôpital Tenon, Service d’anatomie et cytologie pathologiques, Paris, France
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36
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Boppart SA, Richards-Kortum R. Point-of-care and point-of-procedure optical imaging technologies for primary care and global health. Sci Transl Med 2014; 6:253rv2. [PMID: 25210062 PMCID: PMC4370289 DOI: 10.1126/scitranslmed.3009725] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Leveraging advances in consumer electronics and wireless telecommunications, low-cost, portable optical imaging devices have the potential to improve screening and detection of disease at the point of care in primary health care settings in both low- and high-resource countries. Similarly, real-time optical imaging technologies can improve diagnosis and treatment at the point of procedure by circumventing the need for biopsy and analysis by expert pathologists, who are scarce in developing countries. Although many optical imaging technologies have been translated from bench to bedside, industry support is needed to commercialize and broadly disseminate these from the patient level to the population level to transform the standard of care. This review provides an overview of promising optical imaging technologies, the infrastructure needed to integrate them into widespread clinical use, and the challenges that must be addressed to harness the potential of these technologies to improve health care systems around the world.
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Affiliation(s)
- Stephen A Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA. Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA. Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA. Department of Internal Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Rebecca Richards-Kortum
- Department of Bioengineering, Rice University, Houston, TX 77030, USA. Department of Electrical and Computer Engineering, Rice University, Houston, TX 77030, USA
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37
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Shelton RL, Jung W, Sayegh SI, McCormick DT, Kim J, Boppart SA. Optical coherence tomography for advanced screening in the primary care office. JOURNAL OF BIOPHOTONICS 2014; 7:525-33. [PMID: 23606343 PMCID: PMC3922891 DOI: 10.1002/jbio.201200243] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 03/15/2013] [Accepted: 03/16/2013] [Indexed: 05/26/2023]
Abstract
Optical coherence tomography (OCT) has long been used as a diagnostic tool in the field of ophthalmology. The ability to observe microstructural changes in the tissues of the eye has proved very effective in diagnosing ocular disease. However, this technology has yet to be introduced into the primary care office, where indications of disease are first encountered. We have developed a portable, handheld imaging probe for use in the primary care setting and evaluated its tissue site accessibility, ability to observe diseased tissue, and screening capabilities in in vivo human patients, particularly for pathologies related to the eye, ear and skin. Various stages of diabetic retinopathy were investigated using the handheld probe and early-stage diabetic retinopathy was flagged as abnormal from the OCT images. At such early stages of disease, it is difficult to observe abnormalities with the limited tools that are currently available to primary care physicians. These results indicate that OCT shows promise to transform from being a diagnostic technology in the medical and surgical specialities to a screening technology in the primary care office and at the front-line of healthcare.
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Affiliation(s)
- Ryan L. Shelton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Woonggyu Jung
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL USA
- School of Nano-Bioscience and Chemical Engineering, Ulsan National Institute of Science and Technology, Korea
| | | | | | - Jeehyun Kim
- Department of Electrical and Computer Engineering, Kyungpook National University, Korea
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL USA
- Departments of Electrical and Computer Engineering, Bioengineering, and Medicine, University of Illinois at Urbana-Champaign, Urbana, IL USA
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38
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Winter M, Gibson R, Ruszkiewicz A, Thompson SK, Thierry B. Beyond conventional pathology: Towards preoperative and intraoperative lymph node staging. Int J Cancer 2014; 136:743-51. [DOI: 10.1002/ijc.28742] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 12/23/2013] [Indexed: 01/01/2023]
Affiliation(s)
- Marnie Winter
- Ian Wark Research Institute; University of South Australia; Adelaide SA Australia
| | - Rachel Gibson
- Discipline of Anatomy and Pathology School of Medical Sciences; University of Adelaide; Adelaide SA Australia
| | | | - Sarah K. Thompson
- Department of Surgery Royal Adelaide Hospital and School of Health Sciences; University of South Australia; Adelaide SA Australia
| | - Benjamin Thierry
- Ian Wark Research Institute; University of South Australia; Adelaide SA Australia
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39
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Butler-Henderson K, Lee AH, Price RI, Waring K. Intraoperative assessment of margins in breast conserving therapy: a systematic review. Breast 2014; 23:112-9. [PMID: 24468464 DOI: 10.1016/j.breast.2014.01.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/14/2013] [Accepted: 01/05/2014] [Indexed: 11/28/2022] Open
Abstract
Approximately one quarter of patients undergoing breast conserving therapy for breast cancer will require a second operation to achieve adequate clearance of the margins. A number of techniques to assess margins intraoperatively have been reported. This systematic review examines current intraoperative methods for assessing margin status. The final pathology status, statistical measures including accuracy of tumour margin assessment, average time impact on the procedure and second operation rate, were used as criteria for comparison between studies. Although pathological methods, such as frozen section and imprint cytology performed well, they added on average 20-30 min to operation times. An ultrasound probe allows accurate examination of the margins and delivers results in a timely manner, yet it has a limited role with DCIS where calcification is present and in multifocal cancer. Further research is required in other intraoperative margin assessment techniques, such as mammography, radiofrequency spectroscopy and optical coherence tomography.
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Affiliation(s)
- Kerryn Butler-Henderson
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - Andy H Lee
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - Roger I Price
- Medical Technology & Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia; School of Physics, University of Western Australia, Nedlands, Western Australia 6009, Australia.
| | - Kaylene Waring
- Patient Information Service, Armadale Health Service, PO Box 460, Armadale, Western Australia 6992, Australia.
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40
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Scolaro L, McLaughlin RA, Kennedy BF, Saunders CM, Sampson DD. A review of optical coherence tomography in breast cancer. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/plm-2014-0013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractOptical coherence tomography (OCT) is a medical imaging modality that opens up new opportunities for imaging in breast cancer. It provides two- and three-dimensional micro-scale images of tissue structure from bulk tissue,
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41
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Sun JG, Adie SG, Chaney EJ, Boppart SA. SEGMENTATION AND CORRELATION OF OPTICAL COHERENCE TOMOGRAPHY AND X-RAY IMAGES FOR BREAST CANCER DIAGNOSTICS. JOURNAL OF INNOVATIVE OPTICAL HEALTH SCIENCES 2013; 6:1350015. [PMID: 24533035 PMCID: PMC3922042 DOI: 10.1142/s1793545813500156] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Pre-operative X-ray mammography and intraoperative X-ray specimen radiography are routinely used to identify breast cancer pathology. Recent advances in optical coherence tomography (OCT) have enabled its use for the intraoperative assessment of surgical margins during breast cancer surgery. While each modality offers distinct contrast of normal and pathological features, there is an essential need to correlate image-based features between the two modalities to take advantage of the diagnostic capabilities of each technique. We compare OCT to X-ray images of resected human breast tissue and correlate different tissue features between modalities for future use in real-time intraoperative OCT imaging. X-ray imaging (specimen radiography) is currently used during surgical breast cancer procedures to verify tumor margins, but cannot image tissue in situ. OCT has the potential to solve this problem by providing intraoperative imaging of the resected specimen as well as the in situ tumor cavity. OCT and micro-CT (X-ray) images are automatically segmented using different computational approaches, and quantitatively compared to determine the ability of these algorithms to automatically differentiate regions of adipose tissue from tumor. Furthermore, two-dimensional (2D) and three-dimensional (3D) results are compared. These correlations, combined with real-time intraoperative OCT, have the potential to identify possible regions of tumor within breast tissue which correlate to tumor regions identified previously on X-ray imaging (mammography or specimen radiography).
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Affiliation(s)
- Jonathan G Sun
- Beckman Institute for Advanced Science and Technology 405 North Mathews Avenue, Urbana, Illinois 61801, USA ; Department of Bioengineering, Beckman Institute for Advanced Science and Technology 405 North Mathews Avenue, Urbana, Illinois 61801, USA
| | - Steven G Adie
- Beckman Institute for Advanced Science and Technology 405 North Mathews Avenue, Urbana, Illinois 61801, USA
| | - Eric J Chaney
- Beckman Institute for Advanced Science and Technology 405 North Mathews Avenue, Urbana, Illinois 61801, USA
| | - Stephen A Boppart
- Beckman Institute for Advanced Science and Technology 405 North Mathews Avenue, Urbana, Illinois 61801, USA ; Department of Bioengineering, Beckman Institute for Advanced Science and Technology 405 North Mathews Avenue, Urbana, Illinois 61801, USA ; Departments of Electrical and Computer Engineering and Internal Medicine University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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42
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John R, Adie SG, Chaney EJ, Marjanovic M, Tangella KV, Boppart SA. Three-dimensional optical coherence tomography for optical biopsy of lymph nodes and assessment of metastatic disease. Ann Surg Oncol 2012; 20:3685-93. [PMID: 22688663 DOI: 10.1245/s10434-012-2434-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Numerous techniques have been developed for localizing lymph nodes before surgical resection and for their histological assessment. Nondestructive high-resolution transcapsule optical imaging of lymph nodes offers the potential for in situ assessment of metastatic involvement, potentially during surgical procedures. METHODS Three-dimensional optical coherence tomography (3-D OCT) was used for imaging and assessing resected popliteal lymph nodes from a preclinical rat metastatic tumor model over a 9-day time-course study after tumor induction. The spectral-domain OCT system utilized a center wavelength of 800 nm, provided axial and transverse resolutions of 3 and 12 μm, respectively, and performed imaging at 10,000 axial scans per second. RESULTS OCT is capable of providing high-resolution label-free images of intact lymph node microstructure based on intrinsic optical scattering properties with penetration depths of ~1-2 mm. The results demonstrate that OCT is capable of differentiating normal, reactive, and metastatic lymph nodes based on microstructural changes. The optical scattering and structural changes revealed by OCT from day 3 to day 9 after the injection of tumor cells into the lymphatic system correlate with inflammatory and immunological changes observed in the capsule, precortical regions, follicles, and germination centers found during histopathology. CONCLUSIONS We report for the first time a longitudinal study of 3-D transcapsule OCT imaging of intact lymph nodes demonstrating microstructural changes during metastatic infiltration. These results demonstrate the potential of OCT as a technique for intraoperative, real-time in situ 3-D optical biopsy of lymph nodes for the intraoperative staging of cancer.
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Affiliation(s)
- Renu John
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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43
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Scolaro L, McLaughlin RA, Klyen BR, Wood BA, Robbins PD, Saunders CM, Jacques SL, Sampson DD. Parametric imaging of the local attenuation coefficient in human axillary lymph nodes assessed using optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2012; 3:366-79. [PMID: 22312589 PMCID: PMC3269853 DOI: 10.1364/boe.3.000366] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 01/09/2012] [Accepted: 01/18/2012] [Indexed: 05/02/2023]
Abstract
We report the use of optical coherence tomography (OCT) to determine spatially localized optical attenuation coefficients of human axillary lymph nodes and their use to generate parametric images of lymphoid tissue. 3D-OCT images were obtained from excised lymph nodes and optical attenuation coefficients were extracted assuming a single scattering model of OCT. We present the measured attenuation coefficients for several tissue regions in benign and reactive lymph nodes, as identified by histopathology. We show parametric images of the measured attenuation coefficients as well as segmented images of tissue type based on thresholding of the attenuation coefficient values. Comparison to histology demonstrates the enhancement of contrast in parametric images relative to OCT images. This enhancement is a step towards the use of OCT for in situ assessment of lymph nodes.
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Affiliation(s)
- Loretta Scolaro
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic, and Computer Engineering, The University of Western Australia, Crawley, Australia
| | - Robert A. McLaughlin
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic, and Computer Engineering, The University of Western Australia, Crawley, Australia
| | - Blake R. Klyen
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic, and Computer Engineering, The University of Western Australia, Crawley, Australia
| | - Benjamin A. Wood
- PathWest Laboratory Medicine WA, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Peter D. Robbins
- PathWest Laboratory Medicine WA, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Christobel M. Saunders
- School of Surgery, The University of Western Australia, Crawley, Australia
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Steven L. Jacques
- Departments of Dermatology and Biomedical Engineering, Oregon Health and Science University, Portland, Oregon, USA
| | - David D. Sampson
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic, and Computer Engineering, The University of Western Australia, Crawley, Australia
- Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Crawley, Australia
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44
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Stoyanov D. Surgical vision. Ann Biomed Eng 2011; 40:332-45. [PMID: 22012086 DOI: 10.1007/s10439-011-0441-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 10/07/2011] [Indexed: 10/16/2022]
Abstract
The emergence of Minimal Access Surgery (MAS) as a paradigm in modern healthcare treatment has created new challenges and opportunities for automated image understanding and computer vision. In MAS, images recovered from inside the body using specialized devices are used to visualize and operate on the surgical site but they can also be used to computationally infer in vivo 3D tissue surface shape, soft-tissue morphology, and surgical instrument motion. This information is important for facilitating in vivo biophotonic imaging modalities where the interaction between light and tissue is used to infer the structural and functional properties of the tissue. This article provides a review of the literature for computer vision and image understanding techniques applied to MAS images. The focus of this article is to elucidate a perspective on how computer vision techniques can be used to support and enhance the capabilities of biophotonic imaging modalities during surgery. Note that while MAS encompasses a variety of surgical specializations this review does not involve procedures performed in the interventional suite. The review has been carried out based on searches in the PubMed and IEEE databases using the article's keywords.
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Affiliation(s)
- Danail Stoyanov
- Center for Medical Image Computing, University College London, London, WC1 2BT, UK.
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45
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Optical coherence tomography in biomedical research. Anal Bioanal Chem 2011; 400:2721-43. [DOI: 10.1007/s00216-011-5052-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 04/19/2011] [Accepted: 04/21/2011] [Indexed: 12/16/2022]
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46
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Marschall S, Sander B, Mogensen M, Jørgensen TM, Andersen PE. Optical coherence tomography-current technology and applications in clinical and biomedical research. Anal Bioanal Chem 2011; 400:2699-720. [PMID: 21547430 DOI: 10.1007/s00216-011-5008-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 03/25/2011] [Accepted: 04/08/2011] [Indexed: 12/21/2022]
Abstract
Optical coherence tomography (OCT) is a noninvasive imaging technique that provides real-time two- and three-dimensional images of scattering samples with micrometer resolution. By mapping the local reflectivity, OCT visualizes the morphology of the sample. In addition, functional properties such as birefringence, motion, or the distributions of certain substances can be detected with high spatial resolution. Its main field of application is biomedical imaging and diagnostics. In ophthalmology, OCT is accepted as a clinical standard for diagnosing and monitoring the treatment of a number of retinal diseases, and OCT is becoming an important instrument for clinical cardiology. New applications are emerging in various medical fields, such as early-stage cancer detection, surgical guidance, and the early diagnosis of musculoskeletal diseases. OCT has also proven its value as a tool for developmental biology. The number of companies involved in manufacturing OCT systems has increased substantially during the last few years (especially due to its success in opthalmology), and this technology can be expected to continue to spread into various fields of application.
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Affiliation(s)
- Sebastian Marschall
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Roskilde, Denmark
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47
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Nguyen FT, Zysk AM, Chaney EJ, Adie SG, Kotynek JG, Oliphant UJ, Bellafiore FJ, Rowland KM, Johnson PA, Boppart SA. Optical coherence tomography: the intraoperative assessment of lymph nodes in breast cancer. ACTA ACUST UNITED AC 2010; 29:63-70. [PMID: 20659842 DOI: 10.1109/memb.2009.935722] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
During breast-conserving surgeries, axillary lymph nodes draining from the primary tumor site are removed for disease staging. Although a high number of lymph nodes are often resected during sentinel and lymph-node dissections, only a relatively small percentage of nodes are found to be metastatic, a fact that must be weighed against potential complications such as lymphedema. Without a real-time in vivo or in situ intraoperative imaging tool to provide a microscopic assessment of the nodes, postoperative paraffin section histopathological analysis currently remains the gold standard in assessing the status of lymph nodes. This paper investigates the use of optical coherence tomography (OCT), a high-resolution real-time microscopic optical-imaging technique, for the intraoperative ex vivo imaging and assessment of axillary lymph nodes. Normal (13), reactive (1), and metastatic (3) lymph nodes from 17 human patients with breast cancer were imaged intraoperatively with OCT. These preliminary clinical studies have identified scattering changes in the cortex, relative to the capsule, which can be used to differentiate normal from reactive and metastatic nodes. These optical scattering changes are correlated with inflammatory and immunological changes observed in the follicles and germinal centers. These results suggest that intraoperative OCT has the potential to assess the real-time node status in situ, without having to physically resect and histologically process specimens to visualize microscopic features.
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48
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Jung W, Kim J, Jeon M, Chaney EJ, Stewart CN, Boppart SA. Handheld optical coherence tomography scanner for primary care diagnostics. IEEE Trans Biomed Eng 2010; 58:741-4. [PMID: 21134801 DOI: 10.1109/tbme.2010.2096816] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The goal of this study is to develop an advanced point-of-care diagnostic instrument for use in a primary care office using handheld optical coherence tomography (OCT). This system has the potential to enable earlier detection of diseases and accurate image-based diagnostics. Our system was designed to be compact, portable, user-friendly, and fast, making it well suited for the primary care office setting. The unique feature of our system is a versatile handheld OCT imaging scanner which consists of a pair of computer-controlled galvanometer-mounted mirrors, interchangeable lens mounts, and miniaturized video camera. This handheld scanner has the capability to guide the physician in real time for finding suspicious regions to be imaged by OCT. In order to evaluate the performance and use of the handheld OCT scanner, the anterior chamber of a rat eye and in vivo human retina, cornea, skin, and tympanic membrane were imaged. Based on this feasibility study, we believe that this new type of handheld OCT device and system has the potential to be an efficient point-of-care imaging tool in primary care medicine.
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Affiliation(s)
- Woonggyu Jung
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA.
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49
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Ahmad A, Adie SG, Wang M, Boppart SA. Sonification of optical coherence tomography data and images. OPTICS EXPRESS 2010; 18:9934-44. [PMID: 20588846 PMCID: PMC3308194 DOI: 10.1364/oe.18.009934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 04/20/2010] [Accepted: 04/21/2010] [Indexed: 05/23/2023]
Abstract
Sonification is the process of representing data as non-speech audio signals. In this manuscript, we describe the auditory presentation of OCT data and images. OCT acquisition rates frequently exceed our ability to visually analyze image-based data, and multi-sensory input may therefore facilitate rapid interpretation. This conversion will be especially valuable in time-sensitive surgical or diagnostic procedures. In these scenarios, auditory feedback can complement visual data without requiring the surgeon to constantly monitor the screen, or provide additional feedback in non-imaging procedures such as guided needle biopsies which use only axial-scan data. In this paper we present techniques to translate OCT data and images into sound based on the spatial and spatial frequency properties of the OCT data. Results obtained from parameter-mapped sonification of human adipose and tumor tissues are presented, indicating that audio feedback of OCT data may be useful for the interpretation of OCT images.
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Affiliation(s)
- Adeel Ahmad
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 405 N. Mathews Avenue, Urbana, IL 61801,
USA
| | - Steven G. Adie
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 405 N. Mathews Avenue, Urbana, IL 61801,
USA
| | - Morgan Wang
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 405 N. Mathews Avenue, Urbana, IL 61801,
USA
| | - Stephen A. Boppart
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 405 N. Mathews Avenue, Urbana, IL 61801,
USA
- Departments of Bioengineering and Internal Medicine, University of Illinois at Urbana-Champaign, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 405 N. Mathews Avenue, Urbana, IL 61801,
USA
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