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Goshtasbi K, Su E, Jing JC, Nguyen TV, Hong EM, Dilley KD, Ahuja GS, Chen Z, Wong BJF. Long-range optical coherence tomography of pediatric airway during drug induced sleep endoscopy: A preliminary report. Int J Pediatr Otorhinolaryngol 2024; 178:111900. [PMID: 38408413 DOI: 10.1016/j.ijporl.2024.111900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE Drug induced sleep endoscopy (DISE) is often performed for pediatric obstructive sleep apnea (OSA) when initial diagnostic studies do not provide adequate information for therapy. However, DISE scoring is subjective and with limitations. This proof-of-concept study demonstrates the use of a novel long-range optical coherence tomography (LR-OCT) system during DISE of two pediatric patients. METHODS LR-OCT was used to visualize the airway of pediatric patients during DISE. At the conclusion of DISE, the OCT probe was guided in the airway under endoscopic visual guidance, and cross-sectional images were acquired at the four VOTE locations. Data processing involved image resizing and alignment, followed by rendering of three-dimensional (3D) volumetric models of the airways. RESULTS Two patients were included in this study. Patient one had 18.4%, 20.9%, 72.3%, and 97.3% maximal obstruction at velum, oropharynx, tongue base, and epiglottis, while patient two had 40.2%, 41.4%, 8.0%, and 17.5% maximal obstruction at these regions, respectively. Three-dimensional reconstructions of patients' airways were also constructed from the OCT images. CONCLUSION This proof-of-concept study demonstrates the successful evaluation of pediatric airway during DISE using LR-OCT, which accurately identified sites and degrees of obstruction with respective 3D airway reconstruction.
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Affiliation(s)
- Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, CA, USA; Beckman Laser Institute, University of California Irvine, Irvine, CA, USA
| | - Erica Su
- Beckman Laser Institute, University of California Irvine, Irvine, CA, USA
| | - Joseph C Jing
- Beckman Laser Institute, University of California Irvine, Irvine, CA, USA
| | - Theodore V Nguyen
- Beckman Laser Institute, University of California Irvine, Irvine, CA, USA
| | - Ellen M Hong
- Beckman Laser Institute, University of California Irvine, Irvine, CA, USA
| | - Katelyn D Dilley
- Beckman Laser Institute, University of California Irvine, Irvine, CA, USA
| | - Gurpreet S Ahuja
- Division of Pediatric Otolaryngology, Children's Hospital of Orange County, Orange, CA, USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California Irvine, Irvine, CA, USA; School of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Brian J F Wong
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, CA, USA; Beckman Laser Institute, University of California Irvine, Irvine, CA, USA; School of Biomedical Engineering, University of California Irvine, Irvine, CA, USA.
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2
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Zhuang Z, Chen D, Liang Z, Zhang S, Liu Z, Chen W, Qi L. Automatic 3D reconstruction of an anatomically correct upper airway from endoscopic long range OCT images. BIOMEDICAL OPTICS EXPRESS 2023; 14:4594-4608. [PMID: 37791278 PMCID: PMC10545183 DOI: 10.1364/boe.496812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/29/2023] [Accepted: 08/02/2023] [Indexed: 10/05/2023]
Abstract
Endoscopic airway optical coherence tomography (OCT) is a non-invasive and high resolution imaging modality for the diagnosis and analysis of airway-related diseases. During OCT imaging of the upper airway, in order to reliably characterize its 3D structure, there is a need to automatically detect the airway lumen contour, correct rotational distortion and perform 3D airway reconstruction. Based on a long-range endoscopic OCT imaging system equipped with a magnetic tracker, we present a fully automatic framework to reconstruct the 3D upper airway model with correct bending anatomy. Our method includes an automatic segmentation method for the upper airway based on dynamic programming algorithm, an automatic initial rotation angle error correction method for the detected 2D airway lumen contour, and an anatomic bending method combined with the centerline detected from the magnetically tracked imaging probe. The proposed automatic reconstruction framework is validated on experimental datasets acquired from two healthy adults. The result shows that the proposed framework allows the full automation of 3D airway reconstruction from OCT images and thus reveals its potential to improve analysis efficiency of endoscopic OCT images.
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Affiliation(s)
- Zhijian Zhuang
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- The Third People’s Hospital of Zhuhai, 166 Hezheng Rd., Xiangzhou District, Zhuhai, Guangdong, 519000, China
| | - Delang Chen
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Zhichao Liang
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Shuangyang Zhang
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Zhenyang Liu
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Wufan Chen
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
| | - Li Qi
- School of Biomedical Engineering, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, 1023 Shatai Rd., Baiyun District, Guangzhou, Guangdong, 510515, China
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3
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Miao Y, Sudol NT, Li Y, Chen JJ, Arthur RA, Qiu S, Jiang Y, Tadir Y, Lane F, Chen Z. Optical coherence tomography evaluation of vaginal epithelial thickness during CO 2 laser treatment: A pilot study. JOURNAL OF BIOPHOTONICS 2022; 15:e202200052. [PMID: 35860856 PMCID: PMC9633389 DOI: 10.1002/jbio.202200052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/18/2022] [Accepted: 07/19/2022] [Indexed: 05/20/2023]
Abstract
Genitourinary syndrome of menopause (GSM) negatively affects more than half of postmenopausal women. Energy-based therapy has been explored as a minimally invasive treatment for GSM; however, its mechanism of action and efficacy is controversial. Here, we report on a pilot imaging study conducted on a small group of menopause patients undergoing laser treatment. Intravaginal optical coherence tomography (OCT) endoscope was used to quantitatively monitor the changes in the vaginal epithelial thickness (VET) during fractional-pixel CO2 laser treatment. Eleven patients with natural menopause and one surgically induced menopause patient were recruited in this clinical study. Following the laser treatment, 6 out of 11 natural menopause patient showed increase in both proximal and distal VET, while two natural menopause patient showed increase in VET in only one side of vaginal tract. Furthermore, the patient group that showed increased VET had thinner baseline VET compared to the patients that showed decrease in VET after laser treatment. These results demonstrate the potential utility of intravaginal OCT endoscope in evaluating the vaginal tissue integrity and tailoring vaginal laser treatment on a per-person basis, with the potential to monitor other treatment procedures.
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Affiliation(s)
- Yusi Miao
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Neha T Sudol
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, CA, USA
| | - Yan Li
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Jason J Chen
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Rebecca A. Arthur
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, CA, USA
| | - Saijun Qiu
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Yuchen Jiang
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Yona Tadir
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
| | - Felicia Lane
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, CA, USA
| | - Zhongping Chen
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
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4
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Hackmann MJ, Elliot JG, Green FHY, Cairncross A, Cense B, McLaughlin RA, Langton D, James AL, Noble PB, Donovan GM. Requirements and limitations of imaging airway smooth muscle throughout the lung in vivo. Respir Physiol Neurobiol 2022; 301:103884. [PMID: 35301143 DOI: 10.1016/j.resp.2022.103884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/08/2022] [Accepted: 03/05/2022] [Indexed: 11/18/2022]
Abstract
Clinical visualization and quantification of the amount and distribution of airway smooth muscle (ASM) in the lungs of individuals with asthma has major implications for our understanding of airway wall remodeling as well as treatments targeted at the ASM. This paper theoretically investigates the feasibility of quantifying airway wall thickness (focusing on the ASM) throughout the lung in vivo by means of bronchoscopic polarization-sensitive optical coherence tomography (PS-OCT). Using extensive human biobank data from subjects with and without asthma in conjunction with a mathematical model of airway compliance, we define constraints that airways of various sizes pose to any endoscopic imaging technique and how this is impacted by physiologically relevant processes such as constriction, inflation and deflation. We identify critical PS-OCT system parameters and pinpoint parts of the airway tree that are conducive to successful quantification of ASM. We further quantify the impact of breathing and ASM contraction on the measurement error and recommend strategies for standardization and normalization.
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Affiliation(s)
- Michael J Hackmann
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia; School of Engineering, University of Western Australia, Perth, Western Australia, Australia.
| | - John G Elliot
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia; West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Francis H Y Green
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alvenia Cairncross
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Barry Cense
- School of Engineering, University of Western Australia, Perth, Western Australia, Australia; Department of Mechanical Engineering, Yonsei University, Seoul, South-Korea
| | - Robert A McLaughlin
- School of Engineering, University of Western Australia, Perth, Western Australia, Australia; Australian Research Council Centre of Excellence for Nanoscale Biophotonics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia; Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
| | - David Langton
- Faculty of Medicine, Nursing and Allied Health, Monash University, Melbourne, Victoria, Australia
| | - Alan L James
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Peter B Noble
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Graham M Donovan
- Department of Mathematics, University of Auckland, Auckland, New Zealand
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5
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Miao Y, Jing JJ, Chen Z. Graph-based rotational nonuniformity correction for localized compliance measurement in the human nasopharynx. BIOMEDICAL OPTICS EXPRESS 2021; 12:2508-2518. [PMID: 33996244 PMCID: PMC8086476 DOI: 10.1364/boe.419997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/08/2021] [Accepted: 03/11/2021] [Indexed: 05/11/2023]
Abstract
Recent advancements in the high-speed long-range optical coherence tomography (OCT) endoscopy allow characterization of tissue compliance in the upper airway, an indicator of collapsibility. However, the resolution and accuracy of localized tissue compliance measurement are currently limited by the lack of a reliable nonuniform rotational distortion (NURD) correction method. In this study, we developed a robust 2-step NURD correction algorithm that can be applied to the dynamic OCT images obtained during the compliance measurement. We demonstrated the utility of the NURD correction algorithm by characterizing the local compliance of nasopharynx from an awake human subject for the first time.
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Affiliation(s)
- Yusi Miao
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, USA
| | - Joseph J. Jing
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612, USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, USA
- The Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, Irvine, CA 92697, USA
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6
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Hakimi AA, Sharma GK, Ngo T, Heidari AE, Badger CD, Tripathi PB, Hong EM, Chen Z, Wong BJF. Coupling Pressure Sensing with Optical Coherence Tomography to Evaluate the Internal Nasal Valve. Ann Otol Rhinol Laryngol 2020; 130:167-172. [PMID: 32680431 DOI: 10.1177/0003489420944199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate endoscopic long-range optical coherence tomography system combined with a pressure sensor to concurrently measure internal nasal valve cross-sectional area and intraluminal pressure. METHODS A pressure sensor was constructed using an Arduino platform and calibrated using a limiter-controlled vacuum system and industrial absolute pressure gauge. Long-range optical coherence tomography imaging and pressure transduction were performed concurrently in the naris of eight healthy adult subjects during normal respiration and forced inspiration. The internal nasal valve was manually segmented using Mimics software and cross-sectional area was measured. Internal nasal valve cross-sectional area measurements were correlated with pressure recordings. RESULTS Mean cross-sectional area during forced inspiration was 6.49 mm2. The mean change in pressure between normal respiration and forceful inspiration was 12.27 mmHg. The direct correlation between pressure and cross-sectional area as measured by our proposed system was reproducible among subjects. CONCLUSIONS Our results demonstrate a direct correlation between internal nasal valve cross-sectional area and nasal airflow during inspiration cycles. Endoscopic long-range optical coherence tomography coupled with a pressure sensor serves as a useful tool to quantify the dynamic behavior of the internal nasal valve.
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Affiliation(s)
- Amir A Hakimi
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA
| | - Giriraj K Sharma
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA.,Department of Otolaryngology-Head & Neck Surgery, University of California - Irvine, CA, USA
| | - Tuan Ngo
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA
| | - Andrew E Heidari
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA.,Department of Otolaryngology-Head & Neck Surgery, University of California - Irvine, CA, USA
| | - Christopher D Badger
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA
| | - Prem B Tripathi
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA.,Department of Otolaryngology-Head & Neck Surgery, University of California - Irvine, CA, USA
| | - Ellen M Hong
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA
| | - Zhongping Chen
- Department of Biomedical Engineering, University of California - Irvine, CA, USA
| | - Brian J F Wong
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA, USA.,Department of Otolaryngology-Head & Neck Surgery, University of California - Irvine, CA, USA.,Department of Biomedical Engineering, University of California - Irvine, CA, USA
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Rubinstein M, Hu AC, Chung PS, Kim JH, Osann KE, Schalch P, Armstrong WB, Wong BJF. Intraoperative use of optical coherence tomography to differentiate normal and diseased thyroid and parathyroid tissues from lymph node and fat. Lasers Med Sci 2020; 36:269-278. [PMID: 32337680 DOI: 10.1007/s10103-020-03024-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/16/2020] [Indexed: 11/25/2022]
Abstract
The purpose of this study is twofold: (1) to determine the feasibility of optical coherence tomography (OCT) to differentiate normal and diseased tissue of the neck region intraoperatively and (2) to evaluate how accurately a cohort of test subjects can identify various tissue types when shown a sample set of OCT images. In this in vivo, prospective, single institutional study, an OCT imaging system (Niris, Imalux, Cleveland, OH) was used to image parathyroid, thyroid, lymph node, and fat tissue in 76 patients during neck surgery. Biopsies were performed for comparison of OCT images with histology in select cases (n = 20). Finally, a group of either surgeons or scientists familiar with OCT (n = 17) were shown a sample of OCT images and asked to identify the tissue. A total of 437 OCT images were analyzed, and characteristic features of each tissue type were identified. OCT demonstrated distinct differences in structural architecture and signal intensity that allows differentiation between thyroid and parathyroid tissues, lymph nodes, and fat. OCT images were also compared with histology with good correlation. There was no difference in correctly identifying OCT-imaged tissue type between surgeons and scientists. This study is the first in vivo OCT imaging study to evaluate both normal and diseased tissues that may be encountered during neck surgery. OCT has the potential to become a valuable intraoperative tool to differentiate diseased and normal thyroid tissue intraoperatively to obtain an "optical biopsy" in real time without fixation, staining, or tissue resection.
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Affiliation(s)
- Marc Rubinstein
- Departement of Otolaryngology - Head and Neck Surgery, University of California Irvine, Orange, CA, USA
- Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Rd, Irvine, CA, 92617, USA
| | - Allison C Hu
- Departement of Otolaryngology - Head and Neck Surgery, University of California Irvine, Orange, CA, USA
- Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Rd, Irvine, CA, 92617, USA
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Phil-Sang Chung
- Beckman Laser Institute Korea, Dankook University, Cheonan, South Korea
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Dankook University, Cheonan, South Korea
| | - Jason H Kim
- Departement of Otolaryngology - Head and Neck Surgery, University of California Irvine, Orange, CA, USA
| | - Kathryn E Osann
- Department of Medicine, University of California Irvine, Orange, CA, USA
| | - Paul Schalch
- Departement of Otolaryngology - Head and Neck Surgery, University of California Irvine, Orange, CA, USA
| | - William B Armstrong
- Departement of Otolaryngology - Head and Neck Surgery, University of California Irvine, Orange, CA, USA
| | - Brian J F Wong
- Departement of Otolaryngology - Head and Neck Surgery, University of California Irvine, Orange, CA, USA.
- Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Rd, Irvine, CA, 92617, USA.
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA.
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Li Y, Moon S, Chen JJ, Zhu Z, Chen Z. Ultrahigh-sensitive optical coherence elastography. LIGHT, SCIENCE & APPLICATIONS 2020; 9:58. [PMID: 32337022 PMCID: PMC7154028 DOI: 10.1038/s41377-020-0297-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 05/07/2023]
Abstract
The phase stability of an optical coherence elastography (OCE) system is the key determining factor for achieving a precise elasticity measurement, and it can be affected by the signal-to-noise ratio (SNR), timing jitters in the signal acquisition process, and fluctuations in the optical path difference (OPD) between the sample and reference arms. In this study, we developed an OCE system based on swept-source optical coherence tomography (SS-OCT) with a common-path configuration (SS-OCECP). Our system has a phase stability of 4.2 mrad without external stabilization or extensive post-processing, such as averaging. This phase stability allows us to detect a displacement as small as ~300 pm. A common-path interferometer was incorporated by integrating a 3-mm wedged window into the SS-OCT system to provide intrinsic compensation for polarization and dispersion mismatch, as well as to minimize phase fluctuations caused by the OPD variation. The wedged window generates two reference signals that produce two OCT images, allowing for averaging to improve the SNR. Furthermore, the electrical components are optimized to minimize the timing jitters and prevent edge collisions by adjusting the delays between the trigger, k-clock, and signal, utilizing a high-speed waveform digitizer, and incorporating a high-bandwidth balanced photodetector. We validated the SS-OCECP performance in a tissue-mimicking phantom and an in vivo rabbit model, and the results demonstrated a significantly improved phase stability compared to that of the conventional SS-OCE. To the best of our knowledge, we demonstrated the first SS-OCECP system, which possesses high-phase stability and can be utilized to significantly improve the sensitivity of elastography.
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Affiliation(s)
- Yan Li
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612 USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617 USA
| | - Sucbei Moon
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612 USA
- Department of Physics, Kookmin University, Seoul, 02707 South Korea
| | - Jason J. Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612 USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617 USA
| | - Zhikai Zhu
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612 USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617 USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612 USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617 USA
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9
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Kozlowski KM, Sharma GK, Chen JJ, Qi L, Osann K, Jing JC, Ahuja GS, Heidari AE, Chung PS, Kim S, Chen Z, Wong BJF. Dynamic programming and automated segmentation of optical coherence tomography images of the neonatal subglottis: enabling efficient diagnostics to manage subglottic stenosis. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-8. [PMID: 31493317 PMCID: PMC6732661 DOI: 10.1117/1.jbo.24.9.096001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/20/2019] [Indexed: 05/25/2023]
Abstract
Subglottic stenosis (SGS) is a challenging disease to diagnose in neonates. Long-range optical coherence tomography (OCT) is an optical imaging modality that has been described to image the subglottis in intubated neonates. A major challenge associated with OCT imaging is the lack of an automated method for image analysis and micrometry of large volumes of data that are acquired with each airway scan (1 to 2 Gb). We developed a tissue segmentation algorithm that identifies, measures, and conducts image analysis on tissue layers within the mucosa and submucosa and compared these automated tissue measurements with manual tracings. We noted small but statistically significant differences in thickness measurements of the mucosa and submucosa layers in the larynx (p < 0.001), subglottis (p = 0.015), and trachea (p = 0.012). The automated algorithm was also shown to be over 8 times faster than the manual approach. Moderate Pearson correlations were found between different tissue texture parameters and the patient’s gestational age at birth, age in days, duration of intubation, and differences with age (mean age 17 days). Automated OCT data analysis is necessary in the diagnosis and monitoring of SGS, as it can provide vital information about the airway in real time and aid clinicians in making management decisions for intubated neonates.
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Affiliation(s)
- Konrad M. Kozlowski
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
| | - Giriraj K. Sharma
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
| | - Jason J. Chen
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Li Qi
- Southern Medical University, School of Biomedical Engineering, Guangzhou, China
| | - Kathryn Osann
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Joseph C. Jing
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Gurpreet S. Ahuja
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
- Children’s Hospital of Orange County, Orange, California, United States
| | - Andrew E. Heidari
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
| | - Phil-Sang Chung
- Dankook University, Beckman Laser Institute Korea, Cheoan, Republic of Korea
| | - Sehwan Kim
- Dankook University, Beckman Laser Institute Korea, Cheoan, Republic of Korea
- Dankook University, School of Medicine, Department of Biomedical Engineering, Cheoan, Republic of Korea
| | - Zhongping Chen
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
| | - Brian J.-F. Wong
- University of California Irvine, Beckman Laser Institute, Irvine, California, United States
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Orange, California, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California, United States
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10
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Automatic proximal airway volume segmentation using optical coherence tomography for assessment of inhalation injury. J Trauma Acute Care Surg 2019; 87:S132-S137. [PMID: 31246917 DOI: 10.1097/ta.0000000000002277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury with a mortality rate of up to 40%. Early management of ARDS has been difficult due to the lack of sensitive imaging tools and robust analysis software. We previously designed an optical coherence tomography (OCT) system to evaluate mucosa thickness (MT) after smoke inhalation, but the analysis relied on manual segmentation. The aim of this study is to assess in vivo proximal airway volume (PAV) after inhalation injury using automated OCT segmentation and correlate the PAV to lung function for rapid indication of ARDS. METHODS Anesthetized female Yorkshire pigs (n = 14) received smoke inhalation injury (SII) and 40% total body surface area thermal burns. Measurements of PaO2-to-FiO2 ratio (PFR), peak inspiratory pressure (PIP), dynamic compliance, airway resistance, and OCT bronchoscopy were performed at baseline, postinjury, 24 hours, 48 hours, 72 hours after injury. A tissue segmentation algorithm based on graph theory was used to reconstruct a three-dimensional (3D) model of lower respiratory tract and estimate PAV. Proximal airway volume was correlated with PFR, PIP, compliance, resistance, and MT measurement using a linear regression model. RESULTS Proximal airway volume decreased after the SII: the group mean of proximal airway volume at baseline, postinjury, 24 hours, 48 hours, 72 hours were 20.86 cm (±1.39 cm), 17.61 cm (±0.99 cm), 14.83 cm (±1.20 cm), 14.88 cm (±1.21 cm), and 13.11 cm (±1.59 cm), respectively. The decrease in the PAV was more prominent in the animals that developed ARDS after 24 hours after the injury. PAV was significantly correlated with PIP (r = 0.48, p < 0.001), compliance (r = 0.55, p < 0.001), resistance (r = 0.35, p < 0.01), MT (r = 0.60, p < 0.001), and PFR (r = 0.34, p < 0.01). CONCLUSION Optical coherence tomography is a useful tool to quantify changes in MT and PAV after SII and burns, which can be used as predictors of developing ARDS at an early stage. LEVEL OF EVIDENCE Prognostic, level III.
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11
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Miao Y, Brenner M, Chen Z. Endoscopic Optical Coherence Tomography for Assessing Inhalation Airway Injury: A Technical Review. OTOLARYNGOLOGY (SUNNYVALE, CALIF.) 2019; 9:366. [PMID: 31497378 PMCID: PMC6731096 DOI: 10.4172/2161-119x.1000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Diagnosis of inhalation injury has been clinically challenging. Currently, assessment of inhalation injury relies on subjective clinical exams and bronchoscopy, which provides little understanding of tissue conditions and results in limited prognostics. Endoscopic Optical coherence tomography (OCT) technology has been recently utilized in the airway for direct assessment of respiratory tract disorders and injuries. Endoscopic OCT is capable of capturing high-resolution images of tissue morphology 1-3 mm beneath the surface as well as the complex 3D anatomical shape. Previous studies indicate that changes in airway histopathology can be found in the OCT image almost immediately after inhalation of smoke and other toxic chemicals, which correlates well with histology and pulmonary function tests. This review summarizes the recent development of endoscopic OCT technology for airway imaging, current uses of OCT for inhalation injury, and possible future directions.
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Affiliation(s)
- Yusi Miao
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, CA, USA
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12
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Qi L, Zheng K, Li X, Feng Q, Chen Z, Chen W. Automatic three-dimensional segmentation of endoscopic airway OCT images. BIOMEDICAL OPTICS EXPRESS 2019; 10:642-656. [PMID: 30800505 PMCID: PMC6377898 DOI: 10.1364/boe.10.000642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/23/2018] [Accepted: 12/24/2018] [Indexed: 05/25/2023]
Abstract
Automatic delineation and segmentation of airway structures from endoscopic optical coherence tomography (OCT) images improve image analysis efficiency and thus has been of particular interest. Conventional two-dimensional automatic segmentation methods, such as the dynamic programming approach, ensures the edge-continuity in the xz-direction (intra-B-scan), but fails to preserve the surface-continuity when concerning the y-direction (inter-B-scan). To solve this, we present a novel automatic three-dimensional (3D) airway segmentation strategy. Our segmentation scheme includes an artifact-oriented pre-processing pipeline and a modified 3D optimal graph search algorithm incorporating adaptive tissue-curvature adjustment. The proposed algorithm is tested on endoscopic airway OCT image data sets acquired by different swept-source OCT platforms, and on different animal and human models. With our method, the results show continuous surface segmentation performance, which is both robust and accurate.
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Affiliation(s)
- Li Qi
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Kaibin Zheng
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Xipan Li
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Qianjin Feng
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, CA 92612, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92612, USA
- Key Laboratory of Nondestructive Test (Ministry of Education), Nanchang Hangkong University, Nanchang, Jiangxi, 330063, China
| | - Wufan Chen
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China
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13
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Zhu J, He X, Chen Z. Acoustic radiation force optical coherence elastography for elasticity assessment of soft tissues. APPLIED SPECTROSCOPY REVIEWS 2019; 54:457-481. [PMID: 31749516 PMCID: PMC6867804 DOI: 10.1080/05704928.2018.1467436] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Biomechanical properties of soft tissues are important indicators of tissue functions which can be used for clinical diagnosis and disease monitoring. Elastography, incorporating the principles of elasticity measurements into imaging modalities, provides quantitative assessment of elastic properties of biological tissues. Benefiting from high-resolution, noninvasive and three-dimensional optical coherence tomography (OCT), optical coherence elastography (OCE) is an emerging optical imaging modality to characterize and map biomechanical properties of soft tissues. Recently, acoustic radiation force (ARF) OCE has been developed for elasticity measurements of ocular tissues, detection of vascular lesions and monitoring of blood coagulation based on remote and noninvasive ARF excitation to both internal and superficial tissues. Here, we describe the advantages of the ARF-OCE technique, the measurement methods in ARF-OCE, the applications in biomedical detection, current challenges and advances. ARF-OCE technology has the potential to become a powerful tool for in vivo elasticity assessment of biological samples in a non-contact, non-invasive and high-resolution nature.
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Affiliation(s)
- Jiang Zhu
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
| | - Xingdao He
- Key Laboratory of Nondestructive Test (Ministry of Education), Nanchang Hangkong University, Nanchang 330063, China
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
- Key Laboratory of Nondestructive Test (Ministry of Education), Nanchang Hangkong University, Nanchang 330063, China
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California 92697, USA
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14
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Kim YC. Fast upper airway magnetic resonance imaging for assessment of speech production and sleep apnea. PRECISION AND FUTURE MEDICINE 2018. [DOI: 10.23838/pfm.2018.00100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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15
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Kimbell JS, Basu S, Garcia GJM, Frank-Ito DO, Lazarow F, Su E, Protsenko D, Chen Z, Rhee JS, Wong BJ. Upper airway reconstruction using long-range optical coherence tomography: Effects of airway curvature on airflow resistance. Lasers Surg Med 2018; 51:150-160. [PMID: 30051633 DOI: 10.1002/lsm.23005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Adenotonsillectomy (AT) is commonly used to treat upper airway obstruction in children, but selection of patients who will benefit most from AT is challenging. The need for diagnostic evaluation tools without sedation, radiation, or high costs has motivated the development of long-range optical coherence tomography (LR-OCT), providing real-time cross-sectional airway imaging during endoscopy. Since the endoscope channel location is not tracked in conventional LR-OCT, airway curvature must be estimated and may affect predicted airway resistance. The study objective was to assess effects of three realistic airway curvatures on predicted airway resistance using computational fluid dynamics (CFD) in LR-OCT reconstructions of the upper airways of pediatric patients, before and after AT. METHODS Eight subjects (five males, three females, aged 4-9 years) were imaged using LR-OCT before and after AT during sedated endoscopy. Three-dimensional (3D) airway reconstructions included three airway curvatures. Steady-state, inspiratory airflow simulations were conducted under laminar conditions, along with turbulent simulations for one subject using the k-ω turbulence model. Airway resistance (pressure drop/flow) was compared using two-tailed Wilcoxon signed rank tests. RESULTS Regardless of the airway curvatures, CFD findings corroborate a surgical end-goal with computed post-operative airway resistance significantly less than pre-operative (P < 0.01). The individual resistances did not vary significantly for different airway curvatures (P > 0.25). Resistances computed using turbulent simulations differed from laminar results by less than ∼5%. CONCLUSIONS The results suggest that reconstruction of the upper airways from LR-OCT imaging data may not need to account for airway curvature to be predictive of surgical effects on airway resistance. Lasers Surg. Med. 51:150-160, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Julia S Kimbell
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Saikat Basu
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Guilherme J M Garcia
- Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin.,Medical College of Wisconsin, Biotechnology and Bioengineering Center, Milwaukee, Wisconsin
| | - Dennis O Frank-Ito
- Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina
| | - Frances Lazarow
- Beckman Laser Institute, University of California, Irvine, California
| | - Erica Su
- Beckman Laser Institute, University of California, Irvine, California
| | - Dimitry Protsenko
- Beckman Laser Institute, University of California, Irvine, California
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, California
| | - John S Rhee
- Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Brian J Wong
- Beckman Laser Institute, University of California, Irvine, California.,Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
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16
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Miao Y, Jing JC, Desai V, Mahon SB, Brenner M, Veress LA, White CW, Chen Z. Automated 3D segmentation of methyl isocyanate-exposed rat trachea using an ultra-thin, fully fiber optic optical coherence endoscopic probe. Sci Rep 2018; 8:8713. [PMID: 29880863 PMCID: PMC5992171 DOI: 10.1038/s41598-018-26389-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 05/03/2018] [Indexed: 02/06/2023] Open
Abstract
Development of effective rescue countermeasures for toxic inhalational industrial chemicals, such as methyl isocyanate (MIC), has been an emerging interest. Nonetheless, current methods for studying toxin-induced airway injuries are limited by cost, labor time, or accuracy, and only provide indirect or localized information. Optical Coherence Tomography (OCT) endoscopic probes have previously been used to visualize the 3-D airway structure. However, gathering such information in small animal models, such as rat airways after toxic gas exposure, remains a challenge due to the required probe size necessary for accessing the small, narrow, and partially obstructed tracheas. In this study, we have designed a 0.4 mm miniature endoscopic probe and investigated the structural changes in rat trachea after MIC inhalation. An automated 3D segmentation algorithm was implemented so that anatomical changes, such as tracheal lumen volume and cross-sectional areas, could be quantified. The tracheal region of rats exposed to MIC by inhalation showed significant airway narrowing, especially within the upper trachea, as a result of epithelial detachment and extravascular coagulation within the airway. This imaging and automated reconstruction technique is capable of rapid and minimally-invasive identification of airway obstruction. This method can be applied to large-scale quantitative analysis of in vivo animal models.
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Affiliation(s)
- Yusi Miao
- Beckman Laser Institute, University of California Irvine, Irvine, 92612, California, USA.,Department of Biomedical Engineering, University of California Irvine, Irvine, 92697, California, USA
| | - Joseph C Jing
- Beckman Laser Institute, University of California Irvine, Irvine, 92612, California, USA.,Department of Biomedical Engineering, University of California Irvine, Irvine, 92697, California, USA
| | - Vineet Desai
- Beckman Laser Institute, University of California Irvine, Irvine, 92612, California, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California Irvine, Irvine, 92612, California, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California Irvine, Irvine, 92612, California, USA
| | - Livia A Veress
- Department of Pediatrics, University of Colorado Denver, Denver, 80204, Colorado, USA
| | - Carl W White
- Department of Pediatrics, University of Colorado Denver, Denver, 80204, Colorado, USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California Irvine, Irvine, 92612, California, USA. .,Department of Biomedical Engineering, University of California Irvine, Irvine, 92697, California, USA.
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17
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Englhard AS, Wiedmann M, Ledderose GJ, Lemieux B, Badran A, Jing JC, Chen Z, Volgger V, Wong BJF. In vivo imaging of the internal nasal valve during different conditions using optical coherence tomography. Laryngoscope 2018; 128:E105-E110. [PMID: 29044537 PMCID: PMC5814348 DOI: 10.1002/lary.26962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/31/2017] [Accepted: 09/18/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Previously, we proposed long-range optical coherence tomography (LR-OCT) to be an effective method for the quantitative evaluation of the nasal valve geometry. Here, the objective was to quantify the reduction in the internal nasal valve angle and cross-sectional area that results in subjective nasal airway obstruction and to evaluate the dynamic behavior of the valve during respiration using LR-OCT. METHODS For 16 healthy individuals, LR-OCT was performed in each naris during: 1) normal respiration, 2) peak forced inspiration, 3) lateral nasal wall depression (to the onset of obstructive symptoms), and 4) after application of a topical decongestant. The angle and the cross-sectional area of the valve were measured. RESULTS A reduction of the valve angle from 18.3° to 14.1° (11° in Caucasians and 17° in Asians) and a decrease of the cross-sectional area from 0.65 cm2 to 0.55 cm2 led to subjective nasal obstruction. Forceful breathing did not significantly change the internal nasal valve area in healthy individuals. Application of nasal decongestant resulted in increased values. CONCLUSION LR-OCT proved to be a fast and readily performed method for the evaluation of the dynamic behavior of the nasal valve. The values of the angle and the cross-sectional area of the valve were reproducible, and changes in size could be accurately delineated. LEVEL OF EVIDENCE 2b. Laryngoscope, 128:E105-E110, 2018.
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Affiliation(s)
- Anna S Englhard
- Department of Otolaryngology-Head and Neck Surgery, Ludwig Maximilian University of Munich, Munich, Germany
| | - Maximilian Wiedmann
- Department of Biomedical Engineering, University of California, Irvine, Orange, California, U.S.A
| | - Georg J Ledderose
- Department of Otolaryngology-Head and Neck Surgery, Ludwig Maximilian University of Munich, Munich, Germany
| | - Bryan Lemieux
- Beckman Laser Institute, University of California, Irvine, Orange, California, U.S.A
| | - Alan Badran
- Beckman Laser Institute, University of California, Irvine, Orange, California, U.S.A
| | - Joseph C Jing
- Department of Biomedical Engineering, University of California, Irvine, Orange, California, U.S.A
| | - Zhongping Chen
- Department of Biomedical Engineering, University of California, Irvine, Orange, California, U.S.A
| | - Veronika Volgger
- Department of Otolaryngology-Head and Neck Surgery, Ludwig Maximilian University of Munich, Munich, Germany
| | - Brian J F Wong
- Beckman Laser Institute, University of California, Irvine, Orange, California, U.S.A
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, U.S.A
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18
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Park HC, Mavadia-Shukla J, Yuan W, Alemohammad M, Li X. Broadband rotary joint for high-speed ultrahigh-resolution endoscopic OCT imaging at 800 nm. OPTICS LETTERS 2017; 42:4978-4981. [PMID: 29216160 PMCID: PMC5907933 DOI: 10.1364/ol.42.004978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/03/2017] [Indexed: 05/30/2023]
Abstract
We report the development of a broadband rotary joint for high-speed ultrahigh-resolution endoscopic optical coherence tomography (OCT) imaging in the 800 nm spectral range. This rotary joint features a pair of achromatic doublets in order to achieve broadband operation for a 3 dB bandwidth over 150 nm. The measured one-way throughput of the rotary joint is greater than 80%, while the fluctuation of the double-pass coupling efficiency during 360 deg rotation is less than ±5% at a near video-rate speed of 20 revolutions/s (rps). The rotary joint is used in conjunction with a diffractive-optics-based endoscope and 800 nm spectral domain OCT system and achieved an ultrahigh axial resolution of ∼2.4 μm in air. The imaging performance is demonstrated by 3D circumferential imaging of a mouse colon in vivo.
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Affiliation(s)
- Hyeon-Cheol Park
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Jessica Mavadia-Shukla
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Wu Yuan
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Milad Alemohammad
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21205, USA
| | - Xingde Li
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA
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19
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Ding Z, Qiu J, Shen Y, Chen Z, Bao W. Lens-free all-fiber probe with an optimized output beam for optical coherence tomography. OPTICS LETTERS 2017; 42:2814-2817. [PMID: 28708176 DOI: 10.1364/ol.42.002814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 06/19/2017] [Indexed: 06/07/2023]
Abstract
A high-efficiency lensless all-fiber probe for optical coherence tomography (OCT) is presented. The probe is composed of a segment of large-core multimode fiber (MMF), a segment of tapered MMF, and a length of single-mode fiber (SMF). A controllable output beam can be designed by a simple adjustment of its probe structure parameters (PSPs), instead of the selection of fibers with different optical parameters. A side-view probe with a diameter of 340 μm and a rigid length of 6.37 mm was fabricated, which provides an effective imaging range of ∼0.6 mm with a full width at half-maximum beam diameter of less than 30 μm. The insertion loss of the probe was measured to be 0.81 dB, ensuring a high sensitivity of 102.25 dB. Satisfactory images were obtained by the probe-based OCT system, demonstrating the feasibility of the probe for endoscopic OCT applications.
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20
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Gora MJ, Suter MJ, Tearney GJ, Li X. Endoscopic optical coherence tomography: technologies and clinical applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:2405-2444. [PMID: 28663882 PMCID: PMC5480489 DOI: 10.1364/boe.8.002405] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 05/07/2023]
Abstract
In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.
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Affiliation(s)
- Michalina J Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- ICube Laboratory, CNRS, Strasbourg University, 1 Place de l'Hopital, Strasbourg 67091, France
| | - Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Department of Medicine, Division of Pulmonary and Critical Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Xingde Li
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, and Department of Oncology, Johns Hopkins University, 720 Rutland Avenue, Traylor 710, Baltimore, MD 21205, USA
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21
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Bu R, Balakrishnan S, Iftimia N, Price H, Zdanski C, Oldenburg AL. Airway compliance measured by anatomic optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2017; 8:2195-2209. [PMID: 28736665 PMCID: PMC5516819 DOI: 10.1364/boe.8.002195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/16/2017] [Accepted: 03/10/2017] [Indexed: 05/25/2023]
Abstract
Quantification of airway compliance can aid in the diagnosis and treatment of obstructive airway disorders by detecting regions vulnerable to collapse. Here we evaluate the ability of a swept-source anatomic optical coherence tomography (SSaOCT) system to quantify airway cross-sectional compliance (CC) by measuring changes in the luminal cross-sectional area (CSA) under physiologically relevant pressures of 10-40 cmH2O. The accuracy and precision of CC measurements are determined using simulations of non-uniform rotation distortion (NURD) endemic to endoscopic scanning, and experiments performed in a simplified tube phantom and ex vivo porcine tracheas. NURD simulations show that CC measurements are typically more accurate than that of the CSAs from which they are derived. Phantom measurements of CSA versus pressure exhibit high linearity (R2>0.99), validating the dynamic range of the SSaOCT system. Tracheas also exhibited high linearity (R2 = 0.98) suggestive of linear elasticity, while CC measurements were obtained with typically ± 12% standard error.
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Affiliation(s)
- Ruofei Bu
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3216, USA
| | - Santosh Balakrishnan
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3216, USA
| | - Nicusor Iftimia
- Physical Sciences Inc., New England Business Center, Andover, MA 01810, USA
| | - Hillel Price
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3255, USA
| | - Carlton Zdanski
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7070, USA
| | - Amy L. Oldenburg
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3216, USA
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3255, USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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22
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Englhard AS, Betz T, Volgger V, Lankenau E, Ledderose GJ, Stepp H, Homann C, Betz CS. Intraoperative assessment of laryngeal pathologies with optical coherence tomography integrated into a surgical microscope. Lasers Surg Med 2017; 49:490-497. [PMID: 28231390 DOI: 10.1002/lsm.22632] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Endoscopic examination followed by tissue biopsy is the gold standard in the evaluation of lesions of the upper aerodigestive tract. However, it can be difficult to distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical coherence tomography (OCT) is a non-invasive technique which acquires high-resolution, cross-sectional images of tissue in vivo. Integrated into a surgical microscope, it allows the intraoperative evaluation of lesions simultaneously with microscopic visualization. STUDY DESIGN In a prospective case series, we evaluated the use of OCT integrated into a surgical microscope during microlaryngoscopy to help differentiating various laryngeal pathologies. METHODS 33 patients with laryngeal pathologies were examined with an OCT- microscope (OPMedT iOCT-camera, HS Hi-R 1000G-microscope, Haag-Streit Surgical GmbH, Wedel, Germany) during microlaryngoscopy. The suspected intraoperative diagnoses were compared to the histopathological reports of subsequent tissue biopsies. RESULTS Hands-free non-contact OCT revealed high-resolution images of the larynx with a varying penetration depth of up to 1.2 mm and an average of 0.6 mm. Picture quality was variable. OCT showed disorders of horizontal tissue layering in dysplasias with a disruption of the basement membrane in carcinomas. When comparing the suspected diagnosis during OCT-supported microlaryngoscopy with histology, 79% of the laryngeal lesions could be correctly identified. Premalignant lesions were difficult to diagnose and falsely classified as carcinoma. CONCLUSION OCT integrated into a surgical microscope seems to be a promising adjunct tool to discriminate pathologies of the upper aerodigestive tract intraoperatively. However, picture quality and penetration depth were variable. Although premalignant lesions were difficult to diagnose, the system proved overall helpful for the intraoperative discrimination of benign and malignant tumors. Further studies will be necessary to define its value in the future. Lasers Surg. Med. 49:490-497, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Anna S Englhard
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Tom Betz
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Veronika Volgger
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Eva Lankenau
- OptoMedical Technologies GmbH, Maria-Goeppert-Strasse 9, 23562 Lübeck, Germany
| | - Georg J Ledderose
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Herbert Stepp
- Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universität München, Feodor-Lynen-Str.19, 81377 Munich, Germany
| | - Christian Homann
- Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universität München, Feodor-Lynen-Str.19, 81377 Munich, Germany
| | - Christian S Betz
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany
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23
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Anatomically correct visualization of the human upper airway using a high-speed long range optical coherence tomography system with an integrated positioning sensor. Sci Rep 2016; 6:39443. [PMID: 27991580 PMCID: PMC5171831 DOI: 10.1038/srep39443] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/22/2016] [Indexed: 01/28/2023] Open
Abstract
The upper airway is a complex tissue structure that is prone to collapse. Current methods for studying airway obstruction are inadequate in safety, cost, or availability, such as CT or MRI, or only provide localized qualitative information such as flexible endoscopy. Long range optical coherence tomography (OCT) has been used to visualize the human airway in vivo, however the limited imaging range has prevented full delineation of the various shapes and sizes of the lumen. We present a new long range OCT system that integrates high speed imaging with a real-time position tracker to allow for the acquisition of an accurate 3D anatomical structure in vivo. The new system can achieve an imaging range of 30 mm at a frame rate of 200 Hz. The system is capable of generating a rapid and complete visualization and quantification of the airway, which can then be used in computational simulations to determine obstruction sites.
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24
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Ajose-Popoola O, Su E, Hamamoto A, Wang A, Jing JC, Nguyen TD, Chen JJ, Osann KE, Chen Z, Ahuja GS, Wong BJF. Diagnosis of subglottic stenosis in a rabbit model using long-range optical coherence tomography. Laryngoscope 2016; 127:64-69. [PMID: 27559721 DOI: 10.1002/lary.26241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES/HYPOTHESIS Current imaging modalities lack the necessary resolution to diagnose subglottic stenosis. The aim of this study was to use optical coherence tomography (OCT) to evaluate nascent subglottic mucosal injury and characterize mucosal thickness and structural changes using texture analysis in a simulated intubation rabbit model. STUDY DESIGN Prospective animal study in rabbits. METHODS Three-centimeter-long sections of endotracheal tubes (ETT) were endoscopically placed in the subglottis and proximal trachea of New Zealand White rabbits (n = 10) and secured via suture. OCT imaging and conventional endoscopic video was performed just prior to ETT segment placement (day 0), immediately after tube removal (day 7), and 1 week later (day 14). OCT images were analyzed for airway wall thickness and textural properties. RESULTS Endoscopy and histology of intubated rabbits showed a range of normal to edematous tissue, which correlated with OCT images. The mean airway mucosal wall thickness measured using OCT was 336.4 μm (day 0), 391.3 μm (day 7), and 420.4 μm (day 14), with significant differences between day 0 and day 14 (P = .002). Significance was found for correlation and homogeneity texture features across all time points (P < .05). CONCLUSIONS OCT is a minimally invasive endoscopic imaging modality capable of monitoring progression of subglottic mucosal injury. This study is the first to evaluate mucosal injury during simulated intubation using serial OCT imaging and texture analysis. OCT and texture analysis have the potential for early detection of subglottic mucosal injury, which could lead to better management of the neonatal airway and limit the progression to stenosis. LEVEL OF EVIDENCE NA Laryngoscope, 127:64-69, 2017.
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Affiliation(s)
- Olubunmi Ajose-Popoola
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Irvine, California, U.S.A
| | - Erica Su
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A
| | - Ashley Hamamoto
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A
| | - Alex Wang
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A
| | - Joseph C Jing
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A.,Department of Biomedical Engineering, University of California-Irvine, Irvine, California, U.S.A
| | - Tony D Nguyen
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A.,School of Medicine, University of California-Irvine, Irvine, California, U.S.A
| | - Jason J Chen
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A
| | - Kathryn E Osann
- School of Medicine, University of California-Irvine, Irvine, California, U.S.A
| | - Zhongping Chen
- Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A.,Department of Biomedical Engineering, University of California-Irvine, Irvine, California, U.S.A
| | - Gurpreet S Ahuja
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Irvine, California, U.S.A.,CHOC Children's Hospital of Orange County, Orange, California, U.S.A
| | - Brian J F Wong
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Irvine, California, U.S.A.,Beckman Laser Institute, University of California-Irvine, Irvine, California, U.S.A.,Department of Biomedical Engineering, University of California-Irvine, Irvine, California, U.S.A
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25
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Patini R, Arrica M, Di Stasio E, Gallenzi P, Cordaro M. The use of magnetic resonance imaging in the evaluation of upper airway structures in paediatric obstructive sleep apnoea syndrome: a systematic review and meta-analysis. Dentomaxillofac Radiol 2016; 45:20160136. [PMID: 27440304 PMCID: PMC5606260 DOI: 10.1259/dmfr.20160136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/19/2016] [Accepted: 07/18/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES A systematic review was conducted to assess the effectiveness of MRI in evaluating upper airway structures in children affected by obstructive sleep apnoea syndrome (OSAS). METHODS A literature search was performed in the Cochrane Central Register of Controlled Trials, Web of Science, Scopus and PubMed databases from their inception to 31/03/2016, including available randomized controlled trials and controlled clinical trials published in English assessing the use of MRI integrated with traditional polysomnography (PSG) among children up to 15 years of age affected by OSAS. The primary outcome to be evaluated was the efficacy of MRI in analyzing the upper airway total volume among healthy children compared with children affected by OSAS. Secondary outcomes were to compare the efficacy of MRI in analyzing the upper airway cross-sectional area in the areas adjacent to the adenoids and tonsils, adenoid and tonsil volume, and soft-tissue and maxillofacial bone parameters in the same sample. Results were expressed using a random-effects model and mean differences (MD) with 95% confidence intervals (CI). RESULTS The search yielded 1005 titles in total; the selection process narrowed to 3 titles, which were all assessed as indicating an unclear level of risk of bias. The meta-analysis found evidence of MRI effectiveness in evaluating differences in the upper airway total volume between paediatric patients affected by OSAS and paediatric patients not affected by OSAS (MD -0.56 cm(3); 95% CI: -1.05 to -0.07). CONCLUSIONS Although MRI could be considered effective in evaluating upper airway structures in children affected by OSAS, based on the present evidence, PSG is still the golden standard and further studies are required to verify MRI reliability.
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Affiliation(s)
- Romeo Patini
- Dentistry Unit of Head and Neck
Clinical Area, School of Dentistry, Catholic University of Sacred Heart,
Rome, Italy
| | - Mariantonietta Arrica
- Department of Surgery,
Microsurgery and Medical Sciences, School of Dentistry, University of
Sassari, Sassari, Italy
| | - Enrico Di Stasio
- Molecular Clinical Biology Unit
of Laboratory Medicine Clinical Area, Catholic University of Sacred Heart,
Rome, Italy
| | - Patrizia Gallenzi
- Dentistry Unit of Head and Neck
Clinical Area, School of Dentistry, Catholic University of Sacred Heart,
Rome, Italy
| | - Massimo Cordaro
- Dentistry Unit of Head and Neck
Clinical Area, School of Dentistry, Catholic University of Sacred Heart,
Rome, Italy
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26
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Wu Z, Chen W, Khoo MC, Ward SLD, Nayak KS. Evaluation of upper airway collapsibility using real-time MRI. J Magn Reson Imaging 2016; 44:158-67. [PMID: 26708099 PMCID: PMC6768084 DOI: 10.1002/jmri.25133] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/02/2015] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To develop and demonstrate a real-time MRI method for assessing upper airway collapsibility in sleep apnea. MATERIALS AND METHODS Data were acquired on a clinical 3 Tesla scanner using a radial CAIPIRIHNA sequence with modified golden angle view ordering and reconstructed using parallel imaging and compressed sensing with temporal finite difference sparsity constraint. Segmented airway areas together with synchronized facemask pressure were used to calculate airway compliance and projected closing pressure, Pclose , at four axial locations along the upper airway. This technique was demonstrated in five adolescent obstructive sleep apnea (OSA) patients, three adult OSA patients and four healthy volunteers. Heart rate, oxygen saturation, facemask pressure, and abdominal/chest movements were monitored in real-time during the experiments to determine sleep/wakefulness. RESULTS Student's t-tests showed that both compliance and Pclose were significantly different between healthy controls and OSA patients (P < 0.001). The results also suggested that a narrower airway site does not always correspond to higher collapsibility. CONCLUSION With the proposed methods, both compliance and Pclose can be calculated and used to quantify airway collapsibility in OSA with an awake scan of 30 min total scan room time. J. Magn. Reson. Imaging 2016;44:158-167.
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Affiliation(s)
- Ziyue Wu
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
- Alltech Medical Systems America, Solon, Ohio, USA
| | - Weiyi Chen
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
| | - Michael C.K. Khoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Sally L. Davidson Ward
- Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Krishna S. Nayak
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
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27
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Sharma GK, Chin Loy A, Su E, Jing J, Chen Z, Wong BJF, Verma S. Quantitative Evaluation of Adult Subglottic Stenosis Using Intraoperative Long-range Optical Coherence Tomography. Ann Otol Rhinol Laryngol 2016; 125:815-22. [PMID: 27354215 DOI: 10.1177/0003489416655353] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine the feasibility of long-range optical coherence tomography (LR-OCT) as a tool to intraoperatively image and measure the subglottis and trachea during suspension microlaryngoscopy before and after endoscopic treatment of subglottic stenosis (SGS). METHODS Long-range optical coherence tomography of the adult subglottis and trachea was performed during suspension microlaryngoscopy before and after endoscopic treatment for SGS. The anteroposterior and transverse diameters, cross-sectional area (CSA), distance from the vocal cords, and length of the SGS were measured using a MATLAB software. Pre-intervention and postintervention airway dimensions were compared. Three-dimensional volumetric airway reconstructions were generated using medical image processing software (MIMICS). RESULTS Intraoperative LR-OCT imaging was performed in 3 patients undergoing endoscopic management of SGS. Statistically significant differences in mean anteroposterior diameter (P < .01), transverse diameter (P < .001), and CSA (P < .001) were noted between pre-intervention and postintervention data. Three-dimensional airway models were viewed in cross-sectional format and via virtual "fly through" bronchoscopy. CONCLUSIONS This is the first report of intraoperative LR-OCT of the subglottic and tracheal airway before and after surgical management of SGS in humans. Long-range optical coherence tomography offers a practical means to measure the dimensions of SGS and acquire objective data on the response to endoscopic treatment of SGS.
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Affiliation(s)
- Giriraj K Sharma
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Anthony Chin Loy
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Erica Su
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Joe Jing
- Beckman Laser Institute, University of California, Irvine, California, USA Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, California, USA Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Brian J-F Wong
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
| | - Sunil Verma
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA University Voice and Swallowing Center, University of California, Irvine, California, USA
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28
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Sharma GK, Ahuja GS, Wiedmann M, Osann KE, Su E, Heidari AE, Jing JC, Qu Y, Lazarow F, Wang A, Chou L, Uy CC, Dhar V, Cleary JP, Pham N, Huoh K, Chen Z, Wong BJF. Long-Range Optical Coherence Tomography of the Neonatal Upper Airway for Early Diagnosis of Intubation-related Subglottic Injury. Am J Respir Crit Care Med 2016. [PMID: 26214043 DOI: 10.1164/rccm.201501-0053oc] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Subglottic edema and acquired subglottic stenosis are potentially airway-compromising sequelae in neonates following endotracheal intubation. At present, no imaging modality is capable of in vivo diagnosis of subepithelial airway wall pathology as signs of intubation-related injury. OBJECTIVES To use Fourier domain long-range optical coherence tomography (LR-OCT) to acquire micrometer-resolution images of the airway wall of intubated neonates in a neonatal intensive care unit setting and to analyze images for histopathology and airway wall thickness. METHODS LR-OCT of the neonatal laryngotracheal airway was performed a total of 94 times on 72 subjects (age, 1-175 d; total intubation, 1-104 d). LR-OCT images of the airway wall were analyzed in MATLAB. Medical records were reviewed retrospectively for extubation outcome. MEASUREMENTS AND MAIN RESULTS Backward stepwise regression analysis demonstrated a statistically significant association between log(duration of intubation) and both laryngeal (P < 0.001; multiple r(2) = 0.44) and subglottic (P < 0.001; multiple r(2) = 0.55) airway wall thickness. Subjects with positive histopathology on LR-OCT images had a higher likelihood of extubation failure (odds ratio, 5.9; P = 0.007). Longer intubation time was found to be significantly associated with extubation failure. CONCLUSIONS LR-OCT allows for high-resolution evaluation and measurement of the airway wall in intubated neonates. Our data demonstrate a positive correlation between laryngeal and subglottic wall thickness and duration of intubation, suggestive of progressive soft tissue injury. LR-OCT may ultimately aid in the early diagnosis of postintubation subglottic injury and help reduce the incidences of failed extubation caused by subglottic edema or acquired subglottic stenosis in neonates. Clinical trial registered with www.clinicaltrials.gov (NCT 00544427).
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Affiliation(s)
- Giriraj K Sharma
- 1 Department of Otolaryngology-Head and Neck Surgery.,2 Beckman Laser Institute
| | - Gurpreet S Ahuja
- 1 Department of Otolaryngology-Head and Neck Surgery.,3 Division of Otolaryngology and
| | | | | | | | | | - Joseph C Jing
- 2 Beckman Laser Institute.,5 Department of Biomedical Engineering, and
| | - Yueqiao Qu
- 5 Department of Biomedical Engineering, and
| | | | | | | | - Cherry C Uy
- 6 Division of Neonatology, University of California Irvine, Irvine, California; and
| | - Vijay Dhar
- 7 Division of Neonatology, CHOC Children's Hospital of Orange County, Orange, California
| | - John P Cleary
- 6 Division of Neonatology, University of California Irvine, Irvine, California; and.,7 Division of Neonatology, CHOC Children's Hospital of Orange County, Orange, California
| | - Nguyen Pham
- 1 Department of Otolaryngology-Head and Neck Surgery.,3 Division of Otolaryngology and
| | - Kevin Huoh
- 1 Department of Otolaryngology-Head and Neck Surgery.,3 Division of Otolaryngology and
| | - Zhongping Chen
- 2 Beckman Laser Institute.,5 Department of Biomedical Engineering, and
| | - Brian J-F Wong
- 1 Department of Otolaryngology-Head and Neck Surgery.,2 Beckman Laser Institute.,5 Department of Biomedical Engineering, and
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29
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In vivo cross-sectional imaging of the phonating larynx using long-range Doppler optical coherence tomography. Sci Rep 2016; 6:22792. [PMID: 26960250 PMCID: PMC4785353 DOI: 10.1038/srep22792] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/28/2016] [Indexed: 12/04/2022] Open
Abstract
Diagnosis and treatment of vocal fold lesions has been a long-evolving science for the otolaryngologist. Contemporary practice requires biopsy of a glottal lesion in the operating room under general anesthesia for diagnosis. Current in-office technology is limited to visualizing the surface of the vocal folds with fiber-optic or rigid endoscopy and using stroboscopic or high-speed video to infer information about submucosal processes. Previous efforts using optical coherence tomography (OCT) have been limited by small working distances and imaging ranges. Here we report the first full field, high-speed, and long-range OCT images of awake patients’ vocal folds as well as cross-sectional video and Doppler analysis of their vocal fold motions during phonation. These vertical-cavity surface-emitting laser source (VCSEL) OCT images offer depth resolved, high-resolution, high-speed, and panoramic images of both the true and false vocal folds. This technology has the potential to revolutionize in-office imaging of the larynx.
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30
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Visualisation of the Intensity and Phase Dynamics of Semiconductor Lasers via Electric Field Reconstructions. SPRINGER PROCEEDINGS IN PHYSICS 2016. [DOI: 10.1007/978-3-319-24871-4_1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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31
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Qi L, Huang S, Heidari AE, Dai C, Zhu J, Zhang X, Chen Z. Automatic airway wall segmentation and thickness measurement for long-range optical coherence tomography images. OPTICS EXPRESS 2015; 23:33992-4006. [PMID: 26832057 PMCID: PMC4741311 DOI: 10.1364/oe.23.033992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We present an automatic segmentation method for the delineation and quantitative thickness measurement of multiple layers in endoscopic airway optical coherence tomography (OCT) images. The boundaries of the mucosa and the sub-mucosa layers are accurately extracted using a graph-theory-based dynamic programming algorithm. The algorithm was tested with sheep airway OCT images. Quantitative thicknesses of the mucosal layers are obtained automatically for smoke inhalation injury experiments.
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Affiliation(s)
- Li Qi
- Institute of Optical Communication Engineering, Nanjing University, Nanjing, Jiangsu, 210093, China
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
| | - Shenghai Huang
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
| | - Andrew E. Heidari
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California 92697, USA
| | - Cuixia Dai
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
| | - Jiang Zhu
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
| | - Xuping Zhang
- Institute of Optical Communication Engineering, Nanjing University, Nanjing, Jiangsu, 210093, China
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, California 92612, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California 92697, USA
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32
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Englhard AS, Wiedmann M, Ledderose GJ, Lemieux B, Badran A, Chen Z, Betz CS, Wong BJ. Imaging of the internal nasal valve using long-range Fourier domain optical coherence tomography. Laryngoscope 2015; 126:E97-E102. [PMID: 26599137 DOI: 10.1002/lary.25785] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/07/2015] [Accepted: 10/26/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate for the first time the feasibility and methodology of long-range Fourier domain optical coherence tomography (LR-OCT) imaging of the internal nasal valve (INV) area in healthy individuals. STUDY DESIGN Prospective individual cohort study. METHODS For 16 individuals, OCT was performed in each nare. The angle and the cross-sectional area of the INV were measured. OCT images were compared to corresponding digital pictures recorded with a flexible endoscope. RESULTS INV angle measured by OCT was found to be 18.3° ± 3.1° (mean ± standard deviation). The cross-sectional area was 0.65 ± 0.23 cm(2) . The INV angle measured by endoscopy was 18.8° ± 6.9°. There was no statistically significant difference between endoscopy and OCT concerning the mean INV angle (P = .778), but there was a significant difference in test precision (coefficient of variance 50% vs. 15%; P < .001). CONCLUSIONS LR-OCT proved to be a fast and easily performed method. OCT could accurately quantify the INV area. The values of the angle and the cross-sectional area of the INV were reproducible and correlated well with the data seen with other methods. Changes in size could be reliably delineated. Endoscopy showed similar values but was significantly less precise. LEVEL OF EVIDENCE 2b. Laryngoscope, 126:E97-E102, 2016.
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Affiliation(s)
- Anna S Englhard
- Department of Otolaryngology-Head and Neck Surgery, Ludwig Maximilian University Munich, Munich, Germany
| | - Maximilian Wiedmann
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A
| | - Georg J Ledderose
- Department of Otolaryngology-Head and Neck Surgery, Ludwig Maximilian University Munich, Munich, Germany
| | - Bryan Lemieux
- Beckman Laser Institute, University of California, Irvine, Irvine, California, U.S.A
| | - Alan Badran
- Beckman Laser Institute, University of California, Irvine, Irvine, California, U.S.A
| | - Zhongping Chen
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A
| | - Christian S Betz
- Department of Otolaryngology-Head and Neck Surgery, Ludwig Maximilian University Munich, Munich, Germany
| | - Brian J Wong
- Beckman Laser Institute, University of California, Irvine, Irvine, California, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A
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Kang D, Wang A, Volgger V, Chen Z, Wong BJF. Spatiotemporal correlation of optical coherence tomography in-vivo images of rabbit airway for the diagnosis of edema. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:076015. [PMID: 26222962 PMCID: PMC4518273 DOI: 10.1117/1.jbo.20.7.076015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/30/2015] [Indexed: 03/28/2024]
Abstract
Detection of an early stage of subglottic edema is vital for airway management and prevention of stenosis, a life-threatening condition in critically ill neonates. As an observer for the task of diagnosing edema in vivo, we investigated spatiotemporal correlation (STC) of full-range optical coherence tomography (OCT) images acquired in the rabbit airway with experimentally simulated edema. Operating the STC observer on OCT images generates STC coefficients as test statistics for the statistical decision task. Resulting from this, the receiver operating characteristic (ROC) curves for the diagnosis of airway edema with full-range OCT in-vivo images were extracted and areas under ROC curves were calculated. These statistically quantified results demonstrated the potential clinical feasibility of the STC method as a means to identify early airway edema.
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Affiliation(s)
- DongYel Kang
- Hanbat National University, College of Engineering, School of Basic Sciences, 125 DogSeoDaeRo, YuSeong-Gu, Daejeon 305-719, Republic of Korea
| | - Alex Wang
- University of California Irvine, Beckman Laser Institute and Medical Clinic, Irvine, California 92617, United States
| | - Veronika Volgger
- Ludwig-Maximilians-University Munich, Department of Otolaryngology-Head and Neck Surgery, Marchioninistr. 15, Munich 81377, Germany
| | - Zhongping Chen
- University of California Irvine, Beckman Laser Institute and Medical Clinic, Irvine, California 92617, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California 92617, United States
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Irvine, California 92617, United States
| | - Brian J. F. Wong
- University of California Irvine, Beckman Laser Institute and Medical Clinic, Irvine, California 92617, United States
- University of California Irvine, Department of Biomedical Engineering, Irvine, California 92617, United States
- University of California Irvine, Department of Otolaryngology-Head and Neck Surgery, Irvine, California 92617, United States
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Davidson Ward SL, Amin R, Arens R, Davis S, Gutmark E, Superfine R, Wong B, Zdanski C, Khoo MCK. Pediatric sleep-related breathing disorders: advances in imaging and computational modeling. IEEE Pulse 2015; 5:33-9. [PMID: 25437473 DOI: 10.1109/mpul.2014.2339293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We understand now that sleep of sufficient length and quality is required for good health. This is particularly true for infants and children, who have the added physiologic task of growth and development, as compared to their adult counterparts. Sleep-related breathing disorders (SRBDs) are common in childhood and if unrecognized and not treated can result in significant morbidity. For example, children with obstructive sleep apnea (OSA) can exhibit behavioral, mood, and learning difficulties. If left untreated, alterations in the function of the autonomic nervous system and a chronic inflammatory state result, contributing to the risk of heart disease, stroke, glucose intolerance, and hypertension in adulthood.
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35
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McLaughlin RA, Noble PB, Sampson DD. Optical coherence tomography in respiratory science and medicine: from airways to alveoli. Physiology (Bethesda) 2015; 29:369-80. [PMID: 25180266 DOI: 10.1152/physiol.00002.2014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Optical coherence tomography is a rapidly maturing optical imaging technology, enabling study of the in vivo structure of lung tissue at a scale of tens of micrometers. It has been used to assess the layered structure of airway walls, quantify both airway lumen caliber and compliance, and image individual alveoli. This article provides an overview of the technology and reviews its capability to provide new insights into respiratory disease.
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Affiliation(s)
- Robert A McLaughlin
- Optical & Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, Australia;
| | - Peter B Noble
- School of Anatomy, Physiology & Human Biology, and Centre for Neonatal Research & Education, School of Paediatrics and Child Health, The University of Western Australia, Crawley, Australia; and
| | - David D Sampson
- Optical & Biomedical Engineering Laboratory, School of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, Australia; Centre for Microscopy, Characterisation & Analysis, The University of Western Australia, Perth, Australia
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36
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Butler T, Slepneva S, O'Shaughnessy B, Kelleher B, Goulding D, Hegarty SP, Lyu HC, Karnowski K, Wojtkowski M, Huyet G. Single shot, time-resolved measurement of the coherence properties of OCT swept source lasers. OPTICS LETTERS 2015; 40:2277-2280. [PMID: 26393718 DOI: 10.1364/ol.40.002277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A novel, time-resolved interferometric technique is presented that allows the reconstruction of the complex electric field output of a swept source laser in a single-shot measurement. The power of the technique is demonstrated by examining a short cavity swept source designed for optical coherence tomography (OCT) applications with a spectral width of over 100 nm. The novel analysis allows a time-resolved real-time characterization of the roll-off, optical spectrum, linewidth, and coherence properties of a dynamic, rapidly swept laser source.
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37
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Lee J, Chae Y, Ahn YC, Moon S. Ultra-thin and flexible endoscopy probe for optical coherence tomography based on stepwise transitional core fiber. BIOMEDICAL OPTICS EXPRESS 2015; 6:1782-96. [PMID: 26137380 PMCID: PMC4467695 DOI: 10.1364/boe.6.001782] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/09/2015] [Accepted: 04/16/2015] [Indexed: 05/18/2023]
Abstract
We present an ultra-thin fiber-body endoscopy probe for optical coherence tomography (OCT) which is based on a stepwise transitional core (STC) fiber. In a minimalistic design, our probe was made of spliced specialty fibers that could be directly used for beam probing optics without using a lens. In our probe, the OCT light delivered through a single-mode fiber was efficiently expanded to a large mode field of 24 μm diameter for a low beam divergence. The size of our probe was 85 μm in the probe's diameter while operated in a 160-μm thick protective tubing. Through theoretical and experimental analyses, our probe was found to exhibit various attractive features in terms of compactness, flexibility and reliability along with its excellent fabrication simplicity.
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Affiliation(s)
- Jangbeom Lee
- Department of Physics, Kookmin University, Seoul, 136-702,
South Korea
| | - Yugyeong Chae
- Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology, Pukyong National University, Busan, 608-737,
South Korea
| | - Yeh-Chan Ahn
- Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology, Pukyong National University, Busan, 608-737,
South Korea
| | - Sucbei Moon
- Department of Physics, Kookmin University, Seoul, 136-702,
South Korea
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38
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Volgger V, Sharma GK, Jing JC, Peaks YSA, Loy AC, Lazarow F, Wang A, Qu Y, Su E, Chen Z, Ahuja GS, Wong BJF. Long-range Fourier domain optical coherence tomography of the pediatric subglottis. Int J Pediatr Otorhinolaryngol 2015; 79:119-26. [PMID: 25532671 PMCID: PMC4297587 DOI: 10.1016/j.ijporl.2014.11.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 11/08/2014] [Accepted: 11/14/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Acquired subglottic stenosis (SGS) most commonly results from prolonged endotracheal intubation and is a diagnostic challenge in the intubated child. At present, no imaging modality allows for in vivo characterization of subglottic microanatomy to identify early signs of acquired SGS while the child remains intubated. Fourier domain optical coherence tomography (FD-OCT) is a minimally invasive, light-based imaging modality which provides high resolution, three dimensional (3D) cross-sectional images of biological tissue. We used long-range FD-OCT to image the subglottis in intubated pediatric patients undergoing minor head and neck surgical procedures in the operating room. METHODS A long-range FD-OCT system and rotary optical probes (1.2mm and 0.7mm outer diameters) were constructed. Forty-six pediatric patients (ages 2-16 years) undergoing minor upper airway surgery (e.g., tonsillectomy and adenoidectomy) were selected for intraoperative, trans-endotracheal tube FD-OCT of the subglottis. Images were analyzed for anatomical landmarks and subepithelial histology. Volumetric image sets were rendered into virtual 3D airway models in Mimics software. RESULTS FD-OCT was performed on 46 patients (ages 2-16 years) with no complications. Gross airway contour was visible on all 46 data sets. Twenty (43%) high-quality data sets clearly demonstrated airway anatomy (e.g., tracheal rings, cricoid and vocal folds) and layered microanatomy of the mucosa (e.g., epithelium, basement membrane and lamina propria). The remaining 26 data sets were discarded due to artifact, high signal-to-noise ratio or missing data. 3D airway models were allowed for user-controlled manipulation and multiplanar airway slicing (e.g., sagittal, coronal) for visualization of OCT data at multiple anatomic levels simultaneously. CONCLUSIONS Long-range FD-OCT produces high-resolution, 3D volumetric images of the pediatric subglottis. This technology offers a safe and practical means for in vivo evaluation of lower airway microanatomy in intubated pediatric patients. Ultimately, FD-OCT may be applied to serial monitoring of the neonatal subglottis in long-term intubated infants at risk for acquired SGS.
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Affiliation(s)
- Veronika Volgger
- Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig Maximilian University Munich, 80539 München, Germany
| | - Giriraj K Sharma
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA 92868, USA
| | - Joseph C Jing
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA 92612, USA
| | - Ya-Sin A Peaks
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA 92868, USA
| | - Anthony Chin Loy
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA 92868, USA
| | - Frances Lazarow
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA 92868, USA
| | - Alex Wang
- Beckman Laser Institute, University of California Irvine, Irvine, CA 92612, USA
| | - Yueqiao Qu
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA 92612, USA
| | - Erica Su
- Beckman Laser Institute, University of California Irvine, Irvine, CA 92612, USA
| | - Zhongping Chen
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA 92612, USA; Beckman Laser Institute, University of California Irvine, Irvine, CA 92612, USA
| | - Gurpreet S Ahuja
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA 92868, USA; CHOC Children's Hospital of Orange County, Orange, CA 92868, USA
| | - Brian J-F Wong
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA 92868, USA; Beckman Laser Institute, University of California Irvine, Irvine, CA 92612, USA.
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Intraoperative long range optical coherence tomography as a novel method of imaging the pediatric upper airway before and after adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2015; 79:63-70. [PMID: 25479699 PMCID: PMC4313623 DOI: 10.1016/j.ijporl.2014.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 11/04/2014] [Accepted: 11/07/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES While upper airway obstruction is a common problem in the pediatric population, the first-line treatment, adenotonsillectomy, fails in up to 20% of patients. The decision to proceed to surgery is often made without quantitative anatomic guidance. We evaluated the use of a novel technique, long-range optical coherence tomography (LR-OCT), to image the upper airway of children under general anesthesia immediately before and after tonsillectomy and/or adenoidectomy. We investigated the feasibility of LR-OCT to identify both normal anatomy and sites of airway narrowing and to quantitatively compare airway lumen size in the oropharyngeal and nasopharyngeal regions pre- and post-operatively. METHODS 46 children were imaged intraoperatively with a custom-designed LR-OCT system, both before and after adenotonsillectomy. These axial LR-OCT images were both rendered into 3D airway models for qualitative analysis and manually segmented for quantitative comparison of cross-sectional area. RESULTS LR-OCT images demonstrated normal anatomic structures (base of tongue, epiglottis) as well as regions of airway narrowing. Volumetric rendering of pre- and post-operative images clearly showed regions of airway collapse and post-surgical improvement in airway patency. Quantitative analysis of cross-sectional images showed an average change of 70.52mm(2) (standard deviation 47.87mm(2)) in the oropharynx after tonsillectomy and 105.58mm(2) (standard deviation 60.62mm(2)) in the nasopharynx after adenoidectomy. CONCLUSIONS LR-OCT is an emerging technology that rapidly generates 3D images of the pediatric upper airway in a feasible manner. This is the first step toward development of an office-based system to image awake pediatric subjects and thus better identify loci of airway obstruction prior to surgery.
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40
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Heidari AE, Moghaddam S, Truong KK, Chou L, Genberg C, Brenner M, Chen Z. Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:126010. [PMID: 26720877 PMCID: PMC4686586 DOI: 10.1117/1.jbo.20.12.126010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/23/2015] [Indexed: 05/23/2023]
Abstract
Biofilm formation has been linked to ventilator-associated pneumonia, which is a prevalent infection in hospital intensive care units. Currently, there is no rapid diagnostic tool to assess the degree of biofilm formation or cellular biofilm composition. Optical coherence tomography (OCT) is a minimally invasive, nonionizing imaging modality that can be used to provide high-resolution cross-sectional images. Biofilm deposited in critical care patients’ endotracheal tubes was analyzed in vitro. This study demonstrates that OCT could potentially be used as a diagnostic tool to analyze and assess the degree of biofilm formation and extent of airway obstruction caused by biofilm in endotracheal tubes.
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Affiliation(s)
- Andrew E. Heidari
- University of California Irvine, Samueli School of Engineering, Department of Biomedical Engineering, 5200 Engineering Hall, Irvine, California 92697-2700, United States
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
| | - Samer Moghaddam
- University of California Irvine, UC Irvine Health, Pulmonology, 101, The City Drive South, Orange, California 92868, United States
| | - Kimberly K. Truong
- University of California Irvine, UC Irvine Health, Pulmonology, 101, The City Drive South, Orange, California 92868, United States
| | - Lidek Chou
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
| | - Carl Genberg
- N8 Medical, 7165 Mira Monte Circle, Las Vegas, Nevada 89120, United States
| | - Matthew Brenner
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
- University of California Irvine, UC Irvine Health, Pulmonology, 101, The City Drive South, Orange, California 92868, United States
| | - Zhongping Chen
- University of California Irvine, Samueli School of Engineering, Department of Biomedical Engineering, 5200 Engineering Hall, Irvine, California 92697-2700, United States
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
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Tandon R, Herford AS. The case for advanced physics topics in oral and maxillofacial surgery. J Oral Maxillofac Surg 2014; 72:1876-9. [PMID: 25234523 DOI: 10.1016/j.joms.2014.06.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 06/13/2014] [Accepted: 06/17/2014] [Indexed: 11/25/2022]
Abstract
Research in oral and maxillofacial surgery has focused mainly on principles founded in the biological and chemical sciences, which have provided excellent answers to many questions. However, recent technologic advances have begun to gain prominence in many of the medical sciences, providing clinicians with more effective tools for diagnosis and treatment. The era of modern physics has led to the development of diagnostic techniques that could provide information at a more basic level than many of the current biochemical methods used. The goal of this report is to introduce 2 of these methods and describe how they can be applied to oral and maxillofacial surgery.
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Affiliation(s)
- Rahul Tandon
- Resident, Department of Oral and Maxillofacial Surgery, University of Texas Southwestern, Dallas, TX.
| | - Alan S Herford
- Chairman, Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA
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Wijesundara K, Zdanski C, Kimbell J, Price H, Iftimia N, Oldenburg AL. Quantitative upper airway endoscopy with swept-source anatomical optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2014; 5:788-99. [PMID: 24688814 PMCID: PMC3959831 DOI: 10.1364/boe.5.000788] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 02/03/2014] [Accepted: 02/03/2014] [Indexed: 05/15/2023]
Abstract
Minimally invasive imaging of upper airway obstructions in children and adults is needed to improve clinical decision-making. Toward this goal, we demonstrate an anatomical optical coherence tomography (aOCT) system delivered via a small-bore, flexible endoscope to quantify the upper airway lumen geometry. Helical scans were obtained from a proximally-scanned fiber-optic catheter of 820 μm outer diameter and >2 mm focal length. Coupled with a long coherence length wavelength-swept light source, the system exhibited an SNR roll-off of < 10 dB over a 10 mm range. Operating at 10 rotations/s, the average accuracy of segmented cross-sectional areas was found to be -1.4 ± 1.0%. To demonstrate the capability of this system, aOCT was performed on a pediatric airway phantom and on ex vivo swine trachea. The ability for quantitative endoscopy afforded by this system can aid in diagnosis, medical and surgical decision making, and predictive modeling of upper airway obstructive disorders.
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Affiliation(s)
- Kushal Wijesundara
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3255, USA
| | - Carlton Zdanski
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7070, USA
| | - Julia Kimbell
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7070, USA
| | - Hillel Price
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3255, USA
| | - Nicusor Iftimia
- Physical Sciences Inc., New England Business Center, Andover, MA 01810, USA
| | - Amy L. Oldenburg
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3255, USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7513, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7575, USA
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Chou L, Batchinsky A, Belenkiy S, Jing J, Ramalingam T, Brenner M, Chen Z. In vivo detection of inhalation injury in large airway using three-dimensional long-range swept-source optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:36018. [PMID: 24664245 PMCID: PMC3963560 DOI: 10.1117/1.jbo.19.3.036018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/28/2014] [Indexed: 05/15/2023]
Abstract
We report on the feasibility of using long-range swept-source optical coherence tomography (OCT) to detect airway changes following smoke inhalation in a sheep model. The long-range OCT system (with axial imaging range of 25 mm) and probe are capable of rapidly obtaining a series of high-resolution full cross-sectional images and three-dimensional reconstructions covering 20-cm length of tracheal and bronchial airways with airway diameter up to 25 mm, regardless of the position of the probe within the airway lumen. Measurements of airway thickness were performed at baseline and postinjury to show mucosal thickness changes following smoke inhalation.
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Affiliation(s)
- Lidek Chou
- University of California, Beckman Laser Institute, 1002 Health Sciences Road East, Irvine, California 92612
- OCT Medical Imaging Inc., 1002 Health Sciences Road East, Irvine, California 92612
| | - Andriy Batchinsky
- US Army Institute of Surgical Research, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, Texas 78234
| | - Slava Belenkiy
- US Army Institute of Surgical Research, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, Texas 78234
| | - Joseph Jing
- University of California, Beckman Laser Institute, 1002 Health Sciences Road East, Irvine, California 92612
- University of California, Department of Biomedical Engineering, Irvine, California 92697
| | | | - Matthew Brenner
- University of California, Beckman Laser Institute, 1002 Health Sciences Road East, Irvine, California 92612
- University of California, Irvine Medical Center, Division of Pulmonary and Critical Care, Orange, California 92868
| | - Zhongping Chen
- University of California, Beckman Laser Institute, 1002 Health Sciences Road East, Irvine, California 92612
- University of California, Department of Biomedical Engineering, Irvine, California 92697
- Address all correspondence to: Zhongping Chen, E-mail:
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45
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Effect of the velopharynx on intraluminal pressures in reconstructed pharynges derived from individuals with and without sleep apnea. J Biomech 2013; 46:2504-12. [DOI: 10.1016/j.jbiomech.2013.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/28/2013] [Accepted: 07/03/2013] [Indexed: 11/23/2022]
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