Development of a first-generation miniature multiple reference optical coherence tomography imaging device

Indocyanine green fluorescence image processing techniques for breast cancer macroscopic demarcation

Re-operation due to disease being inadvertently close to the resection margin is a major challenge in breast conserving surgery (BCS). Indocyanine green (ICG) fluorescence imaging could be used to visualize the tumor boundaries and help surgeons resect disease more efficiently. In this work, ICG fluorescence and color images were acquired with a custom-built camera system from 40 patients treated with BCS. Images were acquired from the tumor in-situ, surgical cavity post-excision, freshly excised tumor and histopathology tumour grossing. Fluorescence image intensity and texture were used as individual or combined predictors in both logistic regression (LR) and support vector machine models to predict the tumor extent. ICG fluorescence spectra in formalin-fixed histopathology grossing tumor were acquired and analyzed. Our results showed that ICG remains in the tissue after formalin fixation. Therefore, tissue imaging could be validated in freshly excised and in formalin-fixed grossing tumor. The trained LR model with combined fluorescence intensity (pixel values) and texture (slope of power spectral density curve) identified the tumor's extent in the grossing images with pixel-level resolution and sensitivity, specificity of 0.75 ± 0.3, 0.89 ± 0.2.This model was applied on tumor in-situ and surgical cavity (post-excision) images to predict tumor presence.

Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography

SIGNIFICANCE

After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance.

AIM

Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis.

APPROACH

A comprehensive review of state-of-the-art accomplishments in OCT has been performed.

RESULTS

The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential.

CONCLUSIONS

With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.

A review of low-cost and portable optical coherence tomography

Optical coherence tomography (OCT) is a powerful optical imaging technique capable of visualizing the internal structure of biological tissues at near cellular resolution. For years, OCT has been regarded as the standard of care in ophthalmology, acting as an invaluable tool for the assessment of retinal pathology. However, the costly nature of most current commercial OCT systems has limited its general accessibility, especially in low-resource environments. It is therefore timely to review the development of low-cost OCT systems as a route for applying this technology to population-scale disease screening. Low-cost, portable and easy to use OCT systems will be essential to facilitate widespread use at point of care settings while ensuring that they offer the necessary imaging performances needed for clinical detection of retinal pathology. The development of low-cost OCT also offers the potential to enable application in fields outside ophthalmology by lowering the barrier to entry. In this paper, we review the current development and applications of low-cost, portable and handheld OCT in both translational and research settings. Design and cost-reduction techniques are described for general low-cost OCT systems, including considerations regarding spectrometer-based detection, scanning optics, system control, signal processing, and the role of 3D printing technology. Lastly, a review of clinical applications enabled by low-cost OCT is presented, along with a detailed discussion of current limitations and outlook.

Toward optical coherence tomography on a chip: in vivo three-dimensional human retinal imaging using photonic integrated circuit-based arrayed waveguide gratings

In this work, we present a significant step toward in vivo ophthalmic optical coherence tomography and angiography on a photonic integrated chip. The diffraction gratings used in spectral-domain optical coherence tomography can be replaced by photonic integrated circuits comprising an arrayed waveguide grating. Two arrayed waveguide grating designs with 256 channels were tested, which enabled the first chip-based optical coherence tomography and angiography in vivo three-dimensional human retinal measurements. Design 1 supports a bandwidth of 22 nm, with which a sensitivity of up to 91 dB (830 µW) and an axial resolution of 10.7 µm was measured. Design 2 supports a bandwidth of 48 nm, with which a sensitivity of 90 dB (480 µW) and an axial resolution of 6.5 µm was measured. The silicon nitride-based integrated optical waveguides were fabricated with a fully CMOS-compatible process, which allows their monolithic co-integration on top of an optoelectronic silicon chip. As a benchmark for chip-based optical coherence tomography, tomograms generated by a commercially available clinical spectral-domain optical coherence tomography system were compared to those acquired with on-chip gratings. The similarities in the tomograms demonstrate the significant clinical potential for further integration of optical coherence tomography on a chip system.

Optical coherence tomography in the 2020s-outside the eye clinic

Optical coherence tomography (OCT) is a paragon of success in the translation of biophotonics science to clinical practice. OCT systems have become ubiquitous in eye clinics but access beyond this is limited by their cost, size and the skill required to operate the devices. Remarkable progress has been made in the development of OCT technology to improve the speed of acquisition, the quality of images and into functional extensions of OCT such as OCT angiography. However, more needs to be done to radically improve the access to OCT by addressing its limitations and enable penetration outside of typical clinical settings and into underserved populations. Beyond high-income countries, there are 6.5 billion people with similar eye-care needs, which cannot be met by the current generation of bulky, expensive and complex OCT systems. In addition, advancing the portability of this technology to address opportunities in point-of-care diagnostics, telemedicine and remote monitoring may aid development of personalised medicine. In this review, we discuss the major milestones in OCT hardware development to reach those beyond the eye clinic.

Low-coherence digital holography with a multireflection reference mirror

A method for expanding the measurement range of low-coherence digital holography up to several times longer than the coherence length is proposed. The method was implemented with a multireflection reference mirror composed of partially and highly reflective mirrors, in conjunction with the Fourier transform method with spatial filtering for single-shot complex amplitude imaging, making it useful for observing a moving and deforming object. One of the features of the reference arm is that the measurement range is simply controlled by adjusting the position and angle of the highly reflective mirror. The measurement of objects with a general curved shape and a large step height was demonstrated.

The physiology of impenetrable skin: Colossus of the X-Men

The X-Men are an ensemble of superheroes whose powers are associated with the X-Gene, a mutant genetic factor. The powers exhibited by each character differ and are dependent on how the X-Gene has modified their individual genomes. For instance, Wolverine possesses regenerative healing, Storm can control local weather systems, and Colossus can create an impenetrable "organic steel" layer around his body. Thanks to the establishment of the superhero genre in modern cinema, audiences are familiar with Colossus from films such as X-Men: Days of Future Past and Deadpool. While attaining this power might be attractive to many people, there are innumerate scientific obstacles to be overcome to replicate this "organic steel" layer. Due to its unique combination of high strength and flexibility, a graphene-based layer might be a more realistic material for Colossus' impenetrable skin and would also address a number of physiological issues associated with an "organic steel" layer. The actualization of this layer would depend on complex processes associated with protein folding, protein self-assembly, and changing the structure of his skin. In the classroom, Colossus can foster a multidisciplinary learning environment where concepts in physiology can overlap with topics in physics, engineering, and materials science. Just like other superheroes, Colossus can also be used to promote scientific content in outreach for the general public.

Economical and compact briefcase spectral-domain optical coherence tomography system for primary care and point-of-care applications

Development of low-cost and portable optical coherence tomography (OCT) systems is of global interest in the OCT research community. Such systems enable utility broadly throughout a clinical facility, or in remote areas that often lack clinical infrastructure. We report the development and validation of a low-cost, portable briefcase spectral-domain optical coherence tomography (SD-OCT) system for point-of-care diagnostics in primary care centers and/or in remote settings. The self-contained briefcase OCT contains all associated optical hardware, including light source, spectrometer, hand-held probe, and a laptop. Additionally, this system utilizes unique real-time mosaicking of surface video images that are synchronized with rapid A-scan acquisition to eliminate the need for lateral scanning hardware, and enable the construction of cross-sectional B-mode images over extended lateral distances. The entire briefcase system weighs 9 kg and costs ∼USD$8000 using off-the-shelf components. System performance was validated by acquiring images of in vivo human skin on the fingertip, palm, and nail fold. The efficiency, portability, and low-cost enable accessibility and utility in primary care centers and low-resource settings.

Characterization of an amplified piezoelectric actuator for multiple-reference optical coherence tomography

The characterization of an amplified piezoelectric actuator (APA) as a new axial scanning method for multiple-reference optical coherence tomography (MR-OCT) is described. MR-OCT is a compact optical imaging device based on a recirculating reference-arm-scanning optical delay using a partial mirror that can enhance the imaging depth range by more than 10 times the reference mirror's scanning amplitude. The scanning amplitude of the used APA was varied between 30 μm and 250 μm, depending on the scanning frequency of between 0.8 kHz and 1.2 kHz. A silver-coated miniature mirror was attached to the APA via ultraviolet-cured optical adhesive, and the light source was a super-luminescent diode with 1310 nm center wavelength and 56 nm bandwidth. The sensitivity was measured with and without the partial mirror in the reference delay line as a function of scan speed, frequency, and range, therefore providing results for MR-OCT and TD-OCT modes. It was found that the APA provides more than twice the mechanical scanning range compared to other opto-mechanic actuators, but results indicate degradation of signal-to-noise ratio and sensitivity at larger imaging depths. In conjunction with MR-OCT, the scan range of maximum 200 μm can be enhanced up to 1-1.5 mm by using a reduced amount of orders of reflections, which could be of interest to increase sensitivity in the future.