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Brenes D, Kortum A, Coole J, Carns J, Schwarz R, Vohra I, Richards-Kortum R, Liu Y, Cai Z, Sigel K, Anandasabapathy S, Gaisa M, Chiao E. Deployment and assessment of a deep learning model for real-time detection of anal precancer with high frame rate high-resolution microendoscopy. Sci Rep 2023; 13:22267. [PMID: 38097594 PMCID: PMC10721617 DOI: 10.1038/s41598-023-49197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
Anal cancer incidence is significantly higher in people living with HIV as HIV increases the oncogenic potential of human papillomavirus. The incidence of anal cancer in the United States has recently increased, with diagnosis and treatment hampered by high loss-to-follow-up rates. Novel methods for the automated, real-time diagnosis of AIN 2+ could enable "see and treat" strategies, reducing loss-to-follow-up rates. A previous retrospective study demonstrated that the accuracy of a high-resolution microendoscope (HRME) coupled with a deep learning model was comparable to expert clinical impression for diagnosis of AIN 2+ (sensitivity 0.92 [P = 0.68] and specificity 0.60 [P = 0.48]). However, motion artifacts and noise led to many images failing quality control (17%). Here, we present a high frame rate HRME (HF-HRME) with improved image quality, deployed in the clinic alongside a deep learning model and evaluated prospectively for detection of AIN 2+ in real-time. The HF-HRME reduced the fraction of images failing quality control to 4.6% by employing a high frame rate camera that enhances contrast and limits motion artifacts. The HF-HRME outperformed the previous HRME (P < 0.001) and clinical impression (P < 0.0001) in the detection of histopathologically confirmed AIN 2+ with a sensitivity of 0.91 and specificity of 0.87.
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Affiliation(s)
- David Brenes
- Department of Bioengineering, Rice University, MS-142 6100 Main St., Houston, TX, 77005, USA.
| | - Alex Kortum
- Department of Bioengineering, Rice University, MS-142 6100 Main St., Houston, TX, 77005, USA
| | - Jackson Coole
- Department of Bioengineering, Rice University, MS-142 6100 Main St., Houston, TX, 77005, USA
| | - Jennifer Carns
- Department of Bioengineering, Rice University, MS-142 6100 Main St., Houston, TX, 77005, USA
| | - Richard Schwarz
- Department of Bioengineering, Rice University, MS-142 6100 Main St., Houston, TX, 77005, USA
| | - Imran Vohra
- Biotex, 114 Holmes Rd., Houston, TX, 77045, USA
| | - Rebecca Richards-Kortum
- Department of Bioengineering, Rice University, MS-142 6100 Main St., Houston, TX, 77005, USA
| | - Yuxin Liu
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Zhenjian Cai
- Clinical Pathology Laboratories, 9200 Wall Street, Austin, TX, 78754, USA
| | - Keith Sigel
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY, 10029, USA
| | | | - Michael Gaisa
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY, 10029, USA
| | - Elizabeth Chiao
- Department of Epidemiology, Division of Cancer Prevention, University of Texas - MD Anderson Cancer Center, 1155 Pressler St., Unit 1340, Houston, TX, 77030, USA.
- Department Epidemiology, Division of Cancer Prevention, and Department of General Oncology, Division of Cancer Medicine, University of Texas - MD Anderson Cancer Center, 1155 Pressler St., Unit 1340, Houston, TX, 77030, USA.
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2
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Hou H, Tang Y, Coole JB, Kortum A, Schwarz RA, Carns J, Gillenwater AM, Ramalingam P, Milbourne A, Salcedo MP, Schmeler KM, Richards-Kortum RR. Scanning darkfield high-resolution microendoscope for label-free microvascular imaging. BIOMEDICAL OPTICS EXPRESS 2023; 14:5097-5112. [PMID: 37854554 PMCID: PMC10581811 DOI: 10.1364/boe.498584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023]
Abstract
Characterization of microvascular changes during neoplastic progression has the potential to assist in discriminating precancer and early cancer from benign lesions. Here, we introduce a novel high-resolution microendoscope that leverages scanning darkfield reflectance imaging to characterize angiogenesis without exogenous contrast agents. Scanning darkfield imaging is achieved by coupling programmable illumination with a complementary metal-oxide semiconductor (CMOS) camera rolling shutter, eliminating the need for complex optomechanical components and making the system portable, low-cost (<$5,500) and simple to use. Imaging depth is extended by placing a gradient-index (GRIN) lens at the distal end of the imaging fiber to resolve subepithelial microvasculature. We validated the capability of the scanning darkfield microendoscope to visualize microvasculature at different anatomic sites in vivo by imaging the oral cavity of healthy volunteers. Images of cervical specimens resected for suspected neoplasia reveal distinct microvascular patterns in columnar and squamous epithelium with different grades of precancer, indicating the potential of scanning darkfield microendoscopy to aid in efforts to prevent cervical cancer through early diagnosis.
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Affiliation(s)
- Huayu Hou
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Yubo Tang
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Jackson B. Coole
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Alex Kortum
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | | | - Jennifer Carns
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Ann M. Gillenwater
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Preetha Ramalingam
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Andrea Milbourne
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mila P. Salcedo
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Obstetrics and Gynecology, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Santa Casa Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Kathleen M. Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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3
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Choi W, Kang M, Hong JH, Katz O, Lee B, Kim GH, Choi Y, Choi W. Flexible-type ultrathin holographic endoscope for microscopic imaging of unstained biological tissues. Nat Commun 2022; 13:4469. [PMID: 35918348 PMCID: PMC9345988 DOI: 10.1038/s41467-022-32114-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/18/2022] [Indexed: 12/20/2022] Open
Abstract
Ultrathin lensless fibre endoscopes offer minimally invasive investigation, but they mostly operate as a rigid type due to the need for prior calibration of a fibre probe. Furthermore, most implementations work in fluorescence mode rather than label-free imaging mode, making them unsuitable for general medical diagnosis. Herein, we report a fully flexible ultrathin fibre endoscope taking 3D holographic images of unstained tissues with 0.85-μm spatial resolution. Using a bare fibre bundle as thin as 200-μm diameter, we design a lensless Fourier holographic imaging configuration to selectively detect weak reflections from biological tissues, a critical step for label-free endoscopic reflectance imaging. A unique algorithm is developed for calibration-free holographic image reconstruction, allowing us to image through a narrow and curved passage regardless of fibre bending. We demonstrate endoscopic reflectance imaging of unstained rat intestine tissues that are completely invisible to conventional endoscopes. The proposed endoscope will expedite a more accurate and earlier diagnosis than before with minimal complications.
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Affiliation(s)
- Wonjun Choi
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea.,Department of Physics, Korea University, Seoul, Republic of Korea
| | - Munkyu Kang
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea.,Department of Physics, Korea University, Seoul, Republic of Korea
| | - Jin Hee Hong
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea.,Department of Physics, Korea University, Seoul, Republic of Korea
| | - Ori Katz
- Department of Applied Physics, The Selim and Rachel Benin School of Computer Science & Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Byunghak Lee
- Korea Electrotechnology Research Institute, Ansan, Korea.,B2LAB co., ltd, Pohang-si, Gyeongsangbuk, Korea
| | - Guang Hoon Kim
- Korea Electrotechnology Research Institute, Ansan, Korea
| | - Youngwoon Choi
- Department of Bioengineering, Korea University, Seoul, Republic of Korea. .,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
| | - Wonshik Choi
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea. .,Department of Physics, Korea University, Seoul, Republic of Korea.
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4
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Kulkarni N, Masciola A, Nishant A, Kim KJ, Choi H, Gmitro A, Freeman EE, Semeere A, Nakalembe M, Kang D. Low-cost, chromatic confocal endomicroscope for cellular imaging in vivo. BIOMEDICAL OPTICS EXPRESS 2021; 12:5629-5643. [PMID: 34692205 PMCID: PMC8515984 DOI: 10.1364/boe.434892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 05/06/2023]
Abstract
We have developed a low-cost, chromatic confocal endomicroscope (CCE) that can image a cross-section of the tissue at cellular resolution. In CCE, a custom miniature objective lens was used to focus different wavelengths into different tissue depths. Therefore, each tissue depth was encoded with the wavelength. A custom miniature spectrometer was used to spectrally-disperse light reflected from the tissue and generate cross-sectional confocal images. The CCE prototype had a diameter of 9.5 mm and a length of 68 mm. Measured resolution was high, 2 µm and 4 µm for lateral and axial directions, respectively. Effective field size was 468 µm. Preliminary results showed that CCE can visualize cellular details from cross-sections of the tissue in vivo down to the tissue depth of 100 µm.
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Affiliation(s)
- Nachiket Kulkarni
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Andrew Masciola
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Abhinav Nishant
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Kyung-Jo Kim
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Heejoo Choi
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Arthur Gmitro
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Aggrey Semeere
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Miriam Nakalembe
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Dongkyun Kang
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
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5
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Tang Y, Kortum A, Vohra I, Schwarz RA, Carns J, Kannady CR, Clavell-Hernandez J, Hu Z, Dhanani N, Richards-Kortum R. Initial Results of First In Vivo Imaging of Bladder Lesions Using a High-Resolution Confocal Microendoscope. J Endourol 2021; 35:1190-1197. [PMID: 33307957 DOI: 10.1089/end.2020.0757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Purpose: Conventional cystoscopy plays an important role in detection of bladder cancer; however, it is difficult to differentiate benign and neoplastic lesions based on cystoscopic appearance alone. Advanced microscopic modalities, such as confocal laser endomicroscopy and optical coherence tomography, have been shown to provide critical histopathologic information to help identify neoplastic bladder lesions in real time, but their availability and clinical adoption are limited due to a high cost. In this study, we present the first use of a novel and low-cost ($ <5000) confocal high-resolution microendoscope (confocal HRME) for in vivo imaging of bladder lesions. Materials and Methods: In a cohort of 15 patients undergoing white light cystoscopy as part of their standard of care, high-resolution images of proflavine-stained bladder lesions were acquired in vivo using the confocal HRME. Based on these images, we evaluated the ability of the confocal HRME to visualize uroepithelium with subcellular resolution and high contrast. Furthermore, we analyzed the cellular architecture and staining patterns of benign and neoplastic bladder lesions in confocal HRME images and compared results to that of standard cystoscopy and histopathology. Results: In vivo imaging in the pilot study demonstrates that the confocal HRME resolved subcellular structures of bladder uroepithelium with high contrast. In a wide range of clinical conditions from normal bladder wall to benign and neoplastic lesions, confocal HRME images revealed important diagnostic features that correlated to histopathology. Conclusions: The confocal HRME provides an affordable, portable, and easy-to-use tool to allow real-time and high-contrast subcellular characterization of bladder lesions, well suited for bladder cancer detection in community and resource-constrained settings. The ClinicalTrials.gov Identifier: NCT02340650.
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Affiliation(s)
- Yubo Tang
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Alex Kortum
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Imran Vohra
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | - Jennifer Carns
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Christopher R Kannady
- Department of Surgery and University of Texas Health Science Center at Houston, Houston, Texas, USA
| | | | - Zhihong Hu
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Nadeem Dhanani
- Department of Surgery and University of Texas Health Science Center at Houston, Houston, Texas, USA
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6
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Tang Y, Kortum A, Parra SG, Vohra I, Milbourne A, Ramalingam P, Toscano PA, Schmeler KM, Richards-Kortum RR. In vivo imaging of cervical precancer using a low-cost and easy-to-use confocal microendoscope. BIOMEDICAL OPTICS EXPRESS 2020; 11:269-280. [PMID: 32010516 PMCID: PMC6968771 DOI: 10.1364/boe.381064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 05/08/2023]
Abstract
Cervical cancer incidence and mortality rates remain high in medically underserved areas. In this study, we present a low-cost (<$5,000), portable and user-friendly confocal microendoscope, and we report on its clinical use to image precancerous lesions in the cervix. The confocal microendoscope employs digital apertures on a digital light projector and a CMOS sensor to implement line-scanning confocal imaging. Leveraging its versatile programmability, we describe an automated aperture alignment algorithm to ensure clinical ease-of-use and to facilitate technology dissemination in low-resource settings. Imaging performance is then evaluated in ex vivo and in vivo pilot studies; results demonstrate that the confocal microendoscope can enhance visualization of nuclear morphology, contributing to significantly improved recognition of clinically important features for detection of cervical precancer.
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Affiliation(s)
- Yubo Tang
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
- The authors contributed equally to this work
| | - Alex Kortum
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
- The authors contributed equally to this work
| | - Sonia G. Parra
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - Imran Vohra
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - Andrea Milbourne
- The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX 77057, USA
| | - Preetha Ramalingam
- The University of Texas MD Anderson Cancer Center, Department of Pathology, Houston, TX 77030, USA
| | - Paul A. Toscano
- The University of Texas Health Science Center at Houston, School of Public Health, Brownsville, TX 78520, USA
| | - Kathleen M. Schmeler
- The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX 77057, USA
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Kundrod KA, Smith CA, Hunt B, Schwarz RA, Schmeler K, Richards-Kortum R. Advances in technologies for cervical cancer detection in low-resource settings. Expert Rev Mol Diagn 2019; 19:695-714. [PMID: 31368827 DOI: 10.1080/14737159.2019.1648213] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Cervical cancer mortality rates remain high in low- and middle-income countries (LMICs) and other medically underserved areas due to challenges with implementation and sustainability of routine screening, accurate diagnosis, and early treatment of preinvasive lesions. Areas covered: In this review, we first discuss the standard of care for cervical cancer screening and diagnosis in high- and low-resource settings, biomarkers that correlate to cervical precancer and cancer, and needs for new tests. We review technologies for screening and diagnosis with a focus on tests that are already in use in LMICs or have the potential to be adapted for use in LMICs. Finally, we provide perspectives on the next five years of technology development for improved cervical cancer screening and diagnosis in LMICs. Expert opinion: Innovation toward improved molecular and imaging tests is needed to enable effective, affordable see-and-treat approaches to detect and treat cervical precancer in a single visit. Current molecular tests remain too complex and/or costly for widespread use. Especially with imaging tests, decision support may improve performance of new technologies.
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Affiliation(s)
| | - Chelsey A Smith
- Department of Bioengineering, Rice University , Houston , TX , USA
| | - Brady Hunt
- Department of Bioengineering, Rice University , Houston , TX , USA
| | | | - Kathleen Schmeler
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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Tang Y, Kortum A, Vohra I, Othman M, Dhingra S, Mansour N, Carns J, Anandasabapathy S, Richards-Kortum R. Improving nuclear morphometry imaging with real-time and low-cost line-scanning confocal microendoscope. OPTICS LETTERS 2019; 44:654-657. [PMID: 30702702 PMCID: PMC6644037 DOI: 10.1364/ol.44.000654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Fiber-optic endomicroscopy is a minimally invasive tool to probe disease progression with subcellular resolution. In this Letter, we demonstrate a low-cost and compact fluorescence microendoscope capable of line-scanning confocal imaging by synchronizing a digital light projector with a CMOS camera. We present the digital aperture design to enable real-time confocal imaging, and we implement parallel illumination to improve the optical sectioning performance. Furthermore, we show that the confocal microendoscope can enhance visualization of disease-associated features when imaging highly scattering esophageal specimens.
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9
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Dussaux C, Szabo V, Chastagnier Y, Fodor J, Léger JF, Bourdieu L, Perroy J, Ventalon C. Fast confocal fluorescence imaging in freely behaving mice. Sci Rep 2018; 8:16262. [PMID: 30389966 PMCID: PMC6214968 DOI: 10.1038/s41598-018-34472-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/12/2018] [Indexed: 12/13/2022] Open
Abstract
Fluorescence imaging in the brain of freely behaving mice is challenging due to severe miniaturization constraints. In particular, the ability to image a large field of view at high temporal resolution and with efficient out-of-focus background rejection still raises technical difficulties. Here, we present a novel fiberscope system that provides fast (up to 200 Hz) background-free fluorescence imaging in freely behaving mice over a field of view of diameter 230 μm. The fiberscope is composed of a custom-made multipoint-scanning confocal microscope coupled to the animal with an image guide and a micro-objective. By simultaneously registering a multipoint-scanning confocal image and a conventional widefield image, we subtracted the residual out-of-focus background and provided a background-free confocal image. Illumination and detection pinholes were created using a digital micromirror device, providing high adaptability to the sample structure and imaging conditions. Using this novel imaging tool, we demonstrated fast fluorescence imaging of microvasculature up to 120 μm deep in the mouse cortex, with an out-of-focus background reduced by two orders of magnitude compared with widefield microscopy. Taking advantage of the high acquisition rate (200 Hz), we measured red blood cell velocity in the cortical microvasculature and showed an increase in awake, unrestrained mice compared with anaesthetized animals.
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Affiliation(s)
- Clara Dussaux
- Institut de biologie de l'École Normale Supérieure (IBENS), École Normale Supérieure, CNRS, INSERM, PSL Research University, 46 rue d'Ulm, Paris, 75005, France
| | - Vivien Szabo
- IGF, Univ. Montpellier, CNRS, INSERM, 141 rue de la Cardonille, Montpellier, 34094, France
| | - Yan Chastagnier
- IGF, Univ. Montpellier, CNRS, INSERM, 141 rue de la Cardonille, Montpellier, 34094, France
| | - Jozsua Fodor
- Institut de biologie de l'École Normale Supérieure (IBENS), École Normale Supérieure, CNRS, INSERM, PSL Research University, 46 rue d'Ulm, Paris, 75005, France
| | - Jean-François Léger
- Institut de biologie de l'École Normale Supérieure (IBENS), École Normale Supérieure, CNRS, INSERM, PSL Research University, 46 rue d'Ulm, Paris, 75005, France
| | - Laurent Bourdieu
- Institut de biologie de l'École Normale Supérieure (IBENS), École Normale Supérieure, CNRS, INSERM, PSL Research University, 46 rue d'Ulm, Paris, 75005, France
| | - Julie Perroy
- IGF, Univ. Montpellier, CNRS, INSERM, 141 rue de la Cardonille, Montpellier, 34094, France
| | - Cathie Ventalon
- Institut de biologie de l'École Normale Supérieure (IBENS), École Normale Supérieure, CNRS, INSERM, PSL Research University, 46 rue d'Ulm, Paris, 75005, France.
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