DYNAMIC OPTICAL COHERENCE ELASTOGRAPHY: A REVIEW

Acoustomotive diffuse correlation spectroscopy for sensing mechanical stiffness in tissue-mimicking phantoms

Many diseases, such as inflammation, dropsy, or tumors, often cause alterations in the mechanical stiffness of human tissues. Ultrasound-based techniques are commonly adopted in clinics for stiffness assessment, whereas optical methodologies hold promise for sensing strain changes and providing optical information pertaining to the microcirculatory network, thereby facilitating comprehensive measurements of tissue physiopathology. Diffuse correlation spectroscopy (DCS), an emerging dynamic light scattering technique, has been used to capture the enhanced motion of light scatterers induced by acoustic radiation force (ARF). Theoretically, the amplitude of this enhanced scatterers motion is related to the medium stiffness. Based on this relationship, we report a light coherent technique that combines ARF and DCS to qualitatively evaluate changes in the stiffness of medium. We experimentally demonstrate the accuracy and feasibility of this technique for probing stiffness in homogeneous phantom by comparing it with independent ultrasound methods. Additionally, we explore a potential application of this technique in distinguishing between fluid filled lesion and homogeneous tissue through heterogeneous phantom experiments. This unique combination of ARF and DCS, namely, acoustomotive DCS (AM-DCS), would provide an alternative way to measure particle-motion related stiffness, thereby assisting in the diagnosis and treatment of diseases.

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

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

In Vivo Evaluation of the Effects of SMILE with Different Amounts of Stromal Ablation on Corneal Biomechanics by Optical Coherence Elastography

This work aims to depth-resolved quantitatively analyze the effect of different stromal ablation amounts on the corneal biomechanical properties during small incision lenticule extraction (SMILE) using optical coherence elastography (OCE). A 4.5-MHz ultrasonic transducer was used to excite elastic waves in the corneal tissue. The OCE system combined with the antisymmetric Lamb wave model was employed to achieve a high-resolution, high-sensitivity, and depth-resolved quantitative detection of the corneal Young's modulus. Eighteen rabbits were randomly divided into three groups; each group had six rabbits. The first and second groups underwent -3D and -6D SMILE surgeries, and the third group was the control group, respectively. Young's modulus of the corneal cap and residual stromal bed (RSB) were both increased after SMILE, which shared the stress under intraocular pressure (IOP). Furthermore, the Young's modulus of both the corneal cap and RSB after 3D SMILE group were significantly lower than that in the -6D group, which indicated that the increases in the post-operative corneal Young's modulus were positively correlated with the amount of stromal ablation. The OCE system for quantitative spatial characterization of corneal biomechanical properties can provide useful information on the extent of safe ablation for SMILE procedures.

Intravascular optical coherence elastography

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

Comparison between a phenomenological approach and a morphoelasticity approach regarding the displacement of extracellular matrix

Plastic (permanent) deformations were earlier, modeled by a phenomenological model in Peng and Vermolen (Biomech Model Mechanobiol 19(6):2525–2551, 2020). In this manusctipt, we consider a more physics-based formulation that is based on morphoelasticity. We firstly introduce the morphoelasticity approach and investigate the impact of various input variables on the output parameters by sensitivity analysis. A comparison of both model formulations shows that both models give similar computational results. Furthermore, we carry out Monte Carlo simulations of the skin contraction model containing the morphoelasticity approach. Most statistical correlations from the two models are similar, however, the impact of the collagen density on the severeness of contraction is larger for the morphoelasticity model than for the phenomenological model.

Pulsatile tissue deformation dynamics of the murine retina and choroid mapped by 4D optical coherence tomography

Irregular ocular pulsatility and altered mechanical tissue properties are associated with some of the most sight-threatening eye diseases. Here we present 4D optical coherence tomography (OCT) for the quantitative assessment and depth-resolved mapping of pulsatile dynamics in the murine retina and choroid. Through a pixel-wise analysis of phase changes of the complex OCT signal, we reveal spatiotemporal displacement characteristics across repeated frame acquisitions. We demonstrate in vivo fundus elastography (FUEL) imaging in wildtype mouse retinas and in a mouse model of retinal neovascularization and uncover subtle structural deformations related to ocular pulsation. Our data in mouse eyes hold promise for a powerful retinal elastography technique that may enable a new paradigm of OCT-based measurements and image contrast.

Speckle-dependent accuracy in phase-sensitive optical coherence tomography

Phase-sensitive optical coherence tomography (OCT) is used to measure motion in a range of techniques, such as Doppler OCT and optical coherence elastography (OCE). In phase-sensitive OCT, motion is typically estimated using a model of the OCT signal derived from a single reflector. However, this approach is not representative of turbid samples, such as tissue, which exhibit speckle. In this study, for the first time, we demonstrate, through theory and experiment that speckle significantly lowers the accuracy of phase-sensitive OCT in a manner not accounted for by the OCT signal-to-noise ratio (SNR). We describe how the inaccuracy in speckle reduces phase difference sensitivity and introduce a new metric, speckle brightness, to quantify the amount of constructive interference at a given location in an OCT image. Experimental measurements show an almost three-fold degradation in sensitivity between regions of high and low speckle brightness at a constant OCT SNR. Finally, we apply these new results in compression OCE to demonstrate a ten-fold improvement in strain sensitivity, and a five-fold improvement in contrast-to-noise by incorporating independent speckle realizations. Our results show that speckle introduces a limit to the accuracy of phase-sensitive OCT and that speckle brightness should be considered to avoid erroneous interpretation of experimental data.

Ultrasound Shear Wave Elastography and Transient Optical Coherence Elastography: Side-by-Side Comparison of Repeatability and Accuracy

Objective: We compare the repeatability and accuracy of ultrasound shear wave elastography (USE) and transient optical coherence elastography (OCE). Methods: Elastic wave speed in gelatin phantoms and chicken breast was measured with USE and OCE and compared with uniaxial mechanical compression testing. Intra- and Inter-repeatability were analyzed using Bland-Altman plots and intraclass correlation coefficients (ICC). Results: OCE and USE differed from uniaxial testing by a mean absolute percent error of 8.92% and 16.9%, respectively, across eight phantoms of varying stiffness. Upper and lower limits of agreement for intrasample repeatability for USE and OCE were ±0.075 m/s and −0.14 m/s and 0.13 m/s, respectively. OCE and USE both had ICCs of 0.9991. In chicken breast, ICC for USE was 0.9385 and for OCE was 0.9924. Conclusion: OCE and USE can detect small speed changes and give comparable measurements. These measurements correspond well with uniaxial testing.

A formalism for modelling traction forces and cell shape evolution during cell migration in various biomedical processes

The phenomenological model for cell shape deformation and cell migration Chen (BMM 17:1429–1450, 2018), Vermolen and Gefen (BMM 12:301–323, 2012), is extended with the incorporation of cell traction forces and the evolution of cell equilibrium shapes as a result of cell differentiation. Plastic deformations of the extracellular matrix are modelled using morphoelasticity theory. The resulting partial differential differential equations are solved by the use of the finite element method. The paper treats various biological scenarios that entail cell migration and cell shape evolution. The experimental observations in Mak et al. (LC 13:340–348, 2013), where transmigration of cancer cells through narrow apertures is studied, are reproduced using a Monte Carlo framework.

Biomechanical sensing of in vivo magnetic nanoparticle hyperthermia-treated melanoma using magnetomotive optical coherence elastography

Rationale: Magnetic nanoparticle hyperthermia (MH) therapy is capable of thermally damaging tumor cells, yet a biomechanically-sensitive monitoring method for the applied thermal dosage has not been established. Biomechanical changes to tissue are known indicators for tumor diagnosis due to its association with the structural organization and composition of tissues at the cellular and molecular level. Here, by exploiting the theranostic functionality of magnetic nanoparticles (MNPs), we aim to explore the potential of using stiffness-based metrics that reveal the intrinsic biophysical changes of in vivo melanoma tumors after MH therapy. Methods: A total of 14 melanoma-bearing mice were intratumorally injected with dextran-coated MNPs, enabling MH treatment upon the application of an alternating magnetic field (AMF) at 64.7 kHz. The presence of the MNP heating sources was detected by magnetomotive optical coherence tomography (MM-OCT). For the first time, the elasticity alterations of the hyperthermia-treated, MNP-laden, in vivo tumors were also measured with magnetomotive optical coherence elastography (MM-OCE), based on the mechanical resonant frequency detected. To investigate the correlation between stiffness changes and the intrinsic biological changes, histopathology was performed on the excised tumor after the in vivo measurements. Results: Distinct shifts in mechanical resonant frequency were observed only in the MH-treated group, suggesting a heat-induced stiffness change in the melanoma tumor. Moreover, tumor cellularity, protein conformation, and temperature rise all play a role in tumor stiffness changes after MH treatment. With low cellularity, tumor softens after MH even with low temperature elevation. In contrast, with high cellularity, tumor softening occurs only with a low temperature rise, which is potentially due to protein unfolding, whereas tumor stiffening was seen with a higher temperature rise, likely due to protein denaturation. Conclusions: This study exploits the theranostic functionality of MNPs and investigates the MH-induced stiffness change on in vivo melanoma-bearing mice with MM-OCT and MM-OCE for the first time. It was discovered that the elasticity alteration of the melanoma tumor after MH treatment depends on both thermal dosage and the morphological features of the tumor. In summary, changes in tissue-level elasticity can potentially be a physically and physiologically meaningful metric and integrative therapeutic marker for MH treatment, while MM-OCE can be a suitable dosimetry technique.

Advances in multimodal imaging in ophthalmology

Multimodality ophthalmic imaging systems aim to enhance the contrast, resolution, and functionality of existing technologies to improve disease diagnostics and therapeutic guidance. These systems include advanced acquisition and post-processing methods using optical coherence tomography (OCT), combined scanning laser ophthalmoscopy and OCT systems, adaptive optics, surgical guidance, and photoacoustic technologies. Here, we provide an overview of these ophthalmic imaging systems and their clinical and basic science applications.

Camera-based optical palpation

Optical elastography is undergoing extensive development as an imaging tool to map mechanical contrast in tissue. Here, we present a new platform for optical elastography by generating sub-millimetre-scale mechanical contrast from a simple digital camera. This cost-effective, compact and easy-to-implement approach opens the possibility to greatly expand applications of optical elastography both within and beyond the field of medical imaging. Camera-based optical palpation (CBOP) utilises a digital camera to acquire photographs that quantify the light intensity transmitted through a silicone layer comprising a dense distribution of micro-pores (diameter, 30-100 µm). As the transmission of light through the micro-pores increases with compression, we deduce strain in the layer directly from intensity in the digital photograph. By pre-characterising the relationship between stress and strain of the layer, the measured strain map can be converted to an optical palpogram, a map of stress that visualises mechanical contrast in the sample. We demonstrate a spatial resolution as high as 290 µm in CBOP, comparable to that achieved using an optical coherence tomography-based implementation of optical palpation. In this paper, we describe the fabrication of the micro-porous layer and present experimental results from structured phantoms containing stiff inclusions as small as 0.5 × 0.5 × 1 mm. In each case, we demonstrate high contrast between the inclusion and the base material and validate both the contrast and spatial resolution achieved using finite element modelling. By performing CBOP on freshly excised human breast tissue, we demonstrate the capability to delineate tumour from surrounding benign tissue.

Agent-based modelling and parameter sensitivity analysis with a finite-element method for skin contraction

In this paper, we extend the model of wound healing by Boon et al. (J Biomech 49(8):1388–1401, 2016). In addition to explaining the model explicitly regarding every component, namely cells, signalling molecules and tissue bundles, we categorized fibroblasts as regular fibroblasts and myofibroblasts. We do so since it is widely documented that myofibroblasts play a significant role during wound healing and skin contraction and that they are the main phenotype of cells that is responsible for the permanent deformations. Furthermore, we carried out some sensitivity tests of the model by modifying certain parameter values, and we observe that the model shows some consistency with several biological phenomena. Using Monte Carlo simulations, we found that there is a significant strong positive correlation between the final wound area and the minimal wound area. The high correlation between the wound area after 4 days and the final/minimal wound area makes it possible for physicians to predict the most probable time evolution of the wound of the patient. However, the collagen density ratio at the time when the wound area reaches its equilibrium and minimum, cannot indicate the degree of wound contractions, whereas at the 4th day post-wounding, when the collagen is accumulating from null, there is a strong negative correlation between the area and the collagen density ratio. Further, under the circumstances that we modelled, the probability that patients will end up with 5% contraction is about 0.627.

Surface wave investigation and phenomenological analysis: Application on in vivo human cutaneous tissue

The wave phenomenon in free surface media stems from the propagation of mode grouping. Due to the nature of propagation in a given medium, this phenomenon expresses different types of dependence on the medium's properties and represents its mechanical admittance. In contrast with body wave propagation, dependencies related to surface propagation in a medium can be described by spatial-temporal characteristics. These characteristics can be obtained by performing appropriate experiments and do not require prior knowledge of the physical properties of the medium. In this study, we propose an original surface wave investigation and a phenomenological analysis approach adapted to the mechano-bio-structural states evaluation of in vivo human skin. Two objectives are sought with the method proposed: the first concerns the development of a non-invasive device for generating and tracking surface waves in human skin called Free-Skin-Surface-Wave (FSSW); the second concerns the adaptation of the Multi-Chanel Analysis of Surface Waves (MASW) method to evaluate the mechano-bio-structural states of human cutaneous tissue in vivo on the basis of the propagating phenomena observed. As an illustration of the proposed method application, we have done an in vivo evaluation, on intern-forearm of female volunteers population. In addition, we proposed a study of the aging effect and a comparison with ultrasound B-Mode technique, to validate the method sensitivity to follow the mechano-morphological properties of the in vivo human skin. In this study, our medium of application was human skin in vivo, but it is conceivable to extend this application to other soft biological media.

Laser-induced elastic wave classification: thermoelastic versus ablative regimes for all-optical elastography applications

SIGNIFICANCE

Shear wave optical coherence elastography is an emerging technique for characterizing tissue biomechanics that relies on the generation of elastic waves to obtain the mechanical contrast. Various techniques, such as contact, acoustic, and pneumatic methods, have been used to induce elastic waves. However, the lack of higher-frequency components within the elastic wave restricts their use in thin samples. The methods also require moving parts and/or tubing, which therefore limits the extent to which they can be miniaturized.

AIM

To overcome these limitations, we propose an all-optical approach using photothermal excitation. Depending on the absorption coefficient of the sample and the laser pulse energy, elastic waves are generated either through a thermoelastic or an ablative process. Our study aimed to experimentally determine the boundary between the thermoelastic and the ablative regimes for safe all-optical elastography applications.

APPROACH

Tissue-mimicking graphite-doped phantoms and chicken liver samples were used to investigate the boundary between thermoelastic and ablative regimes. A pulsed laser at 532 nm was used to induce elastic waves in the samples. Laser-induced elastic waves were detected using a line field low coherence holography instrument. The shape of the elastic wave amplitude was analyzed and used to determine the transition point between thermoelastic and ablative regimes.

RESULTS

The transition from the thermoelastic to the ablative regime is accompanied by the nonlinear increase in surface wave amplitude as well as the transformation of the wave shape. Correlation between the absorption coefficient and the transition point energy was experimentally determined using graphite-doped phantoms and applied to biological samples ex vivo.

CONCLUSIONS

Our study described a methodology for determining the boundary region between thermoelastic and ablative regimes of elastic wave generation. These can be used for the development of a safe method for completely noncontact, all-optical microscale assessment of tissue biomechanics using laser-induced elastic waves.

Effects of Thickness on Corneal Biomechanical Properties Using Optical Coherence Elastography

SIGNIFICANCE

Measured corneal biomechanical properties are driven by intraocular pressure, tissue thickness, and inherent material properties. We demonstrate tissue thickness as an important factor in the measurement of corneal biomechanics that can confound short-term effects due to UV riboflavin cross-linking (CXL) treatment.

PURPOSE

We isolate the effects of tissue thickness on the measured corneal biomechanical properties using optical coherence elastography by experimentally altering the tissue hydration state and stiffness.

METHODS

Dynamic optical coherence elastography was performed using phase-sensitive optical coherence tomography imaging to quantify the tissue deformation dynamics resulting from a spatially discrete, low-force air pulse (150-μm spot size; 0.8-millisecond duration; <10 Pa [<0.08 mmHg]). The time-dependent surface deformation is characterized by a viscoelastic tissue recovery response, quantified by an exponential decay constant-relaxation rate. Ex vivo rabbit globes (n = 10) with fixed intraocular pressure (15 mmHg) were topically instilled every 5 minutes with 0.9% saline for 60 minutes and 20% dextran for another 60 minutes. Measurements were made after every 20 minutes to determine the central corneal thickness (CCT) and the relaxation rates. Cross-linking treatment was performed on another 13 eyes, applying isotonic riboflavin (n = 6) and hypertonic riboflavin (n = 7) every 5 minutes for 30 minutes, followed by UV irradiation (365 nm, 3 mW/cm) for 30 minutes while instilling riboflavin. Central corneal thickness and relaxation rates were obtained before and after CXL treatment.

RESULTS

Corneal thickness was positively correlated (R = 0.9) with relaxation rates. In the CXL-treated eyes, isotonic riboflavin did not affect CCT and showed a significant increase in relaxation rates (+10%; P = .01) from 2.29 ms to 2.53 ms. Hypertonic riboflavin showed a significant CCT decrease (-31%; P = .01) from 618 μm to 429 μm but showed little change in relaxation rates after CXL treatment.

CONCLUSIONS

Corneal thickness and stiffness are correlated positively. A higher relaxation rate implied stiffer material properties after isotonic CXL treatment. Hypertonic CXL treatment results in a stiffness decrease that offsets the stiffness increase with CXL treatment.

Towards mechanical characterization of granular biofilms by optical coherence elastography measurements of circumferential elastic waves

Microbial granular biofilms are spherical, multi-layered aggregates composed of communities of bacterial cells encased in a complex matrix of hydrated extracellular polymeric substances (EPS). While granular aggregates are increasingly used for applications in industrial and municipal wastewater treatment, their underlying mechanical properties are poorly understood. The challenges of viscoelastic characterization for these structures are due to their spherical geometry, spatially heterogeneous properties, and their delicate nature. In this study, we report a model-based approach for nondestructive characterization of viscoelastic properties (shear modulus and shear viscosity) of alginate spheres with different concentrations, which was motivated by our measurements in granular biofilms. The characterization technique relies on experimental measurements of circumferential elastic wave speeds as a function of frequency in the samples using the Optical Coherence Elastography (OCE) technique. A theoretical model was developed to estimate the viscoelastic properties of the samples from OCE data through inverse analysis. This work represents the first attempt to explore elastic waves for mechanical characterization of granular biofilms. The combination of the OCE technique and the theoretical model presented in this paper provides a framework that can facilitate quantitative viscoelastic characterization of samples with curved geometries and the study of the relationships between morphology and mechanical properties in granular biofilms.

Interstitial magnetic thermotherapy dosimetry based on shear wave magnetomotive optical coherence elastography

While magnetic thermoseeds are often utilized in interstitial magnetic thermotherapy (iMT) to enable localized tumor ablation, we propose to extend their use as the perturbative source in magnetomotive optical coherence elastography (MM-OCE) so that the heat-induced elasticity alterations can be 'theranostically' probed. MM-OCE measurements were found to agree with indentation results. Tissue stiffening was visualized on iMT-treated porcine liver and canine soft tissue sarcoma specimens, where histology confirmed thermal damages. Additionally, the elasticity was found to increase exponentially and linearly with the conventional thermal dosage metrics and the deposited thermal energy, respectively. Collectively, a physiologically-meaningful, MM-OCE-based iMT dosimetry is feasible.

Nondestructive characterization of soft materials and biofilms by measurement of guided elastic wave propagation using optical coherence elastography

Biofilms are soft multicomponent biological materials composed of microbial communities attached to surfaces. Despite the crucial relevance of biofilms to diverse industrial, medical, and environmental applications, the mechanical properties of biofilms are understudied. Moreover, most of the available techniques for the characterization of biofilm mechanical properties are destructive. Here, we detail a model-based approach developed to characterize the viscoelastic properties of soft materials and bacterial biofilms based on experimental data obtained using the nondestructive dynamic optical coherence elastography (OCE) technique. The model predicted the frequency- and geometry-dependent propagation velocities of elastic waves in a soft viscoelastic plate supported by a rigid substratum. Our numerical calculations suggest that the dispersion curves of guided waves recorded in thin soft plates by the dynamic OCE technique are dominated by guided waves, whose phase velocities depend on the viscoelastic properties and plate thickness. The numerical model was validated against experimental measurements in agarose phantom samples with different thicknesses and concentrations. The model was then used to interpret guided wave dispersion curves obtained by the OCE technique in bacterial biofilms developed in a rotating annular reactor, which allowed the quantitative characterization of biofilm shear modulus and viscosity. This study is the first to employ measurements of elastic wave propagation to characterize biofilms, and it provides a novel framework combining a theoretical model and an experimental approach for studying the relationship between the biofilm internal physical structure and mechanical properties.

Quantified elasticity mapping of retinal layers using synchronized acoustic radiation force optical coherence elastography

Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly (over the age of 60 years) in western countries. In the early stages of the disease, structural changes may be subtle and cannot be detected. Recently it has been postulated that the mechanical properties of the retina may change with the onset of AMD. In this manuscript, we present a novel, non-invasive means that utilizes synchronized acoustic radiation force optical coherence elastography (ARF-OCE) to measure and estimate the elasticity of cadaver porcine retina. Both regions near the optic nerve and in the peripheral retina were studied. An acoustic force is exerted on the tissue for excitation and the resulting tissue vibrations, often in the nanometer scale, are detected with high-resolution optical methods. Segmentation has been performed to isolate individual layers and the Young's modulus has been estimated for each. The results have been successfully compared and mapped to corresponding histological results using H&E staining. Finally, 64 elastograms of the retina were analyzed, as well as the elastic properties, with stiffness ranging from 1.3 to 25.9 kPa in the ganglion to the photoreceptor sides respectively. ARF-OCE allows for the elasticity mapping of anatomical retinal layers. This imaging approach needs further evaluation but has the potential to allow physicians to gain a better understanding of the elasticity of retinal layers in retinal diseases such as AMD.

Optical coherence elastography in ophthalmology

Optical coherence elastography (OCE) can provide clinically valuable information based on local measurements of tissue stiffness. Improved light sources and scanning methods in optical coherence tomography (OCT) have led to rapid growth in systems for high-resolution, quantitative elastography using imaged displacements and strains within soft tissue to infer local mechanical properties. We describe in some detail the physical processes underlying tissue mechanical response based on static and dynamic displacement methods. Namely, the assumptions commonly used to interpret displacement and strain measurements in terms of tissue elasticity for static OCE and propagating wave modes in dynamic OCE are discussed with the ultimate focus on OCT system design for ophthalmic applications. Practical OCT motion-tracking methods used to map tissue elasticity are also presented to fully describe technical developments in OCE, particularly noting those focused on the anterior segment of the eye. Clinical issues and future directions are discussed in the hope that OCE techniques will rapidly move forward to translational studies and clinical applications.

Clinical translation of handheld optical coherence tomography: practical considerations and recent advancements

Since the inception of optical coherence tomography (OCT), advancements in imaging system design and handheld probes have allowed for numerous advancements in disease diagnostics and characterization of the structural and optical properties of tissue. OCT system developers continue to reduce form factor and cost, while improving imaging performance (speed, resolution, etc.) and flexibility for applicability in a broad range of fields, and nearly every clinical specialty. An extensive array of components to construct customized systems has also become available, with a range of commercial entities that produce high-quality products, from single components to full systems, for clinical and research use. Many advancements in the development of these miniaturized and portable systems can be linked back to a specific challenge in academic research, or a clinical need in medicine or surgery. Handheld OCT systems are discussed and explored for various applications. Handheld systems are discussed in terms of their relative level of portability and form factor, with mention of the supporting technologies and surrounding ecosystem that bolstered their development. Additional insight from our efforts to implement systems in several clinical environments is provided. The trend toward well-designed, efficient, and compact handheld systems paves the way for more widespread adoption of OCT into point-of-care or point-of-procedure applications in both clinical and commercial settings.

Ocular fundus pulsations within the posterior rat eye: Chorioscleral motion and response to elevated intraocular pressure

A multi-functional optical coherence tomography (OCT) approach is presented to determine ocular fundus pulsations as an axial displacement between the retina and the chorioscleral complex in the albino rat eye. By combining optical coherence elastography and OCT angiography (OCTA), we measure subtle deformations in the nanometer range within the eye and simultaneously map retinal and choroidal perfusion. The conventional OCT reflectivity contrast serves as a backbone to segment the retina and to define several slabs which are subsequently used for quantitative ocular pulsation measurements as well as for a qualitative exploration of the multi-functional OCT image data. The proposed concept is applied in healthy albino rats as well as in rats under acute elevation of the intraocular pressure (IOP). The evaluation of this experiment revealed an increased pulsatility and deformation between the retinal and chorioscleral complex while increasing the IOP level from 15 mmHg to 65 mmHg. At IOP levels exceeding 65 mmHg, the pulsatility decreased significantly and retinal as well as choroidal perfusion vanished in OCTA. Furthermore, the evaluation of the multi-parametric experiment revealed a spatial correlation between fundus pulsatility and choroidal blood flow. This indicates that the assessed pulsatility may be a valuable parameter describing the choroidal perfusion.

Quantitative characterization of mechanically indented in vivo human skin in adults and infants using optical coherence tomography

Influenced by both the intrinsic viscoelasticity of the tissue constituents and the time-evolved redistribution of fluid within the tissue, the biomechanical response of skin can reflect not only localized pathology but also systemic physiology of an individual. While clinical diagnosis of skin pathologies typically relies on visual inspection and manual palpation, a more objective and quantitative approach for tissue characterization is highly desirable. Optical coherence tomography (OCT) is an interferometry-based imaging modality that enables in vivo assessment of cross-sectional tissue morphology with micron-scale resolution, which surpasses those of most standard clinical imaging tools, such as ultrasound imaging and magnetic resonance imaging. This pilot study investigates the feasibility of characterizing the biomechanical response of in vivo human skin using OCT. OCT-based quantitative metrics were developed and demonstrated on the human subject data, where a significant difference between deformed and nondeformed skin was revealed. Additionally, the quantified postindentation recovery results revealed differences between aged (adult) and young (infant) skin. These suggest that OCT has the potential to quantitatively assess the mechanically perturbed skin as well as distinguish different physiological conditions of the skin, such as changes with age or disease.

En face coherence microscopy [Invited]

En face coherence microscopy or flying spot or full field optical coherence tomography or microscopy (FF-OCT/FF-OCM) belongs to the OCT family because the sectioning ability is mostly linked to the source coherence length. In this article we will focus our attention on the advantages and the drawbacks of the following approaches: en face versus B scan tomography in terms of resolution, coherent versus incoherent illumination and influence of aberrations, and scanning versus full field imaging. We then show some examples to illustrate the diverse applications of en face coherent microscopy and show that endogenous or exogenous contrasts can add valuable information to the standard morphological image. To conclude we discuss a few domains that appear promising for future development of en face coherence microscopy.

Optical coherence elastography - OCT at work in tissue biomechanics [Invited]

Optical coherence elastography (OCE), as the use of OCT to perform elastography has come to be known, began in 1998, around ten years after the rest of the field of elastography - the use of imaging to deduce mechanical properties of tissues. After a slow start, the maturation of OCT technology in the early to mid 2000s has underpinned a recent acceleration in the field. With more than 20 papers published in 2015, and more than 25 in 2016, OCE is growing fast, but still small compared to the companion fields of cell mechanics research methods, and medical elastography. In this review, we describe the early developments in OCE, and the factors that led to the current acceleration. Much of our attention is on the key recent advances, with a strong emphasis on future prospects, which are exceptionally bright.

Nonlinear characterization of elasticity using quantitative optical coherence elastography

Optical coherence elastography (OCE) has been used to perform mechanical characterization on biological tissue at the microscopic scale. In this work, we used quantitative optical coherence elastography (qOCE), a novel technology we recently developed, to study the nonlinear elastic behavior of biological tissue. The qOCE system had a fiber-optic probe to exert a compressive force to deform tissue under the tip of the probe. Using the space-division multiplexed optical coherence tomography (OCT) signal detected by a spectral domain OCT engine, we were able to simultaneously quantify the probe deformation that was proportional to the force applied, and to quantify the tissue deformation. In other words, our qOCE system allowed us to establish the relationship between mechanical stimulus and tissue response to characterize the stiffness of biological tissue. Most biological tissues have nonlinear elastic behavior, and the apparent stress-strain relationship characterized by our qOCE system was nonlinear an extended range of strain, for a tissue-mimicking phantom as well as biological tissues. Our experimental results suggested that the quantification of force in OCE was critical for accurate characterization of tissue mechanical properties and the qOCE technique was capable of differentiating biological tissues based on the elasticity of tissue that is generally nonlinear.

Magnetomotive Optical Coherence Elastography for Magnetic Hyperthermia Dosimetry Based on Dynamic Tissue Biomechanics

Magnetic nanoparticles (MNPs) have been used in many diagnostic and therapeutic biomedical applications over the past few decades to enhance imaging contrast, steer drugs to targets, and treat tumors via hyperthermia. Optical coherence tomography (OCT) is an optical biomedical imaging modality that relies on the detection of backscattered light to generate high-resolution cross-sectional images of biological tissue. MNPs have been utilized as imaging contrast and perturbative mechanical agents in OCT in techniques called magnetomotive OCT (MM-OCT) and magnetomotive elastography (MM-OCE), respectively. MNPs have also been independently used for magnetic hyperthermia treatments, enabling therapeutic functions such as killing tumor cells. It is well known that the localized tissue heating during hyperthermia treatments result in a change in the biomechanical properties of the tissue. Therefore, we propose a novel dosimetric technique for hyperthermia treatment based on the viscoelasticity change detected by MM-OCE, further enabling the theranostic function of MNPs. In this paper, we first review the basic principles and applications of MM-OCT, MM-OCE, and magnetic hyperthermia, and present new preliminary results supporting the concept of MM-OCE-based hyperthermia dosimetry.

Wavelength scanning interferometry using multiple light sources

A novel sensing method is proposed for wavelength scanning interferometry using multiple tunable light sources. As it is well known, a deterioration of depth resolution usually occurs when multiple phase intervals, corresponding to the multiple tunable light sources, are used for distance measurement purposes. It is shown here, that it is possible to regain depth resolution characteristics of a complete scan by means of a temporal phase unwrapping extrapolation method. With the proposed method, the resulting phase differences among multiple phase intervals can be successfully unwrapped to find out the intermediate phase. This effectively allows the application of whole-scan phase sensing for distance measurement using reduced scanning intervals, increased speed, and improved depth detection.

Optical coherence elastography for tissue characterization: a review

Optical coherence elastography (OCE) represents the frontier of optical elasticity imaging techniques and focuses on the micro-scale assessment of tissue biomechanics in 3D that is hard to achieve with traditional elastographic methods. Benefit from the advancement of optical coherence tomography, and driven by the increasing requirements in nondestructive biomechanical characterization, this emerging technique recently has experienced a rapid development. In this paper, we start with the description of the mechanical contrast that has been employed by OCE and review the state-of-the-art techniques based on the reported applications and discuss the current technical challenges, emphasizing the unique role of OCE in tissue mechanical characterization. The position of OCE among other elastography techniques.

Optical coherence elastography for tissue characterization: a review

Optical coherence elastography (OCE) represents the frontier of optical elasticity imaging techniques and focuses on the micro-scale assessment of tissue biomechanics in 3D that is hard to achieve with traditional elastographic methods. Benefit from the advancement of optical coherence tomography, and driven by the increasing requirements in nondestructive biomechanical characterization, this emerging technique recently has experienced a rapid development. In this paper, we start with the description of the mechanical contrast that has been employed by OCE and review the state-of-the-art techniques based on the reported applications and discuss the current technical challenges, emphasizing the unique role of OCE in tissue mechanical characterization. The position of OCE among other elastography techniques.

Noncontact depth-resolved micro-scale optical coherence elastography of the cornea

High-resolution elastographic assessment of the cornea can greatly assist clinical diagnosis and treatment of various ocular diseases. Here, we report on the first noncontact depth-resolved micro-scale optical coherence elastography of the cornea achieved using shear wave imaging optical coherence tomography (SWI-OCT) combined with the spectral analysis of the corneal Lamb wave propagation. This imaging method relies on a focused air-puff device to load the cornea with highly-localized low-pressure short-duration air stream and applies phase-resolved OCT detection to capture the low-amplitude deformation with nano-scale sensitivity. The SWI-OCT system is used here to image the corneal Lamb wave propagation with the frame rate the same as the OCT A-line acquisition speed. Based on the spectral analysis of the corneal temporal deformation profiles, the phase velocity of the Lamb wave is obtained at different depths for the major frequency components, which shows the depthwise distribution of the corneal stiffness related to its structural features. Our pilot experiments on ex vivo rabbit eyes demonstrate the feasibility of this method in depth-resolved micro-scale elastography of the cornea. The assessment of the Lamb wave dispersion is also presented, suggesting the potential for the quantitative measurement of corneal viscoelasticity.

Noncontact quantitative biomechanical characterization of cardiac muscle using shear wave imaging optical coherence tomography

We report on a quantitative optical elastographic method based on shear wave imaging optical coherence tomography (SWI-OCT) for biomechanical characterization of cardiac muscle through noncontact elasticity measurement. The SWI-OCT system employs a focused air-puff device for localized loading of the cardiac muscle and utilizes phase-sensitive OCT to monitor the induced tissue deformation. Phase information from the optical interferometry is used to reconstruct 2-D depth-resolved shear wave propagation inside the muscle tissue. Cross-correlation of the displacement profiles at various spatial locations in the propagation direction is applied to measure the group velocity of the shear waves, based on which the Young's modulus of tissue is quantified. The quantitative feature and measurement accuracy of this method is demonstrated from the experiments on tissue-mimicking phantoms with the verification using uniaxial compression test. The experiments are performed on ex vivo cardiac muscle tissue from mice with normal and genetically altered myocardium. Our results indicate this optical elastographic technique is useful as a noncontact tool to assist the cardiac muscle studies.

Magnetomotive optical coherence elastography using magnetic particles to induce mechanical waves

Magnetic particles are versatile imaging agents that have found wide spread applicability in diagnostic, therapeutic, and rheology applications. In this study, we demonstrate that mechanical waves generated by a localized inclusion of magnetic nanoparticles can be used for assessment of the tissue viscoelastic properties using magnetomotive optical coherence elastography. We show these capabilities in tissue mimicking elastic and viscoelastic phantoms and in biological tissues by measuring the shear wave speed under magnetomotive excitation. Furthermore, we demonstrate the extraction of the complex shear modulus by measuring the shear wave speed at different frequencies and fitting to a Kelvin-Voigt model.

Molecular Imaging in Optical Coherence Tomography

Optical coherence tomography (OCT) is a medical imaging technique that provides tomographic images at micron scales in three dimensions and high speeds. The addition of molecular contrast to the available morphological image holds great promise for extending OCT's impact in clinical practice and beyond. Fundamental limitations prevent OCT from directly taking advantage of powerful molecular processes such as fluorescence emission and incoherent Raman scattering. A wide range of approaches is being researched to provide molecular contrast to OCT. Here we review those approaches with particular attention to those that derive their molecular contrast directly from modulation of the OCT signal. We also provide a brief overview of the multimodal approaches to gaining molecular contrast coincident with OCT.

Magnetomotive optical coherence elastography for microrheology of biological tissues

Optical coherence elastography (OCE) is an established paradigm for measuring biomechanical properties of tissues and cells noninvasively, in real time, and with high resolution. We present a different development of a spectral domain OCE technique that enables simultaneous measurements of multiple biomechanical parameters of biological tissues. Our approach extends the capabilities of magnetomotive OCE (MM-OCE), which utilizes iron oxide magnetic nanoparticles (MNPs) distributed and embedded in the specimens as transducers for inducing motion. Step-wise application of an external magnetic field results in displacements in the tissue specimens that are deduced from sensitive phase measurements made with the MM-OCE system. We analyzed freshly excised rabbit lung and muscle tissues. We observe that while they present some similarities, rabbit lung and muscle tissue displacements display characteristic differentiating features. Both tissue types undergo a fast initial displacement followed by a rapidly damped oscillation and the onset of creep. However, the damping is faster in muscle compared to lung tissue, while the creep is steeper in muscle. This approach has the potential to become a novel way of performing real-time measurements of biomechanical properties of tissues and to enable the development of different diagnostic and monitoring tools in biology and medicine.

Optical measurement of arterial mechanical properties: from atherosclerotic plaque initiation to rupture

During the pathogenesis of coronary atherosclerosis, from lesion initiation to rupture, arterial mechanical properties are altered by a number of cellular, molecular, and hemodynamic processes. There is growing recognition that mechanical factors may actively drive vascular cell signaling and regulate atherosclerosis disease progression. In advanced plaques, the mechanical properties of the atheroma influence stress distributions in the fibrous cap and mediate plaque rupture resulting in acute coronary events. This review paper explores current optical technologies that provide information on the mechanical properties of arterial tissue to advance our understanding of the mechanical factors involved in atherosclerosis development leading to plaque rupture. The optical approaches discussed include optical microrheology and traction force microscopy that probe the mechanical behavior of single cell and extracellular matrix components, and intravascular imaging modalities including laser speckle rheology, optical coherence elastography, and polarization-sensitive optical coherence tomography to measure the mechanical properties of advanced coronary lesions. Given the wealth of information that these techniques can provide, optical imaging modalities are poised to play an increasingly significant role in elucidating the mechanical aspects of coronary atherosclerosis in the future.

Dynamic optical coherence tomography measurements of elastic wave propagation in tissue-mimicking phantoms and mouse cornea in vivo

We demonstrate the use of phase-stabilized swept-source optical coherence tomography to assess the propagation of low-amplitude (micron-level) waves induced by a focused air-pulse system in tissue-mimicking phantoms, a contact lens, a silicone eye model, and the mouse cornea in vivo. The results show that the wave velocity can be quantified from the analysis of wave propagation, thereby enabling the estimation of the sample elasticity using the model of surface wave propagation for the tissue-mimicking phantoms. This noninvasive, noncontact measurement technique involves low-force methods of tissue excitation that can be potentially used to assess the biomechanical properties of ocular and other delicate tissues in vivo.

3D static elastography at the micrometer scale using Full Field OCT

Full-Field OCT (FF-OCT) is able to image biological tissues in 3D with micrometer resolution. In this study we add elastographic contrast to the FF-OCT modality. By combining FF-OCT with elastography, we create a virtual palpation map at the micrometer scale. We present here a proof of concept on multi-layer phantoms and preliminary results on ex vivo biological samples such as porcine cornea, human breast tissues and rat heart. The 3D digital volume correlation that is used in connection with the 3D stack of images allows to access to the full 3D strain tensor and to reveal stiffness anisotropy.