Ultra-thin and flexible endoscopy probe for optical coherence tomography based on stepwise transitional core fiber

Reflective axicon based energy-efficient extended depth of focus quasi-Bessel beam probe for common-path optical coherence tomography

This work presents an optical fiber negative/reflective axicon probe that generates an energy-efficient quasi-Bessel beam (QBB) having a central spot (CS) possessing ∼20% of the QBB power. With silver coating around the axicon, the CS power has been increased by ∼45%. The QBB possesses a large depth of field, ∼400µm, with a micron order spot size as obtained experimentally. The probe has further been explored for common-path optical coherence tomography. The probe length has been optimized to minimize the path length difference between the reference and sample signal. With a divergence angle of just 0.013°, the beam provides a lateral resolution of ∼2.5 to ∼16µm for an axial distance of 0.1 to 1.0 mm. The imaging results are presented for standard samples such as onion and Scotch tape.

Passively scanned, single-fiber optical coherence tomography probes for gastrointestinal devices

BACKGROUND/OBJECTIVES

Optical coherence tomography (OCT) uses low coherence interferometry to obtain depth-resolved tissue reflectivity profiles (M-mode) and transverse beam scanning to create images of two-dimensional tissue morphology (B-mode). Endoscopic OCT imaging probes typically employ proximal or distal mechanical beam scanning mechanisms that increase cost, complexity, and size. Here, we demonstrate in the gastrointestinal (GI) tracts of unsedated human patients, that a passive, single-fiber probe can be used to guide device placement, conduct device-tissue physical contact sensing, and obtain two-dimensional OCT images via M-to-B-mode conversion.

MATERIALS AND METHODS

We designed and developed ultrasmall, manually scannable, side- and forward-viewing single fiber-optic probes that can capture M-mode OCT data. Side-viewing M-mode OCT probes were incorporated into brush biopsy devices designed to harvest the microbiome and forward-viewing M-mode OCT probes were integrated into devices that measure intestinal potential difference (IPD). The M-mode OCT probe-coupled devices were utilized in the GI tract in six unsedated patients in vivo. M-mode data were converted into B-mode images using an M-to-B-mode conversion algorithm. The effectiveness of physical contact sensing by the M-mode OCT probes was assessed by comparing the variances of the IPD values when the probe was in physical contact with the tissue versus when it was not. The capacity of forward- and side-viewing M-mode OCT probes to produce high-quality B-mode images was compared by computing the percentages of the M-to-B-mode images that showed close contact between the probe and the luminal surface. Passively scanned M-to-B-mode images were qualitatively compared to B-mode images obtained by mechanical scanning OCT tethered capsule endomicroscopy (TCE) imaging devices.

RESULTS

The incorporation of M-mode OCT probes in these nonendoscopic GI devices safely and effectively enabled M-mode OCT imaging, facilitating real-time device placement guidance and contact sensing in vivo. Results showed that M-mode OCT contact sensing improved the variance of IPD measurements threefold and side-viewing probes increased M-to-B-mode image visibility by 10%. Images of the esophagus, stomach, and duodenum generated by the passively scanned probes and M-to-B-mode conversion were qualitatively superior to B-mode images obtained by mechanically scanning OCT TCE devices.

CONCLUSION

These results show that passive, single optical fiber OCT probes can be effectively utilized for nonendoscopic device placement guidance, device contact sensing, and two-dimensional morphologic imaging in the human GI tract in vivo. Due to their small size, lower cost, and reduced complexity, these M-mode OCT probes may provide an easier avenue for the incorporation of OCT functionality into endoscopic/nonendoscopic devices.

Novel endoscopic optical diagnostic technologies in medical trial research: recent advancements and future prospects

Novel endoscopic biophotonic diagnostic technologies have the potential to non-invasively detect the interior of a hollow organ or cavity of the human body with subcellular resolution or to obtain biochemical information about tissue in real time. With the capability to visualize or analyze the diagnostic target in vivo, these techniques gradually developed as potential candidates to challenge histopathology which remains the gold standard for diagnosis. Consequently, many innovative endoscopic diagnostic techniques have succeeded in detection, characterization, and confirmation: the three critical steps for routine endoscopic diagnosis. In this review, we mainly summarize researches on emerging endoscopic optical diagnostic techniques, with emphasis on recent advances. We also introduce the fundamental principles and the development of those techniques and compare their characteristics. Especially, we shed light on the merit of novel endoscopic imaging technologies in medical research. For example, hyperspectral imaging and Raman spectroscopy provide direct molecular information, while optical coherence tomography and multi-photo endomicroscopy offer a more extensive detection range and excellent spatial-temporal resolution. Furthermore, we summarize the unexplored application fields of these endoscopic optical techniques in major hospital departments for biomedical researchers. Finally, we provide a brief overview of the future perspectives, as well as bottlenecks of those endoscopic optical diagnostic technologies. We believe all these efforts will enrich the diagnostic toolbox for endoscopists, enhance diagnostic efficiency, and reduce the rate of missed diagnosis and misdiagnosis.

Light guidance up to 6.5 µm in borosilicate soft glass hollow-core microstructured optical waveguides

Limited operating bandwidth originated from strong absorption of glass materials in the infrared (IR) spectral region has hindered the potential applications of microstructured optical waveguide (MOW)-based sensors. Here, we demonstrate multimode waveguide regime up to 6.5 µm for the hollow-core (HC) MOWs drawn from borosilicate soft glass. Effective light guidance in central HC (diameter ∼240 µm) was observed from 0.4 to 6.5 µm despite high waveguide losses (0.4 and 1 dB/cm in near- and mid-IR, respectively). Additional optimization of the waveguide structure can potentially extend its operating range and decrease transmission losses, offering an attractive alternative to tellurite and chalcogenide-based fibers. Featuring the transparency in mid-IR, HC MOWs are promising candidates for the creation of MOW-based sensors for chemical and biomedical applications.

Etching-enabled extreme miniaturization of graded-index fiber-based optical coherence tomography probes

We introduced and validated a method to miniaturize graded-index (GRIN) fiber-based optical coherence tomography (OCT) probes down to 70  μm in diameter. The probes consist in an assembly of single-mode (SM), coreless (CL), and graded-index (GRIN) fibers. We opted for a probe design enabling controlled size reduction by hydrogen fluoride etching. The fabrication approach prevents nonuniform etching for both the GRIN and SM fiber components, while it requires no probe polishing postetching. We found that the miniaturized probes present insignificant loss of sensitivity (∼1  dB) compared to their thicker (125  μm) counterparts. We also showed that their focusing capabilities remain tunable and highly predictable. The fabrication process is simple and can be carried out by using inexpensive telecom equipment. Both the fabrication process and the developed probes can benefit the prototyping of minimally invasive endoscopic tools.

Endoscopic Optical Coherence Tomography for Assessing Inhalation Airway Injury: A Technical Review

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.

Depolarization characteristics of spatial modes in imaging probe using short multimode fiber

Optical coherence tomography is one of the standard imaging modalities at present, widely used in the medical and biological fields to obtain three-dimensional (3D) images with high spatial resolution. However, the depth up to which the 3D images can be directly obtained is limited to within 3 mm. Therefore, the suitability of many kinds of catheters and needles has been considered for minimally invasive imaging. We have examined the utility of a short multimode fiber (SMMF) using graded index optical fibers for minimal invasive imaging of deeper areas, up to 6-8 mm. The diameter and length of the SMMF are 125 μm and 6-8 mm, respectively. In the core of the SMMF, scattering and multirefraction occur due to small variations in the refractive index to generate deformations and depolarization of images. In order to investigate the depolarization characteristics, the images reflected at the facet of the SMMF were measured by changing the angle of the polarizer, using an LED as the light source. The reflection image almost corresponds to that obtained with combined linearly polarized modes with the ratio of LP₀₁∶LP₁₁∶LP₂₁ equal to 1∶0.2∶0.7. Comparing the measured results with simulations in the simple model, the depolarization ratio was estimated at 0.7 in the core. The degrees of polarization were measured to be 0.15 around the center and increased to 0.90 at the periphery.

Automated 3D segmentation of methyl isocyanate-exposed rat trachea using an ultra-thin, fully fiber optic optical coherence endoscopic probe

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.

Lamellar keratoplasty using position-guided surgical needle and M-mode optical coherence tomography

Deep anterior lamellar keratoplasty (DALK) is an emerging surgical technique for the restoration of corneal clarity and vision acuity. The big-bubble technique in DALK surgery is the most essential procedure that includes the air injection through a thin syringe needle to separate the dysfunctional region of the cornea. Even though DALK is a well-known transplant method, it is still challenged to manipulate the needle inside the cornea under the surgical microscope, which varies its surgical yield. Here, we introduce the DALK protocol based on the position-guided needle and M-mode optical coherence tomography (OCT). Depth-resolved 26-gage needle was specially designed, fabricated by the stepwise transitional core fiber, and integrated with the swept source OCT system. Since our device is feasible to provide both the position information inside the cornea as well as air injection, it enables the accurate management of bubble formation during DALK. Our results show that real-time feedback of needle end position was intuitionally visualized and fast enough to adjust the location of the needle. Through our research, we realized that position-guided needle combined with M-mode OCT is a very efficient and promising surgical tool, which also to enhance the accuracy and stability of DALK.

Lens-free all-fiber probe with an optimized output beam for optical coherence tomography

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.

Image-Guided Laparoscopic Surgical Tool (IGLaST) Based on the Optical Frequency Domain Imaging (OFDI) to Prevent Bleeding

We present an image-guided laparoscopic surgical tool (IGLaST) to prevent bleeding. By applying optical frequency domain imaging (OFDI) to a specially designed laparoscopic surgical tool, the inside of fatty tissue can be observed before a resection, and the presence and size of blood vessels can be recognized. The optical sensing module on the IGLaST head has a diameter of less than 390 µm and is moved back and forth by a linear servo actuator in the IGLaST body. We proved the feasibility of IGLaST by in vivo imaging inside the fatty tissue of a porcine model. A blood vessel with a diameter of about 2.2 mm was clearly observed. Our proposed scheme can contribute to safe surgery without bleeding by monitoring vessels inside the tissue and can be further expanded to detect invisible nerves of the laparoscopic thyroid during prostate gland surgery.

Design and characterization of a combined OCT and wide field imaging falloposcope for ovarian cancer detection

Early detection of ovarian cancer is only achieved in around 20% of women due to lack of effective screening. We propose a method for surveillance of high risk women based on a microendoscope introduced transvaginally to image the fallopian tubes and ovaries. This requires extreme miniaturization of the optics and catheter sheath. We describe the design of a falloposcope that combines optical coherence tomography (OCT) and wide field imaging into a sub-1 mm diameter package. We characterize the systems and show that they provide contrast on ex-vivo samples of ovary and fallopian tube. In addition, we show the mechanical performance of the endoscope in an anatomically correct model of the female reproductive tract.

Imaging characteristics of an 8.8 mm long and 125 μm thick graded-index short multimode fiber probe

We demonstrated the feasibility of an ultrathin imaging probe with a 50-μm core diameter, a 125 μm total diameter, and an 8.8 mm length, which is a typical graded-index multimode fiber for optical communications. We used an ABCD matrix to analyze the imaging conditions and magnification, which corresponded closely to the measured results. The lateral resolution was calculated at 1.2 μm with a wavelength of 730 nm, which reflects the image test pattern where a period of 4.38 μm was measured with a wavelength of 730 nm. In the numerical aperture of the objective lens, we experimentally evaluated the tradeoff between the magnification and the coupling efficiency. At four wavelengths of 540 nm, 632 nm, 730 nm, and 852 nm, the contrast and signal intensity versus the wavelength were investigated to show that the contrast at 632 and 730 nm is relatively high. By using a thin random phase screen model, we explained that as the wavelength decreases the greater the decrease in the optical transfer function at higher spatial frequencies. Using a 635 nm LED light source, we imaged the surfaces of chicken tendons in contact and the surface roughness was visible.