In vivo three-dimensional optical coherence elastography

Mouse brain elastography changes with sleep/wake cycles, aging, and Alzheimer's disease

Understanding the physiological processes in aging and how neurodegenerative disorders affect cognitive function is a high priority for advancing human health. One specific area of recently enabled research is the in vivo biomechanical state of the brain. This study utilized reverberant optical coherence elastography, a high-resolution elasticity imaging method, to investigate stiffness changes during the sleep/wake cycle, aging, and Alzheimer's disease in murine models. Four-dimensional scans of 44 wildtype mice, 13 mice with deletion of aquaporin-4 water channel, and 12 mice with Alzheimer-related pathology (APP/PS1) demonstrated that (1) cortical tissue became softer (on the order of a 10% decrease in shear wave speed) when young wildtype mice transitioned from wake to anesthetized, yet this effect was lost in aging and with mice overexpressing amyloid-β or lacking the water channel AQP4. (2) Cortical stiffness increased with age in all mice lines, but wildtype mice exhibited the most prominent changes as a function of aging. The study provides novel insight into the brain's biomechanics, the constraints of fluid flow, and how the state of brain activity affects basic properties of cortical tissues.

Non-contact elasticity contrast imaging using photon counting

Significance

Tissues' biomechanical properties, such as elasticity, are related to tissue health. Optical coherence elastography produces images of tissues based on their elasticity, but its performance is constrained by the laser power used, working distance, and excitation methods.

Aim

We develop a new method to reconstruct the elasticity contrast image over a long working distance, with only low-intensity illumination, and by non-contact acoustic wave excitation.

Approach

We combine single-photon vibrometry and quantum parametric mode sorting (QPMS) to measure the oscillating backscattered signals at a single-photon level and derive the phantoms' relative elasticity.

Results

We test our system on tissue-mimicking phantoms consisting of contrast sections with different concentrations and thus stiffness. Our results show that as the driving acoustic frequency is swept, the phantoms' vibrational responses are mapped onto the photon-counting histograms from which their mechanical properties-including elasticity-can be derived. Through lateral and longitudinal laser scanning at a fixed frequency, a contrast image based on samples' elasticity can be reliably reconstructed upon photon level signals.

Conclusions

We demonstrated the reliability of QPMS-based elasticity contrast imaging of agar phantoms in a long working distance, low-intensity environment. This technique has the potential for in-depth images of real biological tissue and provides a new approach to elastography research and applications.

Stratum corneum compliance enhances tactile sensitivity through increasing skin deformation: A study protocol for a randomized controlled trial

BACKGROUND

Tactile sensation plays a crucial role in object manipulation, communication, and even emotional well-being. It has been reported that the deformability of skin (also described as skin compliance) that shows a large mechanical response to stimuli is associated with high tactile sensitivity. However, although the compliance of the stratum corneum, the outermost layer of skin, can change daily due to skin care and environmental factors, few studies have quantified the effect of the stratum corneum on tactile sensation.

AIMS

We investigated the changes in tactile sensitivity resulting from skin hydration and identified corresponding alterations in the compliance of the stratum corneum.

METHODS

A randomized controlled trial was conducted. Participants were randomly assigned to an intervention group (n = 20) that had a moisturizing cream applied to their cheeks or a control group (n = 19) that had Milli-Q water applied to their cheeks. Tactile discrimination performance was assessed using psychophysical techniques before and after application. The water content, mechanical response characteristics, and penetration of PEG/PPG-17/4 dimethyl ether from the cream in the stratum corneum were evaluated to identify hydration effects. Skin deformations occurring during tactile sensation were measured concurrently using a suction device employed for tactile stimulation.

RESULTS

Tactile sensitivity was increased in participants who had cream applied to the skin surface, while no significant change was observed in participants who received Milli-Q water. The improved discrimination of tactile stimulus intensity was directly related to the magnitude of skin displacement. The higher water content of the stratum corneum due to cream application decreased the dynamic modulus of elasticity of the stratum corneum and increased the skin's extensibility in response to tactile stimuli.

CONCLUSIONS

Hydrating the stratum corneum significantly enhances tactile sensitivity and is accompanied by an increase in skin extensibility, a factor in tactile intensity perception. The compliance of the thin stratum corneum layer plays a crucial role in tactile experiences that involve skin stretching.

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.

Quantifying skin sensitivity caused by mechanical insults: A review

BACKGROUND

Skin sensitivity (SS) is a commonly occurring response to a range of stimuli, including environmental conditions (e.g., sun exposure), chemical irritants (e.g., soaps and cosmetics), and mechanical forces (e.g., while shaving). From both industry and academia, many efforts have been taken to quantify the characteristics of SS in a standardised manner, but the study is hindered by the lack of an objective definition.

METHODS

A review of the scientific literature regarding different parameters attributed to the loss of skin integrity and linked with exhibition of SS was conducted. Articles included were screened for mechanical stimulation of the skin, with objective quantification of tissue responses using biophysical or imaging techniques. Additionally, studies where cohorts of SS and non-SS individuals were reported have been critiqued.

RESULTS

The findings identified that the structure and function of the stratum corneum and its effective barrier properties are closely associated with SS. Thus, an array of skin tissue responses has been selected for characterization of SS due to mechanical stimuli, including: transepidermal water loss, hydration, redness, temperature, and sebum index. Additionally, certain imaging tools allow quantification of the superficial skin layers, providing structural characteristics underlying SS.

CONCLUSION

This review proposes a multimodal approach for identification of SS, providing a means to characterise skin tissue responses objectively. Optical coherence tomography (OCT) has been suggested as a suitable tool for dermatological research with clinical applications. Such an approach would enhance the knowledge underlying the multifactorial nature of SS and aid the development of personalised solutions in medical and consumer devices.

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.

3-D compressed sensing optical coherence tomography using predictive coding

We present a compressed sensing (CS) algorithm and sampling strategy for reconstructing 3-D Optical Coherence Tomography (OCT) image volumes from as little as 10% of the original data. Reconstruction using the proposed method, Denoising Predictive Coding (DN-PC), is demonstrated for five clinically relevant tissue types including human heart, retina, uterus, breast, and bovine ligament. DN-PC reconstructs the difference between adjacent b-scans in a volume and iteratively applies Gaussian filtering to improve image sparsity. An a-line sampling strategy was developed that can be easily implemented in existing Spectral-Domain OCT systems and reduce scan time by up to 90%.

Sonoelastography in the Diagnosis of Carpal Tunnel Syndrome: A Systematic Review of Diagnostic Values Compared With the Normative Population

BACKGROUND

Sonoelastography (SEL) is widely used for assessing tissue stiffness and pathophysiology. It has also been used to diagnose carpal tunnel syndrome (CTS). However, the current criteria to diagnose CTS in SEL are diverse. The aim of this study was to systematically review the literature and assess the diagnostic value of SEL for CTS.

METHODS

A literature review was performed using MEDLINE (PubMed), EMBASE, and the Cochrane Collaboration Library for primary research articles using the keywords sonoelastography and carpal tunnel syndrome. Data related to diagnostic and cutoff value were extracted. Bias assessment was performed.

RESULTS

A total of 121 publications were reviewed. Nineteen primary case series met the inclusion criteria and were selected for full analysis. Different diagnostic approaches were identified, with units/expressions including kilopascals, conduct velocity, and strain ratio. The kilopascals and conduct velocity were measured using shear wave elastography, whereas strain ratio was calculated by relative compression quantification. A mean shear modulus cutoff value from 38.25 to 86 kPa and an acoustic radiation force impulse cutoff value of 3.0 to 3.23 m/s were used to diagnose CTS. Eight articles reported strain ratio between the median nerve and nearby tissues with diverse results due to different reference points. The other 3 additional diagnostic values were reported.

CONCLUSIONS

Sonoelastography is a useful noninvasive and promising modality to diagnose CTS. It may reflect both the condition of soft tissue scarring and quantitative values for CTS and median nerve stiffness. A diversity of examination values was found in different modalities. A high level of evidence was absent.

Four-dimensional (4D) phase velocity optical coherence elastography in heterogeneous materials and biological tissue

The variations of mechanical properties in soft tissues are biomarkers used for clinical diagnosis and disease monitoring. Optical coherence elastography (OCE) has been extensively developed to investigate mechanical properties of various biological tissues. These methods are generally based on time-domain data and measure the time-of-flight of the localized shear wave propagations to estimate the group velocity. However, there is considerable information that can be obtained from examining the mechanical properties such as wave propagation velocities at different frequencies. Here we propose a method to evaluate phase velocity, wave velocity at various frequencies, in four-dimensional space (x, y, z, f), called 4D-OCE phase velocity. The method enables local estimates of the phase velocity of propagating mechanical waves in a medium. We acquired and analyzed data with this method from a homogeneous reference phantom, a heterogeneous phantom material with four different excitation cases, and ex vivo porcine kidney tissue. The 3D-OCE group velocity was also estimated to compare with 4D-OCE phase velocity. Moreover, we performed numerical simulation of wave propagations to illustrate the boundary behavior of the propagating waves. The proposed 4D-OCE phase velocity is capable of providing further information in OCE to better understand the spatial variation of mechanical properties of various biological tissues with respect to frequency.

Optimal stimulation frequency for vibrational optical coherence elastography

Vibrational optical coherence elastography (OCE) is a promising tool for extracting the mechanical property of soft tissue. Purpose of this study is focusing on settling the optimal frequency range for vibrational OCE with evenly distributed stress filed. A finite element model of 2% agar phantom was built by ANSYS with a vibration stimulation frequency range from 200 to 3000 Hz. Practical experiments were carried out for cross-validation with the same frequencies and sample. Lateral and horizontal stress filed distributions under different frequencies were mathematically evaluated by coefficient of variance and degree of linearity. Results from simulation and practical experiment cross-validated each other and 1000 Hz was set as the maximum ideal frequency for vibrational OCE, while the minimum frequency is set by theoretical calculation with a result of 250 Hz. An ex vivo biological sample was utilised to testify performance of vibrational OCE with excitation frequencies in and out of concluded optimal range, which showed that stiffness was better mapped out in optimal frequency range.

Spatial localization of mechanical excitation affects spatial resolution, contrast, and contrast-to-noise ratio in acoustic radiation force optical coherence elastography

The notion that a spatially confined mechanical excitation would produce an elastogram with high spatial resolution has motivated the development of various elastography techniques with localized mechanical excitation. However, a quantitative investigation of the effects of spatial localization of mechanical excitation on the spatial resolution of elastograms is still lacking in optical coherence elastography (OCE). Here, we experimentally investigated the effect of spatial localization of acoustic radiation force (ARF) excitation on spatial resolution, contrast, and contrast-to-noise ratio (CNR) of dynamic uniaxial strain elastograms in dynamic ARF-OCE, based on a framework for analyzing the factors that influence the quality of the elastogram at different stages of the elastography workflow. Our results show that localized ARF excitation with a smaller acoustic focal spot size produced a strain elastogram with superior spatial resolution, contrast, and CNR. Our results also suggest that the spatial extent spanned by the displacement response in the sample may connect between the spatial localization of the mechanical excitation and the resulting elastogram quality. The elastography framework and experimental approach presented here may provide a basis for the quantitative analysis of elastogram quality in OCE that can be adapted and applied to different OCE systems and applications.

Analysis of spatial resolution in phase-sensitive compression optical coherence elastography

Optical coherence elastography (OCE) is emerging as a method to image the mechanical properties of tissue on the microscale. However, the spatial resolution, a main advantage of OCE, has not been investigated and is not trivial to evaluate. To address this, we present a framework to analyze resolution in phase-sensitive compression OCE that incorporates the three main determinants of resolution: mechanical deformation of the sample, detection of this deformation using optical coherence tomography (OCT), and signal processing to estimate local axial strain. We demonstrate for the first time, through close correspondence between experiment and simulation of structured phantoms, that resolution in compression OCE is both spatially varying and sample dependent, which we link to the discrepancies between the model of elasticity and the mechanical deformation of the sample. We demonstrate that resolution is dependent on factors such as feature size and mechanical contrast. We believe that the analysis of image formation provided by our framework can expedite the development of compression OCE.

Handheld optical palpation of turbid tissue with motion-artifact correction

Handheld imaging probes are needed to extend the clinical translation of optical elastography to in vivo applications, yet such probes have received little attention. In this paper, we present the first demonstration of optical palpation using a handheld probe. Optical palpation is a variant of optical elastography that uses three-dimensional optical coherence tomography (3D-OCT) to provide maps of stress at the tissue surface under static compression. Using this technique, stiff features present beneath the surface of turbid tissues are identified, providing mechanical contrast complementary to the optical contrast provided by OCT. However, during handheld operation, relative motion between the probe and the tissue can induce motion artifact, causing spatial distortion of 3D-OCT and in turn, optical palpation images. We overcome this issue using a novel, dual-function bi-layer that provides both a fiducial marker for co-registration and a compliant section for estimation of the stress at the tissue surface. Co-registration of digital photographs of the bi-layer laid out over the tissue surface is used to measure and correct for motion in the lateral (xy) plane. We also demonstrate, for the first time, that optical palpation can be used as a method for monitoring pressure applied to the tissue during handheld operation, thus providing a more repeatable and robust imaging technique between different users. Handheld optical palpation is demonstrated on a structured phantom, in vivo human skin and excised human breast tissue. In each case, image quality comparable to bench-top 3D-OCT and optical palpation is achieved.

Soft tissue elastography via shearing interferometry

Early detection of cancer can significantly increase the survival chances of patients. Palpation is a traditional method in order to detect cancer; however, in minimally invasive surgery the surgeon is deprived of the sense of touch. We demonstrate how shearing elastography can recover elastic parameters and furthermore can be used to localize stiffness imhomogenities even if hidden underneath the surface. Furthermore, the influence of size and depth of the stiffness imhomogenities on the detection accuracy and localization is investigated.

Stiffness reconstruction methods for MR elastography

Assessment of tissue stiffness is desirable for clinicians and researchers, as it is well established that pathophysiological mechanisms often alter the structural properties of tissue. Magnetic resonance elastography (MRE) provides an avenue for measuring tissue stiffness and has a long history of clinical application, including staging liver fibrosis and stratifying breast cancer malignancy. A vital component of MRE consists of the reconstruction algorithms used to derive stiffness from wave-motion images by solving inverse problems. A large range of reconstruction methods have been presented in the literature, with differing computational expense, required user input, underlying physical assumptions, and techniques for numerical evaluation. These differences, in turn, have led to varying accuracy, robustness, and ease of use. While most reconstruction techniques have been validated against in silico or in vitro phantoms, performance with real data is often more challenging, stressing the robustness and assumptions of these algorithms. This article reviews many current MRE reconstruction methods and discusses the aforementioned differences. The material assumptions underlying the methods are developed and various approaches for noise reduction, regularization, and numerical discretization are discussed. Reconstruction methods are categorized by inversion type, underlying assumptions, and their use in human and animal studies. Future directions, such as alternative material assumptions, are also discussed.

Role of extracellular matrix in the biomechanical behavior of pancreatic tissue

Correlating the biomechanical properties of tissue with its function is an emerging area of research with potential impact in diagnostics, therapeutics, and prognostics. A critical stepping-stone in developing structure-function models is creating methods that can correlate the tissue structure with its mechanical behavior. As an initial step in addressing this challenge, we have characterized the mechanical behavior of unprocessed pancreatic tissue using optical fiber polarimetric elastography. To correlate the observed behavior to physiologically relevant structural features, a series of architectures are designed and fabricated using 3D printing. The mechanical response of the 3D printed elastomeric structures is analyzed using compressive testing and modeled using finite element analysis. The biomechanical behavior and buckling point of the 3D printed structures is used to create a calibration curve to understand the measured response of the resected pancreatic tissue. Based on the modeling and biomimetic results, the biomechanical behavior of pancreatic tissue is likely due to the collagen IV network.

Visualization of viscoelastic behavior in skin equivalent using optical coherence tomography-based straingraphy

BACKGROUND/PURPOSE

The relationships between the skin components and these mechanical roles are still unclear. To clarify these relationships, we investigated spatial mapping of the mechanical behavior of cultured skin equivalents (SEs) using optical coherence tomography (OCT)-based straingraphy.

METHODS

We built a strain relaxation test system combined with OCT and developed an algorithm that could visualize a time-dependent strain distribution, named dynamic-optical coherence straingraphy (D-OCSA). Using this system, we analyzed how the spatial mechanical changes in the SEs depended on the culture duration. For quantitative analysis of viscoelastic behavior, we defined a relaxation attenuation coefficient of strain rate, which indicates the ratio of viscosity and elasticity in the Klevin-Voight model.

RESULTS

By culturing for 4 days in comparison to culturing for 1 day, the strain relaxation attenuation coefficient of the whole skin, especially at the region of the dermal-epidermal junction (DEJ), significantly increased in the negative direction. In tissue slices taken for microscopy, several cracks were observed in the SEs cultured for 4 days.

CONCLUSION

This study is the first to provide quantified evidence that the DEJ is a dynamically specialized region. An OCT-based straingraphy system (D-OCSA) would be beneficial for evaluating the quality of SEs, as well as functional analysis of their mechanics.

The validity and reliability of using ultrasound elastography to measure cutaneous stiffness, a systematic review

BACKGROUND

Ultrasound elastography is an imaging technology which can objectively and non-invasively assess tissue stiffness. It is emerging as a useful marker for disease diagnosis, progression and treatment efficacy.

OBJECTIVE

To examine current, published research evaluating the use of ultrasound elastography for the measurement of cutaneous or subcutaneous stiffness and to determine the level of validity and reliability, recommended methodologies and limitations.

METHODS

MEDLINE, Web of science and Scopus were systematically searched in August 2016 to identify original articles evaluating the use of ultrasound elastography to assess cutaneous stiffness. Relevant studies were then quality evaluated using the Quality Assessment of Diagnostic Accuracy Studies v 2 (QUADAS-2) tool and the Quality Appraisal of Reliability Studies (QAREL).

RESULTS

From a total of 688 articles, 14 met the inclusion criteria for full review. Within the 14 studies, elastography was used to evaluate tumors, systemic sclerosis, lymphedema, abscess, and post-radiation neck fibrosis. Only three robust studies demonstrated good interrater reliability, whereas all validity studies had low sample sizes and demonstrated risks of bias.

CONCLUSION

Robust evidence supporting the use of ultrasound elastography as a diagnostic tool in cutaneous conditions is low, however, initial indicators support further research to establish the utility of ultrasound elastography in dermatology.

Optical coherence tomography in gastroenterology: a review and future outlook

Optical coherence tomography (OCT) is an imaging technique optically analogous to ultrasound that can generate depth-resolved images with micrometer-scale resolution. Advances in fiber optics and miniaturized actuation technologies allow OCT imaging of the human body and further expand OCT utilization in applications including but not limited to cardiology and gastroenterology. This review article provides an overview of current OCT development and its clinical utility in the gastrointestinal tract, including disease detection/differentiation and endoscopic therapy guidance, as well as a discussion of its future applications.

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.

In vivo volumetric quantitative micro-elastography of human skin

In this paper, we demonstrate in vivo volumetric quantitative micro-elastography of human skin. Elasticity is estimated at each point in the captured volume by combining local axial strain measured in the skin with local axial stress estimated at the skin surface. This is achieved by utilizing phase-sensitive detection to measure axial displacements resulting from compressive loading of the skin and an overlying, compliant, transparent layer with known stress/strain behavior. We use an imaging probe head that provides optical coherence tomography imaging and compression from the same direction. We demonstrate our technique on a tissue phantom containing a rigid inclusion, and present in vivo elastograms acquired from locations on the hand, wrist, forearm and leg of human volunteers.

Multi-functional Ultrasonic Micro-elastography Imaging System

In clinical decision making, in addition to anatomical information, biomechanical properties of soft tissues may provide additional clues for disease diagnosis. Given the fact that most of diseases are originated from micron sized structures, an elastography imaging system of fine resolution (~100 µm) and deep penetration depth capable of providing both qualitative and quantitative measurements of biomechanical properties is desired. Here, we report a newly developed multi-functional ultrasonic micro-elastography imaging system in which acoustic radiation force impulse imaging (ARFI) and shear wave elasticity imaging (SWEI) are implemented. To accomplish this, the 4.5 MHz/40 MHz transducer were used as the excitation/detection source, respectively. The imaging system was tested with tissue-mimicking phantoms and an ex vivo chicken liver through 2D/3D imaging. The measured lateral/axial elastography resolution and field of view are 223.7 ± 20.1/109.8 ± 6.9 µm and 1.5 mm for ARFI, 543.6 ± 39.3/117.6 ± 8.7 µm and 2 mm for SWEI, respectively. These results demonstrate that the promising capability of this high resolution elastography imaging system for characterizing tissue biomechanical properties at microscale level and its translational potential into clinical practice.

Investigation of optical attenuation imaging using optical coherence tomography for monitoring of scars undergoing fractional laser treatment

We demonstrate the use of the near-infrared attenuation coefficient, measured using optical coherence tomography (OCT), in longitudinal assessment of hypertrophic burn scars undergoing fractional laser treatment. The measurement method incorporates blood vessel detection by speckle decorrelation and masking, and a robust regression estimator to produce 2D en face parametric images of the attenuation coefficient of the dermis. Through reliable co-location of the field of view across pre- and post-treatment imaging sessions, the study was able to quantify changes in the attenuation coefficient of the dermis over a period of ∼20 weeks in seven patients. Minimal variation was observed in the mean attenuation coefficient of normal skin and control (untreated) mature scars, as expected. However, a significant decrease (13 ± 5%, mean ± standard deviation) was observed in the treated mature scars, resulting in a greater distinction from normal skin in response to localized damage from the laser treatment. By contrast, we observed an increase in the mean attenuation coefficient of treated (31 ± 27%) and control (27 ± 20%) immature scars, with numerical values incrementally approaching normal skin as the healing progressed. This pilot study supports conducting a more extensive investigation of OCT attenuation imaging for quantitative longitudinal monitoring of scars. En face 2D OCT attenuation coefficient map of a treated immature scar derived from the pre-treatment (top) and the post-treatment (bottom) scans. (Vasculature (black) is masked out.) The scale bars are 0.5 mm.

Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review

Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures.

Cell-matrix mechanical interaction in electrospun polymeric scaffolds for tissue engineering: Implications for scaffold design and performance

Engineered scaffolds produced by electrospinning of biodegradable polymers offer a 3D, nanofibrous environment with controllable structural, chemical, and mechanical properties that mimic the extracellular matrix of native tissues and have shown promise for a number of tissue engineering applications. The microscale mechanical interactions between cells and electrospun matrices drive cell behaviors including migration and differentiation that are critical to promote tissue regeneration. Recent developments in understanding these mechanical interactions in electrospun environments are reviewed, with emphasis on how fiber geometry and polymer structure impact on the local mechanical properties of scaffolds, how altering the micromechanics cues cell behaviors, and how, in turn, cellular and extrinsic forces exerted on the matrix mechanically remodel an electrospun scaffold throughout tissue development. Techniques used to measure and visualize these mechanical interactions are described. We provide a critical outlook on technological gaps that must be overcome to advance the ability to design, assess, and manipulate the mechanical environment in electrospun scaffolds toward constructs that may be successfully applied in tissue engineering and regenerative medicine.

STATEMENT OF SIGNIFICANCE

Tissue engineering requires design of scaffolds that interact with cells to promote tissue development. Electrospinning is a promising technique for fabricating fibrous, biomimetic scaffolds. Effects of electrospun matrix microstructure and biochemical properties on cell behavior have been extensively reviewed previously; here, we consider cell-matrix interaction from a mechanical perspective. Micromechanical properties as a driver of cell behavior has been well established in planar substrates, but more recently, many studies have provided new insights into mechanical interaction in fibrillar, electrospun environments. This review provides readers with an overview of how electrospun scaffold mechanics and cell behavior work in a dynamic feedback loop to drive tissue development, and discusses opportunities for improved design of mechanical environments that are conducive to tissue development.

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.

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.

3D mapping of elastic modulus using shear wave optical micro-elastography

Elastography provides a powerful tool for histopathological identification and clinical diagnosis based on information from tissue stiffness. Benefiting from high resolution, three-dimensional (3D), and noninvasive optical coherence tomography (OCT), optical micro-elastography has the ability to determine elastic properties with a resolution of ~10 μm in a 3D specimen. The shear wave velocity measurement can be used to quantify the elastic modulus. However, in current methods, shear waves are measured near the surface with an interference of surface waves. In this study, we developed acoustic radiation force (ARF) orthogonal excitation optical coherence elastography (ARFOE-OCE) to visualize shear waves in 3D. This method uses acoustic force perpendicular to the OCT beam to excite shear waves in internal specimens and uses Doppler variance method to visualize shear wave propagation in 3D. The measured propagation of shear waves agrees well with the simulation results obtained from finite element analysis (FEA). Orthogonal acoustic excitation allows this method to measure the shear modulus in a deeper specimen which extends the elasticity measurement range beyond the OCT imaging depth. The results show that the ARFOE-OCE system has the ability to noninvasively determine the 3D elastic map.

Multi-Functional OCT Enables Longitudinal Study of Retinal Changes in a VLDLR Knockout Mouse Model

We present a multi-functional optical coherence tomography (OCT) imaging approach to study retinal changes in the very-low-density-lipoprotein-receptor (VLDLR) knockout mouse model with a threefold contrast. In the retinas of VLDLR knockout mice spontaneous retinal-chorodoidal neovascularizations form, having an appearance similar to choroidal and retinal neovascularizations (CNV and RNV) in neovascular age-related macular degeneration (AMD) or retinal angiomatous proliferation (RAP). For this longitudinal study, the mice were imaged every 4 to 6 weeks starting with an age of 4 weeks and following up to the age of 11 months. Significant retinal changes were identified by the multi-functional imaging approach offering a threefold contrast: reflectivity, polarization sensitivity (PS) and motion contrast based OCT angiography (OCTA). By use of this intrinsic contrast, the long-term development of neovascularizations was studied and associated processes, such as the migration of melanin pigments or retinal-choroidal anastomosis, were assessed in vivo. Furthermore, the in vivo imaging results were validated with histological sections at the endpoint of the experiment. Multi-functional OCT proves as a powerful tool for longitudinal retinal studies in preclinical research of ophthalmic diseases. Intrinsic contrast offered by the functional extensions of OCT might help to describe regulative processes in genetic animal models and potentially deepen the understanding of the pathogenesis of retinal diseases such as wet AMD.

Wide-field optical coherence micro-elastography for intraoperative assessment of human breast cancer margins

Incomplete excision of malignant tissue is a major issue in breast-conserving surgery, with typically 20 - 30% of cases requiring a second surgical procedure arising from postoperative detection of an involved margin. We report advances in the development of a new intraoperative tool, optical coherence micro-elastography, for the assessment of tumor margins on the micro-scale. We demonstrate an important step by conducting whole specimen imaging in intraoperative time frames with a wide-field scanning system acquiring mosaicked elastograms with overall dimensions of ~50 × 50 mm, large enough to image an entire face of most lumpectomy specimens. This capability is enabled by a wide-aperture annular actuator with an internal diameter of 65 mm. We demonstrate feasibility by presenting elastograms recorded from freshly excised human breast tissue, including from a mastectomy, lumpectomies and a cavity shaving.

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.

Investigation of Thermal Effects of Photocoagulation on Retinal Tissue Using Fine-Motion-Sensitive Dynamic Optical Coherence Tomography

To enable an objective evaluation of photocoagulation, we characterize thermal tissue changes induced by laser irradiation with different laser parameters using optical coherence tomography (OCT). Spectral-domain OCT with a newly developed image processing method was used to monitor the thermal changes of ex vivo porcine retina. A sequence of OCT B-scans was obtained at the same retinal position simultaneously with the photocoagulation. Cross-sectional tissue displacement maps with respect to an OCT image taken before laser irradiation were computed for images taken before, during, and after laser irradiation, by using a correlation-based custom algorithm. Cross-sectional correlation maps (OCT correlation maps) were also computed from an OCT image taken before laser irradiation as a base-line to visualize alterations of tissue microstructure induced by laser irradiation. By systematically controlling laser power and exposure times, tissue displacements and structural changes of 200 retinal regions of 10 porcine eyes were characterized. Thermal tissue changes were characterized by B-scan images, OCT correlation maps, and tissue displacement maps. Larger tissue deformation was induced with higher laser power and shorter exposure time, while the same total laser energy (10 mJ) was applied. The measured tissue displacements revealed the complicated dynamics of tissue displacements. Three types of dynamics were observed; lateral expansion, lateral constriction, and a type showing more complicated dynamics. The results demonstrated the ability of this OCT-based method to evaluate retinal changes induced by laser irradiation. This evaluation could lead to further understanding of thermal effects, and increasing reproducibility of photocoagulation therapy.

Effects of fixation and preservation on tissue elastic properties measured by quantitative optical coherence elastography (OCE)

Fixed and preserved tissues have been massively used in the development of biomedical equipment and instrumentation. Not only the tissue morphology, but also its mechanical properties need to be considered in the fixation and preservation procedures since mechanical properties have significant influence on the design and performance of such instruments. Understanding the effects of storage and preservation conditions on the mechanical properties of soft tissue has both clinical and experimental significance. To this end, we aimed to study the effects of tissue preservation (by 10% formalin and Thiel fluids) on the elastic properties of five different kinds of fresh tissues from pig and chicken; specifically fat, liver, muscle, tendon and cartilage. The tissue elasticity was measured intensively and strictly within a controlled timeline of 6 months by quantitative optical coherence elastography (OCE) system. Our findings suggest that the elasticity change of tissues in the formalin solution has an ascending trend, but that of Thiel remains almost constant, providing a more real texture and properties.

Quantitative optical coherence elastography based on fiber-optic probe for in situ measurement of tissue mechanical properties

We developed a miniature quantitative optical coherence elastography (qOCE) instrument with an integrated Fabry-Perot force sensor, for in situ elasticity measurement of biological tissue. The technique has great potential for biomechanics modeling and clinical diagnosis. We designed the fiber-optic qOCE probe that was used to exert a compressive force to deform tissue at 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 quantify the probe deformation that was proportional to the force applied, and to quantify the tissue deformation corresponding to the external stimulus. Simultaneous measurement of force and displacement allowed us to extract Young's modulus of biological tissue. We experimentally calibrated our qOCE instrument, and validated its effectiveness on tissue mimicking phantoms and biological tissues.

Application of Elastography for the Noninvasive Assessment of Biomechanics in Engineered Biomaterials and Tissues

The elastic properties of engineered biomaterials and tissues impact their post-implantation repair potential and structural integrity, and are critical to help regulate cell fate and gene expression. The measurement of properties (e.g., stiffness or shear modulus) can be attained using elastography, which exploits noninvasive imaging modalities to provide functional information of a material indicative of the regeneration state. In this review, we outline the current leading elastography methodologies available to characterize the properties of biomaterials and tissues suitable for repair and mechanobiology research. We describe methods utilizing magnetic resonance, ultrasound, and optical coherent elastography, highlighting their potential for longitudinal monitoring of implanted materials in vivo, in addition to spatiotemporal limits of each method for probing changes in cell-laden constructs. Micro-elastography methods now allow acquisitions at length scales approaching 5-100 μm in two and three dimensions. Many of the methods introduced in this review are therefore capable of longitudinal monitoring in biomaterials and tissues approaching the cellular scale. However, critical factors such as anisotropy, heterogeneity and viscoelasity-inherent in many soft tissues-are often not fully described and therefore require further advancements and future developments.

Stiffness measurement using terahertz and acoustic waves for biological samples

A method is proposed to measure sample stiffness using terahertz wave and acoustic stimulation. The stiffness-dependent vibration is measured using terahertz wave (T-ray) during an acoustic stimulation. To quantify the vibration, time of the peak amplitude of the reflected T-ray is measured. In our experiment, the T-ray is asynchronously applied during the period of the acoustic stimulation, and multiple measurements are taken to use the standard deviation and the maximum difference in the peak times to estimate the amplitude of the vibration. Some preliminary results are shown using biological samples.

Mapping 3D Strains with Ultrasound Speckle Tracking: Method Validation and Initial Results in Porcine Scleral Inflation

This study aimed to develop and validate a high frequency ultrasound method for measuring distributive, 3D strains in the sclera during elevations of intraocular pressure. A 3D cross-correlation based speckle-tracking algorithm was implemented to compute the 3D displacement vector and strain tensor at each tracking point. Simulated ultrasound radiofrequency data from a sclera-like structure at undeformed and deformed states with known strains were used to evaluate the accuracy and signal-to-noise ratio (SNR) of strain estimation. An experimental high frequency ultrasound (55 MHz) system was built to acquire 3D scans of porcine eyes inflated from 15 to 17 and then 19 mmHg. Simulations confirmed good strain estimation accuracy and SNR (e.g., the axial strains had less than 4.5% error with SNRs greater than 16.5 for strains from 0.005 to 0.05). Experimental data in porcine eyes showed increasing tensile, compressive, and shear strains in the posterior sclera during inflation, with a volume ratio close to one suggesting near-incompressibility. This study established the feasibility of using high frequency ultrasound speckle tracking for measuring 3D tissue strains and its potential to characterize physiological deformations in the posterior eye.

Quantitative micro-elastography: imaging of tissue elasticity using compression optical coherence elastography

Probing the mechanical properties of tissue on the microscale could aid in the identification of diseased tissues that are inadequately detected using palpation or current clinical imaging modalities, with potential to guide medical procedures such as the excision of breast tumours. Compression optical coherence elastography (OCE) maps tissue strain with microscale spatial resolution and can delineate microstructural features within breast tissues. However, without a measure of the locally applied stress, strain provides only a qualitative indication of mechanical properties. To overcome this limitation, we present quantitative micro-elastography, which combines compression OCE with a compliant stress sensor to image tissue elasticity. The sensor consists of a layer of translucent silicone with well-characterized stress-strain behaviour. The measured strain in the sensor is used to estimate the two-dimensional stress distribution applied to the sample surface. Elasticity is determined by dividing the stress by the strain in the sample. We show that quantification of elasticity can improve the ability of compression OCE to distinguish between tissues, thereby extending the potential for inter-sample comparison and longitudinal studies of tissue elasticity. We validate the technique using tissue-mimicking phantoms and demonstrate the ability to map elasticity of freshly excised malignant and benign human breast tissues.

From Finite Element Meshes to Clouds of Points: A Review of Methods for Generation of Computational Biomechanics Models for Patient-Specific Applications

It has been envisaged that advances in computing and engineering technologies could extend surgeons' ability to plan and carry out surgical interventions more accurately and with less trauma. The progress in this area depends crucially on the ability to create robustly and rapidly patient-specific biomechanical models. We focus on methods for generation of patient-specific computational grids used for solving partial differential equations governing the mechanics of the body organs. We review state-of-the-art in this area and provide suggestions for future research. To provide a complete picture of the field of patient-specific model generation, we also discuss methods for identifying and assigning patient-specific material properties of tissues and boundary conditions.

Investigation of Optical Coherence Microelastography as a Method to Visualize Cancers in Human Breast Tissue

An accurate intraoperative identification of malignant tissue is a challenge in the surgical management of breast cancer. Imaging techniques that help address this challenge could contribute to more complete and accurate tumor excision, and thereby help reduce the current high reexcision rates without resorting to the removal of excess healthy tissue. Optical coherence microelastography (OCME) is a three-dimensional, high-resolution imaging technique that is sensitive to microscale variations of the mechanical properties of tissue. As the tumor modifies the mechanical properties of breast tissue, OCME has the potential to identify, on the microscale, involved regions of fresh, unstained tissue. OCME is based on the use of optical coherence tomography (OCT) to measure tissue deformation in response to applied mechanical compression. In this feasibility study on 58 ex vivo samples from patients undergoing mastectomy or wide local excision, we demonstrate the performance of OCME as a means to visualize tissue microarchitecture in benign and malignant human breast tissues. Through a comparison with corresponding histology and OCT images, OCME is shown to enable ready visualization of features such as ducts, lobules, microcysts, blood vessels, and arterioles and to identify invasive tumor through distinctive patterns in OCME images, often with enhanced contrast compared with OCT. These results lay the foundation for future intraoperative studies. Cancer Res; 75(16); 3236-45. ©2015 AACR.

Functional optical coherence tomography: principles and progress

In the past decade, several functional extensions of optical coherence tomography (OCT) have emerged, and this review highlights key advances in instrumentation, theoretical analysis, signal processing and clinical application of these extensions. We review five principal extensions: Doppler OCT (DOCT), polarization-sensitive OCT (PS-OCT), optical coherence elastography (OCE), spectroscopic OCT (SOCT), and molecular imaging OCT. The former three have been further developed with studies in both ex vivo and in vivo human tissues. This review emphasizes the newer techniques of SOCT and molecular imaging OCT, which show excellent potential for clinical application but have yet to be well reviewed in the literature. SOCT elucidates tissue characteristics, such as oxygenation and carcinogenesis, by detecting wavelength-dependent absorption and scattering of light in tissues. While SOCT measures endogenous biochemical distributions, molecular imaging OCT detects exogenous molecular contrast agents. These newer advances in functional OCT broaden the potential clinical application of OCT by providing novel ways to understand tissue activity that cannot be accomplished by other current imaging methodologies.

Quantitative methods for reconstructing tissue biomechanical properties in optical coherence elastography: a comparison study

We present a systematic analysis of the accuracy of five different methods for extracting the biomechanical properties of soft samples using optical coherence elastography (OCE). OCE is an emerging noninvasive technique, which allows assessment of biomechanical properties of tissues with micrometer spatial resolution. However, in order to accurately extract biomechanical properties from OCE measurements, application of a proper mechanical model is required. In this study, we utilize tissue-mimicking phantoms with controlled elastic properties and investigate the feasibilities of four available methods for reconstructing elasticity (Young's modulus) based on OCE measurements of an air-pulse induced elastic wave. The approaches are based on the shear wave equation (SWE), the surface wave equation (SuWE), Rayleigh-Lamb frequency equation (RLFE), and finite element method (FEM), Elasticity values were compared with uniaxial mechanical testing. The results show that the RLFE and the FEM are more robust in quantitatively assessing elasticity than the other simplified models. This study provides a foundation and reference for reconstructing the biomechanical properties of tissues from OCE data, which is important for the further development of noninvasive elastography methods.

Imaging and characterizing shear wave and shear modulus under orthogonal acoustic radiation force excitation using OCT Doppler variance method

We report on a novel acoustic radiation force orthogonal excitation optical coherence elastography (ARFOE-OCE) technique for imaging shear wave and quantifying shear modulus under orthogonal acoustic radiation force (ARF) excitation using the optical coherence tomography (OCT) Doppler variance method. The ARF perpendicular to the OCT beam is produced by a remote ultrasonic transducer. A shear wave induced by ARF excitation propagates parallel to the OCT beam. The OCT Doppler variance method, which is sensitive to the transverse vibration, is used to measure the ARF-induced vibration. For analysis of the shear modulus, the Doppler variance method is utilized to visualize shear wave propagation instead of Doppler OCT method, and the propagation velocity of the shear wave is measured at different depths of one location with the M scan. In order to quantify shear modulus beyond the OCT imaging depth, we move ARF to a deeper layer at a known step and measure the time delay of the shear wave propagating to the same OCT imaging depth. We also quantitatively map the shear modulus of a cross-section in a tissue-equivalent phantom after employing the B scan.

In-plane and out-of-plane tissue micro-displacement measurement by correlation coefficients of optical coherence tomography

We propose a method to measure the in-plane and out-of-plane displacements of tissue using the correlation coefficients of optical coherence tomography (OCT) signals. The displacements are determined by the local correlation coefficients between digitally shifted reference OCT images and a target image. The method achieves sub-micron displacement measurement with an accuracy better than 0.32 μm and repeatability better than 0.36 μm. The feasibility of the method was examined by measuring the displacement field of a laser irradiated porcine retina. This method successfully visualized the dynamic change of the displacement field during laser irradiation.

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.