1
|
Jones GL, Albadawi H, Hariri LP, Bouma BE, Oklu R, Villiger M. Aging of deep venous thrombosis in-vivo using polarization sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2024; 15:3627-3638. [PMID: 38867781 PMCID: PMC11166430 DOI: 10.1364/boe.522238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 06/14/2024]
Abstract
Deep venous thrombosis (DVT) is a medical condition with significant post-event morbidity and mortality coupled with limited treatment options. Treatment strategy and efficacy are highly dependent on the structural composition of the thrombus, which evolves over time from initial formation and is currently unevaluable with standard clinical testing. Here, we investigate the use of intravascular polarization-sensitive optical coherence tomography (PS-OCT) to assess thrombus morphology and composition in a rat DVT model in-vivo, including changes that occur over the thrombus aging process. PS-OCT measures tissue birefringence, which provides contrast for collagen and smooth muscle cells that are present in older, chronic clots. Thrombi in the inferior vena cava of two cohorts of rats were imaged in-vivo with intravascular PS-OCT at 24 hours (acute, nrats = 3, 73 cross-sections) or 28 days (chronic, nrats = 4, 41 cross-sections) after thrombus formation. Co-registered histology was labelled by an independent pathologist to establish ground-truth clot composition. Automated analysis of OCT cross-sectional images differentiated acute and chronic thrombi with 97.6% sensitivity and 98.6% specificity using a linear discriminant model comprised of both polarization and conventional OCT metrics. These results support PS-OCT as a highly sensitive imaging modality for the assessment of DVT composition to differentiate acute and chronic thrombi. Intravascular PS-OCT imaging could be integrated with advanced catheter-based treatment strategies and serve to guide therapeutic decision-making and deployment, by offering an accurate assessment of DVT patients in real time.
Collapse
Affiliation(s)
- Georgia L. Jones
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Hassan Albadawi
- Division of Vascular and Interventional Radiology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Lida P. Hariri
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Brett E. Bouma
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Rahmi Oklu
- Division of Vascular and Interventional Radiology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Martin Villiger
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| |
Collapse
|
2
|
Tang P, Wang RK, Chao Q. Digital calibration method to enable depth-resolved all-fiber polarization sensitive optical coherence tomography with an arbitrary input polarization state. BIOMEDICAL OPTICS EXPRESS 2024; 15:3329-3343. [PMID: 38855689 PMCID: PMC11161387 DOI: 10.1364/boe.517826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 06/11/2024]
Abstract
We present a fully integrated depth-resolved all fiber-based polarization sensitive optical coherence tomography (PSOCT). In contrast to conventional fiber-based PSOCT systems, which require additional modules to generate two or more input polarization states, or a pre-adjustment procedure to generate a circularly polarized light, the proposed all-fiber PSOCT system can provide depth-resolved birefringent imaging using an arbitrary single input polarization state. Utilizing the discrete differential geometry (DDG)-based polarization state tracing (PST) method, combined with several geometric rotations and transformations in the Stokes space, two problems induced by the optical fibers can be mitigated: 1) The change in the polarization state introduced by the optical fibers can be effectively compensated using a calibration target at the distal end of the probe, and the computations of the local axis orientation and local phase retardation can be achieved with a single arbitrary input polarization state, eliminating the need for a pre-defined input polarization state, allowing a flexible system design and user-friendly experimental procedure; 2) The polarization mode dispersion (PMD) induced by the optical fibers can be compensated digitally without the requirement of additional input polarization states, providing an accurate PSOCT imaging result. To demonstrate the performance of the proposed method, the depth resolved PSOCT results of a plastic phantom and in vivo skin imaging are obtained using the proposed all-fiber PSOCT system.
Collapse
Affiliation(s)
- Peijun Tang
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, Washington 98195,
USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, Washington 98195,
USA
- Department of Ophthalmology,
University of Washington, 750 Republican
St., Seattle, Washington 98195, USA
| | - Qing Chao
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, Washington 98195,
USA
| |
Collapse
|
3
|
Chen G, Wang W, Li Y. Reducing noise in polarization-sensitive optical coherence tomography for high-quality local phase retardation imaging. APPLIED OPTICS 2024; 63:2822-2830. [PMID: 38856377 DOI: 10.1364/ao.515942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/17/2024] [Indexed: 06/11/2024]
Abstract
Local phase retardation (LPR) is increasingly recognized as a crucial biomarker for assessing disease progression. However, the presence of speckle noise significantly challenges its accuracy and polarization contrast. To address this challenge, we propose a signal-processing strategy aimed at reducing the impact of noise on LPR measurements. In this approach, the LPR is reconstructed by polar decomposition after averaging multiple Mueller matrices from different overlapping sub-spectra. To optimize measurement accuracy, we systematically combined and traversed different sub-spectral numbers and bandwidths. By examining the quarter-wave plate and glass slide, high-accuracy phase retardation measurements were successfully verified, and the maximum polarization contrast was improved by 23%. Moreover, experimental results from multi-tissue imaging vividly illustrate that the equivalent number of looks (ENL) and polarization contrast were improved by 18% and 19%, respectively. This outcome indicates that our proposed strategy can effectively reduce the noise spikes, enhancing tissue discrimination capabilities.
Collapse
|
4
|
Bec J, Zhou X, Villiger M, Southard JA, Bouma B, Marcu L. Dual modality intravascular catheter system combining pulse-sampling fluorescence lifetime imaging and polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2024; 15:2114-2132. [PMID: 38633060 PMCID: PMC11019710 DOI: 10.1364/boe.516515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 04/19/2024]
Abstract
The clinical management of coronary artery disease and the prevention of acute coronary syndromes require knowledge of the underlying atherosclerotic plaque pathobiology. Hybrid imaging modalities capable of comprehensive assessment of biochemical and morphological plaques features can address this need. Here we report the first implementation of an intravascular catheter system combining fluorescence lifetime imaging (FLIm) with polarization-sensitive optical coherence tomography (PSOCT). This system provides multi-scale assessment of plaque structure and composition via high spatial resolution morphology from OCT, polarimetry-derived tissue microstructure, and biochemical composition from FLIm, without requiring any molecular contrast agent. This result was achieved with a low profile (2.7 Fr) double-clad fiber (DCF) catheter and high speed (100 fps B-scan rate, 40 mm/s pullback speed) console. Use of a DCF and broadband rotary junction required extensive optimization to mitigate the reduction in OCT performance originating from additional reflections and multipath artifacts. This challenge was addressed by the development of a broad-band (UV-visible-IR), high return loss (47 dB) rotary junction. We demonstrate in phantoms, ex vivo swine coronary specimens and in vivo swine heart (percutaneous coronary access) that the FLIm-PSOCT catheter system can simultaneously acquire co-registered FLIm data over four distinct spectral bands (380/20 nm, 400/20 nm, 452/45 nm, 540/45 nm) and PSOCT backscattered intensity, birefringence, and depolarization. The unique ability to collect complementary information from tissue (e.g., morphology, extracellular matrix composition, inflammation) with a device suitable for percutaneous coronary intervention offers new opportunities for cardiovascular research and clinical diagnosis.
Collapse
Affiliation(s)
- Julien Bec
- Biomedical Engineering, University of California, Davis, CA 95616, USA
| | - Xiangnan Zhou
- Biomedical Engineering, University of California, Davis, CA 95616, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jeffrey A. Southard
- Division of Cardiovascular Medicine, UC Davis Health System, University of California-Davis, Sacramento, CA 95817, USA
| | - Brett Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Laura Marcu
- Biomedical Engineering, University of California, Davis, CA 95616, USA
| |
Collapse
|
5
|
Haft-Javaherian M, Villiger M, Otsuka K, Daemen J, Libby P, Golland P, Bouma BE. Segmentation of anatomical layers and imaging artifacts in intravascular polarization sensitive optical coherence tomography using attending physician and boundary cardinality losses. BIOMEDICAL OPTICS EXPRESS 2024; 15:1719-1738. [PMID: 38495711 PMCID: PMC10942710 DOI: 10.1364/boe.514673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 03/19/2024]
Abstract
Intravascular ultrasound and optical coherence tomography are widely available for assessing coronary stenoses and provide critical information to optimize percutaneous coronary intervention. Intravascular polarization-sensitive optical coherence tomography (PS-OCT) measures the polarization state of the light scattered by the vessel wall in addition to conventional cross-sectional images of subsurface microstructure. This affords reconstruction of tissue polarization properties and reveals improved contrast between the layers of the vessel wall along with insight into collagen and smooth muscle content. Here, we propose a convolutional neural network model, optimized using two new loss terms (Boundary Cardinality and Attending Physician), that takes advantage of the additional polarization contrast and classifies the lumen, intima, and media layers in addition to guidewire and plaque shadows. Our model segments the media boundaries through fibrotic plaques and continues to estimate the outer media boundary behind shadows of lipid-rich plaques. We demonstrate that our multi-class classification model outperforms existing methods that exclusively use conventional OCT data, predominantly segment the lumen, and consider subsurface layers at most in regions of minimal disease. Segmentation of all anatomical layers throughout diseased vessels may facilitate stent sizing and will enable automated characterization of plaque polarization properties for investigation of the natural history and significance of coronary atheromas.
Collapse
Affiliation(s)
- Mohammad Haft-Javaherian
- Computer Science and Artificial Intelligence Laboratory (CSAIL), Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Kenichiro Otsuka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Joost Daemen
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Peter Libby
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Polina Golland
- Computer Science and Artificial Intelligence Laboratory (CSAIL), Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| |
Collapse
|
6
|
Steuer S, Morgenstern J, Kirsten L, Bornitz M, Neudert M, Koch E, Golde J. In vivo microstructural investigation of the human tympanic membrane by endoscopic polarization-sensitive optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:121203. [PMID: 37007626 PMCID: PMC10050973 DOI: 10.1117/1.jbo.28.12.121203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
SIGNIFICANCE Endoscopic optical coherence tomography (OCT) is of growing interest for in vivo diagnostics of the tympanic membrane (TM) and the middle ear but generally lacks a tissue-specific contrast. AIM To assess the collagen fiber layer within the in vivo TM, an endoscopic imaging method utilizing the polarization changes induced by the birefringent connective tissue was developed. APPROACH An endoscopic swept-source OCT setup was redesigned and extended by a polarization-diverse balanced detection unit. Polarization-sensitive OCT (PS-OCT) data were visualized by a differential Stokes-based processing and the derived local retardation. The left and right ears of a healthy volunteer were examined. RESULTS Distinct retardation signals in the annulus region of the TM and near the umbo revealed the layered structure of the TM. Due to the TM's conical shape and orientation in the ear canal, high incident angles onto the TM's surface, and low thicknesses compared to the axial resolution limit of the system, other regions of the TM were more difficult to evaluate. CONCLUSIONS The use of endoscopic PS-OCT is feasible to differentiate birefringent and nonbirefringent tissue of the human TM in vivo. Further investigations on healthy as well as pathologically altered TMs are required to validate the diagnostic potential of this technique.
Collapse
Affiliation(s)
- Svea Steuer
- TU Dresden, Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Dresden, Germany
- TU Dresden, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Faculty of Medicine, Dresden, Germany
| | - Joseph Morgenstern
- TU Dresden, Otorhinolaryngology, Ear Research Center Dresden, Faculty of Medicine, Dresden, Germany
- TU Dresden, Else Kröner-Fresenius Center for Digital Health, Dresden, Germany
| | - Lars Kirsten
- TU Dresden, Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Dresden, Germany
| | - Matthias Bornitz
- TU Dresden, Otorhinolaryngology, Ear Research Center Dresden, Faculty of Medicine, Dresden, Germany
| | - Marcus Neudert
- TU Dresden, Otorhinolaryngology, Ear Research Center Dresden, Faculty of Medicine, Dresden, Germany
- TU Dresden, Else Kröner-Fresenius Center for Digital Health, Dresden, Germany
| | - Edmund Koch
- TU Dresden, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Faculty of Medicine, Dresden, Germany
- TU Dresden, Else Kröner-Fresenius Center for Digital Health, Dresden, Germany
| | - Jonas Golde
- TU Dresden, Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Dresden, Germany
- TU Dresden, Else Kröner-Fresenius Center for Digital Health, Dresden, Germany
| |
Collapse
|
7
|
Bagdasarian IA, Tonmoy TI, Park BH, Morgan JT. In vitro formation and extended culture of highly metabolically active and contractile tissues. PLoS One 2023; 18:e0293609. [PMID: 37910543 PMCID: PMC10619834 DOI: 10.1371/journal.pone.0293609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
3D cell culture models have gained popularity in recent years as an alternative to animal and 2D cell culture models for pharmaceutical testing and disease modeling. Polydimethylsiloxane (PDMS) is a cost-effective and accessible molding material for 3D cultures; however, routine PDMS molding may not be appropriate for extended culture of contractile and metabolically active tissues. Failures can include loss of culture adhesion to the PDMS mold and limited culture surfaces for nutrient and waste diffusion. In this study, we evaluated PDMS molding materials and surface treatments for highly contractile and metabolically active 3D cell cultures. PDMS functionalized with polydopamine allowed for extended culture duration (14.8 ± 3.97 days) when compared to polyethylamine/glutaraldehyde functionalization (6.94 ± 2.74 days); Additionally, porous PDMS extended culture duration (16.7 ± 3.51 days) compared to smooth PDMS (6.33 ± 2.05 days) after treatment with TGF-β2 to increase culture contraction. Porous PDMS additionally allowed for large (13 mm tall × 8 mm diameter) constructs to be fed by diffusion through the mold, resulting in increased cell density (0.0210 ± 0.0049 mean nuclear fraction) compared to controls (0.0045 ± 0.0016 mean nuclear fraction). As a practical demonstration of the flexibility of porous PDMS, we engineered a vascular bioartificial muscle model (VBAM) and demonstrated extended culture of VBAMs anchored with porous PDMS posts. Using this model, we assessed the effect of feeding frequency on VBAM cellularity. Feeding 3×/week significantly increased nuclear fraction at multiple tissue depths relative to 2×/day. VBAM maturation was similarly improved in 3×/week feeding as measured by nuclear alignment (23.49° ± 3.644) and nuclear aspect ratio (2.274 ± 0.0643) relative to 2x/day (35.93° ± 2.942) and (1.371 ± 0.1127), respectively. The described techniques are designed to be simple and easy to implement with minimal training or expense, improving access to dense and/or metabolically active 3D cell culture models.
Collapse
Affiliation(s)
- Isabella A. Bagdasarian
- Department of Bioengineering, University of California, Riverside, CA, United States of America
| | - Thamidul Islam Tonmoy
- Department of Bioengineering, University of California, Riverside, CA, United States of America
| | - B. Hyle Park
- Department of Bioengineering, University of California, Riverside, CA, United States of America
| | - Joshua T. Morgan
- Department of Bioengineering, University of California, Riverside, CA, United States of America
| |
Collapse
|
8
|
Harper DJ, Kim Y, Gómez-Ramírez A, Vakoc BJ. Needle guidance with Doppler-tracked polarization-sensitive optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:102910. [PMID: 37799938 PMCID: PMC10548115 DOI: 10.1117/1.jbo.28.10.102910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/25/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
Significance Optical coherence tomography (OCT) can be integrated into needle probes to provide real-time navigational guidance. However, unscanned implementations, which are the simplest to build, often struggle to discriminate the relevant tissues. Aim We explore the use of polarization-sensitive (PS) methods as a means to enhance signal interpretability within unscanned coherence tomography probes. Approach Broadband light from a laser centered at 1310 nm was sent through a fiber that was embedded into a needle. The polarization signal from OCT fringes was combined with Doppler-based tracking to create visualizations of the birefringence properties of the tissue. Experiments were performed in (i) well-understood structured tissues (salmon and shrimp) and (ii) ex vivo porcine spine. The porcine experiments were selected to illustrate an epidural guidance use case. Results In the porcine spine, unscanned and Doppler-tracked PS OCT imaging data successfully identified the skin, subcutaneous tissue, ligament, and epidural spaces during needle insertion. Conclusions PS imaging within a needle probe improves signal interpretability relative to structural OCT methods and may advance the clinical utility of unscanned OCT needle probes in a variety of applications.
Collapse
Affiliation(s)
- Danielle J. Harper
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Yongjoo Kim
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Alejandra Gómez-Ramírez
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Universidad Nacional de Colombia sede Medellín, School of Physics, Medellín, Colombia
| | - Benjamin J. Vakoc
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, United States
| |
Collapse
|
9
|
Ruiz-Lopera S, Restrepo R, Cannon TM, Villiger M, Bouma BE, Uribe-Patarroyo N. Computational refocusing in phase-unstable polarization-sensitive optical coherence tomography. OPTICS LETTERS 2023; 48:4765-4768. [PMID: 37707897 PMCID: PMC10871002 DOI: 10.1364/ol.499051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023]
Abstract
We present computational refocusing in polarization-sensitive optical coherence tomography (PS-OCT) to improve spatial resolution in the calculated polarimetric parameters and extend the depth-of-field in phase-unstable, fiber-based PS-OCT systems. To achieve this, we successfully adapted short A-line range phase-stability adaptive optics (SHARP), a computational aberration correction technique compatible with phase-unstable systems, into a Stokes-based PS-OCT system with inter-A-line polarization modulation. Together with the spectral binning technique to mitigate system-induced chromatic polarization effects, we show that computational refocusing improves image quality in tissue polarimetry of swine eye anterior segment ex vivo with PS-OCT. The benefits, drawbacks, and potential applications of computational refocusing in anterior segment imaging are discussed.
Collapse
Affiliation(s)
- Sebastián Ruiz-Lopera
- Applied Optics Group, Universidad EAFIT, Carrera 49 # 7 Sur-50, Medellín, Colombia
- MIT Graduate Program in Electrical Engineering and Computer Science, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114, USA
| | - René Restrepo
- Applied Optics Group, Universidad EAFIT, Carrera 49 # 7 Sur-50, Medellín, Colombia
| | - Taylor M. Cannon
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, 77 Massachusetts Avenue, Massachusetts 02139, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114, USA
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, 77 Massachusetts Avenue, Massachusetts 02139, USA
| | - Néstor Uribe-Patarroyo
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts 02114, USA
| |
Collapse
|
10
|
Jones GL, Xiong Q, Liu X, Bouma BE, Villiger M. Single-input polarization-sensitive optical coherence tomography through a catheter. BIOMEDICAL OPTICS EXPRESS 2023; 14:4609-4626. [PMID: 37791262 PMCID: PMC10545192 DOI: 10.1364/boe.497123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 10/05/2023]
Abstract
Intravascular polarimetry with catheter-based polarization-sensitive optical coherence tomography (PS-OCT) complements the high-resolution structural tomograms of OCT with morphological contrast available through polarimetry. Its clinical translation has been complicated by the need for modification of conventional OCT hardware to enable polarimetric measurements. Here, we present a signal processing method to reconstruct the polarization properties of tissue from measurements with a single input polarization state, bypassing the need for modulation or multiplexing of input states. Our method relies on a polarization symmetry intrinsic to round-trip measurements and uses the residual spectral variation of the polarization states incident on the tissue to avoid measurement ambiguities. We demonstrate depth-resolved birefringence and optic axis orientation maps reconstructed from in-vivo data of human coronary arteries. We validate our method through comparison with conventional dual-input state measurements and find a mean cumulative retardance error of 13.2deg without observable bias. The 95% limit of agreement between depth-resolved birefringence is 2.80 · 10-4, which is less than the agreement between two repeat pullbacks of conventional PS-OCT (3.14 · 10-4), indicating that the two methods can be used interchangeably. The hardware simplification arising from using a single input state may be decisive in realizing the potential of polarimetric measurements for assessing coronary atherosclerosis in clinical practice.
Collapse
Affiliation(s)
- Georgia L. Jones
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Qiaozhou Xiong
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
| | - Xinyu Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, 169856, Singapore
- Academic Clinical Program, Duke-NUS Medical School, 169857, Singapore
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| |
Collapse
|
11
|
Cannon TM, Bouma BE, Uribe-Patarroyo N. Mapping optical scattering properties to physical particle information in singly and multiply scattering samples. BIOMEDICAL OPTICS EXPRESS 2023; 14:4326-4348. [PMID: 37799686 PMCID: PMC10549752 DOI: 10.1364/boe.494518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 10/07/2023]
Abstract
Optical coherence tomography (OCT) leverages light scattering by biological tissues as endogenous contrast to form structural images. Light scattering behavior is dictated by the optical properties of the tissue, which depend on microstructural details at the cellular or sub-cellular level. Methods to measure these properties from OCT intensity data have been explored in the context of a number of biomedical applications seeking to access this sub-resolution tissue microstructure and thereby increase the diagnostic impact of OCT. Most commonly, the optical attenuation coefficient, an analogue of the scattering coefficient, has been used as a surrogate metric linking OCT intensity to subcellular particle characteristics. To record attenuation coefficient data that is accurately representative of the underlying physical properties of a given sample, it is necessary to account for the impact of the OCT imaging system itself on the distribution of light intensity in the sample, including the numerical aperture (NA) of the system and the location of the focal plane with respect to the sample surface, as well as the potential contribution of multiple scattering to the reconstructed intensity signal. Although these considerations complicate attenuation coefficient measurement and interpretation, a suitably calibrated system may potentiate a powerful strategy for gaining additional information about the scattering behavior and microstructure of samples. In this work, we experimentally show that altering the OCT system geometry minimally impacts measured attenuation coefficients in samples presumed to be singly scattering, but changes these measurements in more highly scattering samples. Using both depth-resolved attenuation coefficient data and layer-resolved backscattering coefficients, we demonstrate the retrieval of scattering particle diameter and concentration in tissue-mimicking phantoms, and the impact of presumed multiple scattering on these calculations. We further extend our approach to characterize a murine brain tissue sample and highlight a tumor-bearing region based on increased scattering particle density. Through these methods, we not only enhance conventional OCT attenuation coefficient analysis by decoupling the independent effects of particle size and concentration, but also discriminate areas of strong multiple scattering through minor changes to system topology to provide a framework for assessing the accuracy of these measurements.
Collapse
Affiliation(s)
- Taylor M. Cannon
- Massachusetts Institute of Technology, Institute of Medical Engineering and Science, 70 Massachusetts Avenue, Cambridge, MA 02141, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom St, Boston, MA 02114, USA
| | - Brett E. Bouma
- Massachusetts Institute of Technology, Institute of Medical Engineering and Science, 70 Massachusetts Avenue, Cambridge, MA 02141, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom St, Boston, MA 02114, USA
| | - Néstor Uribe-Patarroyo
- Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom St, Boston, MA 02114, USA
| |
Collapse
|
12
|
Liu X, Jiang L, Ke M, Sigal IA, Chua J, Hoang QV, Chia AW, Najjar RP, Tan B, Cheong J, Bellemo V, Chong RS, Girard MJA, Ang M, Liu M, Garhöfer G, Barathi VA, Saw SM, Villiger M, Schmetterer L. Posterior scleral birefringence measured by triple-input polarization-sensitive imaging as a biomarker of myopia progression. Nat Biomed Eng 2023; 7:986-1000. [PMID: 37365268 PMCID: PMC10427432 DOI: 10.1038/s41551-023-01062-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
In myopic eyes, pathological remodelling of collagen in the posterior sclera has mostly been observed ex vivo. Here we report the development of triple-input polarization-sensitive optical coherence tomography (OCT) for measuring posterior scleral birefringence. In guinea pigs and humans, the technique offers superior imaging sensitivities and accuracies than dual-input polarization-sensitive OCT. In 8-week-long studies with young guinea pigs, scleral birefringence was positively correlated with spherical equivalent refractive errors and predicted the onset of myopia. In a cross-sectional study involving adult individuals, scleral birefringence was associated with myopia status and negatively correlated with refractive errors. Triple-input polarization-sensitive OCT may help establish posterior scleral birefringence as a non-invasive biomarker for assessing the progression of myopia.
Collapse
Affiliation(s)
- Xinyu Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
| | - Liqin Jiang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Mengyuan Ke
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Ian A Sigal
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
- Department of Ophthalmology, Columbia University, New York, NY, USA
| | - Audrey Wi Chia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Raymond P Najjar
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore, Singapore
| | - Jocelyn Cheong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Valentina Bellemo
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rachel S Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Michaël J A Girard
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Mengyang Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Veluchamy A Barathi
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
- Translational Pre-Clinical Model Platform, Singapore Eye Research Institute, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, ,National University of Singapore, National University Health System, Singapore, Singapore
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore.
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
| |
Collapse
|
13
|
Monroy GL, Erfanzadeh M, Tao M, DePaoli DT, Saytashev I, Nam SA, Rafi H, Kwong KC, Shea K, Vakoc BJ, Vasudevan S, Hammer DX. Development of polarization-sensitive optical coherence tomography imaging platform and metrics to quantify electrostimulation-induced peripheral nerve injury in vivo in a small animal model. NEUROPHOTONICS 2023; 10:025004. [PMID: 37077218 PMCID: PMC10109528 DOI: 10.1117/1.nph.10.2.025004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/28/2023] [Indexed: 05/03/2023]
Abstract
Significance Neuromodulation devices are rapidly evolving for the treatment of neurological diseases and conditions. Injury from implantation or long-term use without obvious functional losses is often only detectable through terminal histology. New technologies are needed that assess the peripheral nervous system (PNS) under normal and diseased or injured conditions. Aim We aim to demonstrate an imaging and stimulation platform that can elucidate the biological mechanisms and impacts of neurostimulation in the PNS and apply it to the sciatic nerve to extract imaging metrics indicating electrical overstimulation. Approach A sciatic nerve injury model in a 15-rat cohort was observed using a newly developed imaging and stimulation platform that can detect electrical overstimulation effects with polarization-sensitive optical coherence tomography. The sciatic nerve was electrically stimulated using a custom-developed nerve holder with embedded electrodes for 1 h, followed by a 1-h recovery period, delivered at above-threshold Shannon model k -values in experimental groups: sham control (SC, n = 5 , 0.0 mA / 0 Hz ), stimulation level 1 (SL1, n = 5 , 3.4 mA / 50 Hz , and k = 2.57 ), and stimulation level 2 (SL2, n = 5 , 6.8 mA / 100 Hz , and k = 3.17 ). Results The stimulation and imaging system successfully captured study data across the cohort. When compared to a SC after a 1-week recovery, the fascicle closest to the stimulation lead showed an average change of + 4 % / - 309 % (SL1/SL2) in phase retardation and - 79 % / - 148 % in optical attenuation relative to SC. Analysis of immunohistochemistry (IHC) shows a + 1 % / - 36 % difference in myelin pixel counts and - 13 % / + 29 % difference in axon pixel counts, and an overall increase in cell nuclei pixel count of + 20 % / + 35 % . These metrics were consistent with IHC and hematoxylin/eosin tissue section analysis. Conclusions The poststimulation changes observed in our study are manifestations of nerve injury and repair, specifically degeneration and angiogenesis. Optical imaging metrics quantify these processes and may help evaluate the safety and efficacy of neuromodulation devices.
Collapse
Affiliation(s)
- Guillermo L. Monroy
- U. S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Mohsen Erfanzadeh
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Michael Tao
- U. S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Damon T. DePaoli
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Ilyas Saytashev
- U. S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Stephanie A. Nam
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Harmain Rafi
- U. S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Kasey C. Kwong
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - Katherine Shea
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Clinical Pharmacology, Office of Translational Science, Division of Applied Regulatory Science, Silver Spring, Maryland, United States
| | - Benjamin J. Vakoc
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
- Massachusetts Institute of Technology, Division of Health Science and Technology, Cambridge, Massachusetts, United States
| | - Srikanth Vasudevan
- U. S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biomedical Physics, Silver Spring, Maryland, United States
- Address all correspondence to Srikanth Vasudevan, ; Daniel X. Hammer,
| | - Daniel X. Hammer
- U. S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Biomedical Physics, Silver Spring, Maryland, United States
- Address all correspondence to Srikanth Vasudevan, ; Daniel X. Hammer,
| |
Collapse
|
14
|
DePaoli D, Côté DC, Bouma BE, Villiger M. Endoscopic imaging of white matter fiber tracts using polarization-sensitive optical coherence tomography. Neuroimage 2022; 264:119755. [PMID: 36400379 PMCID: PMC9802682 DOI: 10.1016/j.neuroimage.2022.119755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/29/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
Polarization sensitive optical coherence tomography (PSOCT) has been shown to image and delineate white matter fibers in a label-free manner by revealing optical birefringence within the myelin sheath using a microscope setup. In this proof-of-concept study, we adapt recent advancements in endoscopic PSOCT to perform depth-resolved imaging of white matter structures deep inside intact porcine brain tissue ex-vivo, through a small, rotational fiber probe. The probe geometry is comparable to microelectrodes currently used in neurosurgical interventions. The presented imaging system is mobile, robust, and uses biologically safe levels of optical radiation making it well suited for clinical translation. In neurosurgery, where accuracy is imperative, endoscopic PSOCT through a narrow-gauge fiber probe could provide intra-operative feedback on the location of critical white matter structures.
Collapse
Affiliation(s)
- Damon DePaoli
- Harvard Medical School, Boston, MA 02115, USA,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Daniel C. Côté
- CERVO Brain Research Center, Université Laval, Quebec City, Quebec G1E 1T2, Canada
| | - Brett E. Bouma
- Harvard Medical School, Boston, MA 02115, USA,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Martin Villiger
- Harvard Medical School, Boston, MA 02115, USA,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA,Corresponding author. (M. Villiger)
| |
Collapse
|
15
|
Rico-Jimenez JJ, Jo JA. Rapid lipid-laden plaque identification in intravascular optical coherence tomography imaging based on time-series deep learning. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:106006. [PMID: 36307914 PMCID: PMC9616160 DOI: 10.1117/1.jbo.27.10.106006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
SIGNIFICANCE Coronary heart disease has the highest rate of death and morbidity in the Western world. Atherosclerosis is an asymptomatic condition that is considered the primary cause of cardiovascular diseases. The accumulation of low-density lipoprotein triggers an inflammatory process in focal areas of arteries, which leads to the formation of plaques. Lipid-laden plaques containing a necrotic core may eventually rupture, causing heart attack and stroke. Lately, intravascular optical coherence tomography (IV-OCT) imaging has been used for plaque assessment. The interpretation of the IV-OCT images is performed visually, which is burdensome and requires highly trained physicians for accurate plaque identification. AIM Our study aims to provide high throughput lipid-laden plaque identification that can assist in vivo imaging by offering faster screening and guided decision making during percutaneous coronary interventions. APPROACH An A-line-wise classification methodology based on time-series deep learning is presented to fulfill this aim. The classifier was trained and validated with a database consisting of IV-OCT images of 98 artery sections. A trained physician with expertise in the analysis of IV-OCT imaging provided the visual evaluation of the database that was used as ground truth for training and validation. RESULTS This method showed an accuracy, sensitivity, and specificity of 89.6%, 83.6%, and 91.1%, respectively. This deep learning methodology has the potential to increase the speed of lipid-laden plaques identification to provide a high throughput of more than 100 B-scans/s. CONCLUSIONS These encouraging results suggest that this method will allow for high throughput video-rate atherosclerotic plaque assessment through automated tissue characterization for in vivo imaging by providing faster screening to assist in guided decision making during percutaneous coronary interventions.
Collapse
Affiliation(s)
- Jose J. Rico-Jimenez
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas, United States
| | - Javier A. Jo
- University of Oklahoma, School of Electrical and Computer Engineering, Norman, Oklahoma, United States
| |
Collapse
|
16
|
Nandy S, Berigei SR, Keyes CM, Muniappan A, Auchincloss HG, Lanuti M, Roop BW, Shih AR, Colby TV, Medoff BD, Suter MJ, Villiger M, Hariri LP. Polarization-Sensitive Endobronchial Optical Coherence Tomography for Microscopic Imaging of Fibrosis in Interstitial Lung Disease. Am J Respir Crit Care Med 2022; 206:905-910. [PMID: 35675552 DOI: 10.1164/rccm.202112-2832le] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sreyankar Nandy
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | | | - Colleen M Keyes
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | - Ashok Muniappan
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | - Hugh G Auchincloss
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | - Michael Lanuti
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | | | - Angela R Shih
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | | | - Benjamin D Medoff
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | - Melissa J Suter
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | - Martin Villiger
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| | - Lida P Hariri
- Massachusetts General Hospital Boston, Massachusetts.,Harvard Medical School Boston, Massachusetts
| |
Collapse
|
17
|
Chen G, Wang W, Li Y. Comparative study of OCTA algorithms with a high-sensitivity multi-contrast Jones matrix OCT system for human skin imaging. BIOMEDICAL OPTICS EXPRESS 2022; 13:4718-4736. [PMID: 36187265 PMCID: PMC9484425 DOI: 10.1364/boe.462941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/21/2022] [Accepted: 07/28/2022] [Indexed: 06/16/2023]
Abstract
The multi-contrast Jones matrix OCT (JMT) system can not only improve the tissue-specific contrast but also enhance the sensitivity of detecting flow, which is gaining increasing attention. However, for the JMT system, there is currently a lack of studies evaluating and guiding the selection of suitable angiography algorithms to map the most appealing quality of angiograms for clinical use. In this paper, by a homemade high-sensitivity multi-contrast JMT system based 200 kHz swept source, the performance of two complex-signal-based OCTA methods that are insensitive to phase instability and one amplitude-signal-based OCTA method are compared for in-vivo imaging of human skin qualitatively and quantitatively. Six metrics, including vascular connectivity, image contrast-to-noise ratio, image signal-to-noise ratio, vessel diameter index, blood vessel density, and processing time, are assessed. The results show that the vascular networks processed by all OCTA methods and the texture of skin could be visualized simultaneously and markedly. Additionally, the complex-signal-based OCTA methods successfully suppress phase instabilities and even outperform the amplitude-signal-based OCTA algorithm in some indicators. This paper has a certain guiding significance for selecting an appropriate angiography algorithm and expanding the application field with this system.
Collapse
Affiliation(s)
- Guoqiang Chen
- Key Laboratory of Photoelectronic Imaging Technology and System of Ministry of Education of China, School of Optics and Photonics, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, China
| | - Wen’ai Wang
- Key Laboratory of Photoelectronic Imaging Technology and System of Ministry of Education of China, School of Optics and Photonics, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, China
- Institute of Engineering Medicine, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, China
| | - Yanqiu Li
- Key Laboratory of Photoelectronic Imaging Technology and System of Ministry of Education of China, School of Optics and Photonics, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, China
- Institute of Engineering Medicine, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, China
| |
Collapse
|
18
|
Tang P, Le N, Lu J, Chung KH, Subhash H, Kilpatrick-Liverman L, Wang RK. Local axis orientation mapped by polarization sensitive optical coherence tomography provides a unique contrast to identify caries lesions in enamel. BIOMEDICAL OPTICS EXPRESS 2022; 13:4247-4260. [PMID: 36032575 PMCID: PMC9408248 DOI: 10.1364/boe.464707] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 05/11/2023]
Abstract
Due to rod-like hydroxyapatite crystal organizations, dental enamel is optically anisotropic, i.e., birefringent. Healthy enamel is known to be intrinsically negatively birefringent. However, when demineralization of enamel occurs, a considerable number of inter-crystallite spaces would be created between the crystallites in the enamel, which could lead to a sign reversion in birefringence of the enamel structure. We propose that this sign reversion can be leveraged in polarization sensitive OCT (PSOCT) imaging to differentiate early caries lesions from healthy enamel. In this study using PSOCT, we first confirm that the change in birefringence sign (negative to positive) can lead to a 90-degree alteration in the local axis orientation because of the switch between the fast and slow optic axes. We then demonstrate, for the first time, that the local axis orientation can be utilized to map and visualize the WSLs from the healthy enamel with a unique contrast. Moreover, the sharp alteration in local axis orientation gives a clear boundary between the WSLs and the healthy enamel, providing an opportunity to automatically segment the three-dimensional WSLs from the healthy enamel, enabling the characterization of their size and depth information in an intuitive way, which may aid clinical decision making and treatment planning.
Collapse
Affiliation(s)
- Peijun Tang
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA 98195, USA
| | - Nhan Le
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA 98195, USA
| | - Jie Lu
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA 98195, USA
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, WA,98195, USA
| | - Hrebesh Subhash
- Clinical Method Development – Oral Care, Colgate-Palmolive Company, Piscataway, New Jersey, USA
| | | | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA 98195, USA
| |
Collapse
|
19
|
Cannon TM, Uribe-Patarroyo N, Villiger M, Bouma BE. Measuring collagen injury depth for burn severity determination using polarization sensitive optical coherence tomography. Sci Rep 2022; 12:10479. [PMID: 35729262 PMCID: PMC9213509 DOI: 10.1038/s41598-022-14326-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 12/19/2022] Open
Abstract
Determining the optimal treatment course for a dermatologic burn wound requires knowledge of the wound’s severity, as quantified by the depth of thermal damage. In current clinical practice, burn depth is inferred based exclusively on superficial visual assessment, a method which is subject to substantial error rates in the classification of partial thickness (second degree) burns. Here, we present methods for direct, quantitative determination of the depth extent of injury to the dermal collagen matrix using polarization-sensitive optical coherence tomography (PS-OCT). By visualizing the depth-dependence of the degree of polarization of light in the tissue, rather than cumulative retardation, we enable direct and volumetric assessment of local collagen status. We further augment our PS-OCT measurements by visualizing adnexal structures such as hair follicles to relay overall dermal viability in the wounded region. Our methods, which we have validated ex vivo with matched histology, offer an information-rich tool for precise interrogation of burn wound severity and healing potential in both research and clinical settings.
Collapse
Affiliation(s)
- Taylor M Cannon
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA. .,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Néstor Uribe-Patarroyo
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Brett E Bouma
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| |
Collapse
|
20
|
Adams DC, Majid A, Suter MJ. Polarization mode dispersion correction in endoscopic polarization-sensitive optical coherence tomography with incoherent polarization input states. BIOMEDICAL OPTICS EXPRESS 2022; 13:3446-3460. [PMID: 35781955 PMCID: PMC9208610 DOI: 10.1364/boe.457790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/09/2022] [Accepted: 04/21/2022] [Indexed: 05/11/2023]
Abstract
The incorporation of polarization sensitivity into optical coherence tomography (PS-OCT) imaging can greatly enhance utility by allowing differentiation via intrinsic contrast of many types of tissue. In fiber-based OCT systems such as those employing endoscopic imaging probes, however, polarization mode dispersion (PMD) can significantly impact the ability to obtain accurate polarization data unless valuable axial resolution is sacrificed. In this work we present a new technique for compensating for PMD in endoscopic PS-OCT with minimal impact on axial resolution and without requiring mutually coherent polarization inputs, needing only a birefringent structure with known orientation in view (such as the catheter sheath). We then demonstrate the advantages of this technique by comparing it against the current state of the art approach.
Collapse
Affiliation(s)
- David C. Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Adnan Majid
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02114, USA
| | - Melissa J. Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| |
Collapse
|
21
|
Li Y, Moon S, Jiang Y, Qiu S, Chen Z. Intravascular polarization-sensitive optical coherence tomography based on polarization mode delay. Sci Rep 2022; 12:6831. [PMID: 35477738 PMCID: PMC9046432 DOI: 10.1038/s41598-022-10709-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 04/11/2022] [Indexed: 01/13/2023] Open
Abstract
Intravascular polarization-sensitive optical coherence tomography (IV-PSOCT) provides depth-resolved tissue birefringence which can be used to evaluate the mechanical stability of a plaque. In our previous study, we reported a new strategy to construct polarization-sensitive optical coherence tomography in a microscope platform. Here, we demonstrated that this technology can be implemented in an endoscope platform, which has many clinical applications. A conventional intravascular OCT system can be modified for IV-PSOCT by introducing a 12-m polarization-maintaining fiber-based imaging probe. Its two polarization modes separately produce OCT images of polarization detection channels spatially distinguished by an image separation of 2.7 mm. We experimentally validated our IV-PSOCT with chicken tendon, chicken breast, and coronary artery as the image samples. We found that the birefringent properties can be successfully visualized by our IV-PSOCT.
Collapse
Affiliation(s)
- Yan Li
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, 92617, USA
| | - Sucbei Moon
- Department of Physics, Kookmin University, Seoul, 02707, South Korea
| | - Yuchen Jiang
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, 92617, USA.,Department of Physics, Kookmin University, Seoul, 02707, South Korea
| | - Saijun Qiu
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, 92617, USA.,Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, 92697, USA
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, 92617, USA. .,Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, 92697, USA. .,The Cardiovascular Innovation and Research Center, University of California, Irvine, , Irvine, CA, 92617, USA.
| |
Collapse
|
22
|
Harper DJ, Vakoc BJ. Relationship between axial resolution and signal-to-noise ratio in optical coherence tomography. OPTICS LETTERS 2022; 47:1517-1520. [PMID: 35290353 PMCID: PMC8958905 DOI: 10.1364/ol.449421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/15/2022] [Indexed: 06/14/2023]
Abstract
In optical coherence tomography (OCT), axial resolution and signal-to-noise ratio (SNR) are typically viewed as uncoupled parameters. We show that this is true only for mirror-like surfaces and that in diffuse scattering samples such as biological tissues there is an inherent coupling between axial resolution and measurement SNR. We explain the origin of this coupling and demonstrate that it can be used to achieve increased imaging penetration depth at the expense of resolution. Finally, we argue that this coupling should be considered during OCT system design processes that seek to balance the competing needs of resolution, sensitivity, and system/source complexity.
Collapse
Affiliation(s)
- Danielle J. Harper
- Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| |
Collapse
|
23
|
Seesan T, Abd El-Sadek I, Mukherjee P, Zhu L, Oikawa K, Miyazawa A, Shen LTW, Matsusaka S, Buranasiri P, Makita S, Yasuno Y. Deep convolutional neural network-based scatterer density and resolution estimators in optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2022; 13:168-183. [PMID: 35154862 PMCID: PMC8803045 DOI: 10.1364/boe.443343] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/25/2021] [Indexed: 05/02/2023]
Abstract
We present deep convolutional neural network (DCNN)-based estimators of the tissue scatterer density (SD), lateral and axial resolutions, signal-to-noise ratio (SNR), and effective number of scatterers (ENS, the number of scatterers within a resolution volume). The estimators analyze the speckle pattern of an optical coherence tomography (OCT) image in estimating these parameters. The DCNN is trained by a large number (1,280,000) of image patches that are fully numerically generated in OCT imaging simulation. Numerical and experimental validations were performed. The numerical validation shows good estimation accuracy as the root mean square errors were 0.23%, 3.65%, 3.58%, 3.79%, and 6.15% for SD, lateral and axial resolutions, SNR, and ENS, respectively. The experimental validation using scattering phantoms (Intralipid emulsion) shows reasonable estimations. Namely, the estimated SDs were proportional to the Intralipid concentrations, and the average estimation errors of lateral and axial resolutions were 1.36% and 0.68%, respectively. The scatterer density estimator was also applied to an in vitro tumor cell spheroid, and a reduction in the scatterer density during cell necrosis was found.
Collapse
Affiliation(s)
- Thitiya Seesan
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Physics, School of Science, King Mongkut’s Institute of Technology Ladkrabang, Ladkrabang, Bangkok, Thailand
| | - Ibrahim Abd El-Sadek
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Physics, Faculty of Science, Damietta University, New Damietta City, Damietta, Egypt
| | - Pradipta Mukherjee
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Lida Zhu
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kensuke Oikawa
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Arata Miyazawa
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Sky Technology Inc., Tsukuba, Ibaraki, Japan
| | - Larina Tzu-Wei Shen
- Clinical Research and Regional Innovation, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Satoshi Matsusaka
- Clinical Research and Regional Innovation, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Prathan Buranasiri
- Department of Physics, School of Science, King Mongkut’s Institute of Technology Ladkrabang, Ladkrabang, Bangkok, Thailand
| | - Shuichi Makita
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiaki Yasuno
- Computational Optics Group, University of Tsukuba, Tsukuba, Ibaraki, Japan
| |
Collapse
|
24
|
Chang S, Handwerker J, Giannico GA, Chang SS, Bowden AK. Birefringent tissue-mimicking phantom for polarization-sensitive optical coherence tomography imaging. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:074711. [PMID: 35064658 PMCID: PMC8781524 DOI: 10.1117/1.jbo.27.7.074711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
SIGNIFICANCE Tissue birefringence is an important parameter to consider when designing realistic, tissue-mimicking phantoms. Options for suitable birefringent materials that can be used to accurately represent tissue scattering are limited. AIM To introduce a method of fabricating birefringent tissue phantoms with a commonly used material-polydimethylsiloxane (PDMS)-for imaging with polarization-sensitive optical coherence tomography (PS-OCT). APPROACH Stretch-induced birefringence was characterized in PDMS phantoms made with varying curing ratios, and the resulting phantom birefringence values were compared with those of biological tissues. RESULTS We showed that, with induced birefringence levels up to 2.1 × 10 - 4, PDMS can be used to resemble the birefringence levels in weakly birefringent tissues. We demonstrated the use of PDMS in the development of phantoms to mimic the normal and diseased bladder wall layers, which can be differentiated by their birefringence levels. CONCLUSIONS PDMS allows accurate control of tissue scattering and thickness, and it exhibits controllable birefringent properties. The use of PDMS as a birefringent phantom material can be extended to other birefringence imaging systems beyond PS-OCT and to mimic other organs.
Collapse
Affiliation(s)
- Shuang Chang
- Vanderbilt University, Vanderbilt Biophotonics Center, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Jessica Handwerker
- Vanderbilt University, Vanderbilt Biophotonics Center, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Giovanna A. Giannico
- Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, United States
| | - Sam S. Chang
- Vanderbilt University Medical Center, Department of Urology, Nashville, Tennessee, United States
| | - Audrey K. Bowden
- Vanderbilt University, Vanderbilt Biophotonics Center, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Vanderbilt University, Department of Electrical and Computer Engineering, Nashville, Tennessee, United States
| |
Collapse
|
25
|
Bouma B, de Boer J, Huang D, Jang I, Yonetsu T, Leggett C, Leitgeb R, Sampson D, Suter M, Vakoc B, Villiger M, Wojtkowski M. Optical coherence tomography. NATURE REVIEWS. METHODS PRIMERS 2022; 2:79. [PMID: 36751306 PMCID: PMC9901537 DOI: 10.1038/s43586-022-00162-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Optical coherence tomography (OCT) is a non-contact method for imaging the topological and internal microstructure of samples in three dimensions. OCT can be configured as a conventional microscope, as an ophthalmic scanner, or using endoscopes and small diameter catheters for accessing internal biological organs. In this Primer, we describe the principles underpinning the different instrument configurations that are tailored to distinct imaging applications and explain the origin of signal, based on light scattering and propagation. Although OCT has been used for imaging inanimate objects, we focus our discussion on biological and medical imaging. We examine the signal processing methods and algorithms that make OCT exquisitely sensitive to reflections as weak as just a few photons and that reveal functional information in addition to structure. Image processing, display and interpretation, which are all critical for effective biomedical imaging, are discussed in the context of specific applications. Finally, we consider image artifacts and limitations that commonly arise and reflect on future advances and opportunities.
Collapse
Affiliation(s)
- B.E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Institute for Medical Engineering and Physics, Massachusetts Institute of Technology, Cambridge, MA, USA,Harvard Medical School, Boston, MA, USA,Corresponding author:
| | - J.F. de Boer
- Department of Physics and Astronomy, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D. Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
| | - I.K. Jang
- Harvard Medical School, Boston, MA, USA,Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - T. Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - C.L. Leggett
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - R. Leitgeb
- Institute of Medical Physics, University of Vienna, Wien, Austria
| | - D.D. Sampson
- School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - M. Suter
- Harvard Medical School, Boston, MA, USA,Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - B. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - M. Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - M. Wojtkowski
- Institute of Physical Chemistry and International Center for Translational Eye Research, Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland,Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland
| |
Collapse
|
26
|
Tang P, Kirby MA, Le N, Li Y, Zeinstra N, Lu GN, Murry CE, Zheng Y, Wang RK. Polarization sensitive optical coherence tomography with single input for imaging depth-resolved collagen organizations. LIGHT, SCIENCE & APPLICATIONS 2021; 10:237. [PMID: 34819490 PMCID: PMC8613400 DOI: 10.1038/s41377-021-00679-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/26/2021] [Accepted: 11/10/2021] [Indexed: 05/02/2023]
Abstract
Collagen organization plays an important role in maintaining structural integrity and determining tissue function. Polarization-sensitive optical coherence tomography (PSOCT) is a promising noninvasive three-dimensional imaging tool for mapping collagen organization in vivo. While PSOCT systems with multiple polarization inputs have demonstrated the ability to visualize depth-resolved collagen organization, systems, which use a single input polarization state have not yet demonstrated sufficient reconstruction quality. Herein we describe a PSOCT based polarization state transmission model that reveals the depth-dependent polarization state evolution of light backscattered within a birefringent sample. Based on this model, we propose a polarization state tracing method that relies on a discrete differential geometric analysis of the evolution of the polarization state in depth along the Poincare sphere for depth-resolved birefringent imaging using only one single input polarization state. We demonstrate the ability of this method to visualize depth-resolved myocardial architecture in both healthy and infarcted rodent hearts (ex vivo) and collagen structures responsible for skin tension lines at various anatomical locations on the face of a healthy human volunteer (in vivo).
Collapse
Affiliation(s)
- Peijun Tang
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Mitchell A Kirby
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Nhan Le
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Yuandong Li
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - Nicole Zeinstra
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
| | - G Nina Lu
- Department of Otolaryngology- Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, University of Washington, Seattle, WA, 98195, USA
| | - Charles E Murry
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
- Department of Pathology, University of Washington, Seattle, WA, 98109, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, 98109, USA
- Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - Ying Zheng
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA
- Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA, 98195, USA.
- Department of Ophthalmology, University of Washington, Seattle, WA, 98105, USA.
| |
Collapse
|
27
|
Keahey P, Si P, Razavi M, Yu S, Lippok N, Villiger M, Padera TP, de la Zerda A, Bouma B. Spectral- and Polarization-Dependent Scattering of Gold Nanobipyramids for Exogenous Contrast in Optical Coherence Tomography. NANO LETTERS 2021; 21:8595-8601. [PMID: 34644094 PMCID: PMC8555503 DOI: 10.1021/acs.nanolett.1c02291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Polarization-sensitive optical coherence tomography (PS-OCT) reveals the subsurface microstructure of biological tissue and provides information regarding the polarization state of light backscattered from tissue. Complementing OCT's structural signal with molecular imaging requires strategies to simultaneously detect multiple exogenous contrast agents with high specificity in tissue. Specific detection of molecular probes enables the parallel visualization of physiological, cellular, and molecular processes. Here we demonstrate that, by combining PS-OCT and spectral contrast (SC)-OCT measurements, we can distinguish signatures of different gold nanobipyramids (GNBPs) in lymphatic vessels from the surrounding tissue and blood vessels in live mouse models. This technique could well be extended to other anisotropic nanoparticle-based OCT contrast agents and presents significant progress toward enabling OCT molecular imaging.
Collapse
Affiliation(s)
- Pelham Keahey
- Wellman
Center for Photomedicine, Massachusetts
General Hospital, Boston, Massachusetts 02114, United States
- Harvard
Medical School, Boston, Massachusetts 02115, United States
- Email for P.K.:
| | - Peng Si
- Department
of Structural Biology, Stanford University, Stanford, California 94305, United States
- Molecular
Imaging Program at Stanford, Stanford, California 94305, United States
| | - Mohammad Razavi
- Harvard
Medical School, Boston, Massachusetts 02115, United States
- Edwin
L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Shangjie Yu
- Department
of Electrical Engineering, Stanford University, Stanford, California 94305, United States
| | - Norman Lippok
- Wellman
Center for Photomedicine, Massachusetts
General Hospital, Boston, Massachusetts 02114, United States
- Harvard
Medical School, Boston, Massachusetts 02115, United States
| | - Martin Villiger
- Wellman
Center for Photomedicine, Massachusetts
General Hospital, Boston, Massachusetts 02114, United States
- Harvard
Medical School, Boston, Massachusetts 02115, United States
| | - Timothy P. Padera
- Harvard
Medical School, Boston, Massachusetts 02115, United States
- Edwin
L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Adam de la Zerda
- Department
of Structural Biology, Stanford University, Stanford, California 94305, United States
- Molecular
Imaging Program at Stanford, Stanford, California 94305, United States
- Department
of Electrical Engineering, Stanford University, Stanford, California 94305, United States
- Biophysics
Program at Stanford, Stanford, California 94305, United States
- The
Bio-X Program, Stanford, California 94305, United States
- The
Chan Zuckerberg Biohub, San Francisco, California 94158, United States
- Email for A.d.l.Z.:
| | - Brett Bouma
- Wellman
Center for Photomedicine, Massachusetts
General Hospital, Boston, Massachusetts 02114, United States
- Harvard
Medical School, Boston, Massachusetts 02115, United States
- Institute
for Medical Engineering and Science, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
| |
Collapse
|
28
|
van Zandvoort LJC, Otsuka K, Villiger M, Neleman T, Dijkstra J, Zijlstra F, van Mieghem NM, Bouma BE, Daemen J. Polarimetric Signatures of Coronary Thrombus in Patients With Acute Coronary Syndrome. Circ J 2021; 85:1806-1813. [PMID: 33828020 PMCID: PMC10782573 DOI: 10.1253/circj.cj-20-0862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Intravascular polarization-sensitive optical frequency domain imaging (PS-OFDI) offers a novel approach to measure tissue birefringence, which is elevated in collagen and smooth muscle cells, that in turn plays a critical role in healing coronary thrombus (HCT). This study aimed to quantitatively assess polarization properties of coronary fresh and organizing thrombus with PS-OFDI in patients with acute coronary syndrome (ACS).Methods and Results:The POLARIS-I prospective registry enrolled 32 patients with ACS. Pre-procedural PS-OFDI pullbacks using conventional imaging catheters revealed 26 thrombus-regions in 21 patients. Thrombus was manually delineated in conventional OFDI cross-sections separated by 0.5 mm and categorized into fresh thrombus caused by plaque rupture, stent thrombosis, or erosion in 18 thrombus-regions (182 frames) or into HCT for 8 thrombus-regions (141 frames). Birefringence of coronary thrombus was compared between the 2 categories. Birefringence in HCTs was significantly higher than in fresh thrombus (∆n=0.47 (0.37-0.72) vs. ∆n=0.25 (0.17-0.29), P=0.007). In a subgroup analysis, when only using thrombus-regions from culprit lesions, ischemic time was a significant predictor for birefringence (ß (∆n)=0.001 per hour, 95% CI [0.0002-0.002], P=0.023). CONCLUSIONS Intravascular PS-OFDI offers the opportunity to quantitatively assess the polarimetric properties of fresh and organizing coronary thrombus, providing new insights into vascular healing and plaque stability.
Collapse
Affiliation(s)
| | - Kenichiro Otsuka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School
| | - Tara Neleman
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center
| | - Felix Zijlstra
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center
| | | | - Brett E Bouma
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology
| | - Joost Daemen
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Center
| |
Collapse
|
29
|
Nandy S, Helland TL, Roop BW, Raphaely RA, Ly A, Lew M, Berigei SR, Villiger M, Sorokina A, Szabari MV, Fintelmann FJ, Suter MJ, Hariri LP. Rapid non-destructive volumetric tumor yield assessment in fresh lung core needle biopsies using polarization sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2021; 12:5597-5613. [PMID: 34692203 PMCID: PMC8515979 DOI: 10.1364/boe.433346] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 05/28/2023]
Abstract
Adequate tumor yield in core-needle biopsy (CNB) specimens is essential in lung cancer for accurate histological diagnosis, molecular testing for therapeutic decision-making, and tumor biobanking for research. Insufficient tumor sampling in CNB is common, primarily due to inadvertent sampling of tumor-associated fibrosis or atelectatic lung, leading to repeat procedures and delayed diagnosis. Currently, there is no method for rapid, non-destructive intraprocedural assessment of CNBs. Polarization-sensitive optical coherence tomography (PS-OCT) is a high-resolution, volumetric imaging technique that has the potential to meet this clinical need. PS-OCT detects endogenous tissue properties, including birefringence from collagen, and degree of polarization uniformity (DOPU) indicative of tissue depolarization. Here, PS-OCT birefringence and DOPU measurements were used to quantify the amount of tumor, fibrosis, and normal lung parenchyma in 42 fresh, intact lung CNB specimens. PS-OCT results were compared to and validated against matched histology in a blinded assessment. Linear regression analysis showed strong correlations between PS-OCT and matched histology for quantification of tumors, fibrosis, and normal lung parenchyma in CNBs. PS-OCT distinguished CNBs with low tumor content from those with higher tumor content with high sensitivity and specificity. This study demonstrates the potential of PS-OCT as a method for rapid, non-destructive, label-free intra-procedural tumor yield assessment.
Collapse
Affiliation(s)
- Sreyankar Nandy
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Timothy L. Helland
- Harvard Medical School, Boston, MA 02110, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Benjamin W. Roop
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Rebecca A. Raphaely
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Amy Ly
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan, Ann Arbor, MI 48104, USA
| | - Sarita R. Berigei
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Anastasia Sorokina
- Department of Pathology, University of Illinois at Chicago, Chicago, IL 60131, USA
- Department of Pathology, Research Institute of Human Morphology, Moscow 103132, Russia
| | - Margit V. Szabari
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Florian J. Fintelmann
- Harvard Medical School, Boston, MA 02110, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02110, USA
| | - Melissa J. Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
| | - Lida P. Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02110, USA
- Harvard Medical School, Boston, MA 02110, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02110, USA
| |
Collapse
|
30
|
Liu X, Jiang L, Ke M, Schmetterer L, Barathi VA. Using image data to numerically correct the jitter in polarization depth encoding PS-OCT. OPTICS LETTERS 2021; 46:1692-1695. [PMID: 33793520 DOI: 10.1364/ol.420029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
In swept source polarization depth encoding polarization sensitive optical coherence tomography (PS-OCT), the laser jitter induces additional noise to the polarization sensitive measurement. In this Letter, we developed a numerical algorithm to correct the jitter phases based on the image data using the Mueller matrix calculus. The algorithm was demonstrated on in vivo retina imaging of a guinea pig with a custom-built PS-OCT system. The performance of the proposed algorithm was almost comparable to the conventional method of using a physical calibration signal. By not requiring a hardware generated calibration signal and k-clock, the proposed algorithm is useful to reduce the complexity and the cost of a polarization depth encoding PS-OCT system.
Collapse
|
31
|
Tang P, Wang RK. Polarization state tracing method to map local birefringent properties in samples using polarization sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2020; 11:6852-6863. [PMID: 33408966 PMCID: PMC7747894 DOI: 10.1364/boe.408667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 05/25/2023]
Abstract
We propose a method that utilizes the trajectory of output polarization states on the Poincaré sphere to derive depth-resolved birefringent information within samples using a fiber-based polarization sensitive optical coherence tomography. The apparent (or intermediate) optic axis and the local phase retardation are first obtained by fitting a plane to the adjacent output polarization states along depths in the Poincare sphere. A sequence of 3D rotation operation determined by the local birefringent property of the upper layers is then applied to the apparent axis to finally determine the local optic axis. This method requires only one input polarization state and is compatible with both free-space and fiber-based PSOCT systems, simplifying the imaging system setup. The theoretical framework is presented to derive the local phase retardation and optic axis from the output polarization states and then demonstrated by mapping local birefringent information of the mouse thigh tissue in vitro.
Collapse
|
32
|
Tang P, Wang RK. Stable fiber-based polarization-sensitive optical coherence tomography using polarization maintaining common-path interferometer. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200125RR. [PMID: 33205634 PMCID: PMC7670096 DOI: 10.1117/1.jbo.25.11.116009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Our work advances the development of fiber-based polarization-sensitive optical coherence tomography (PS-OCT) by stabilizing the output polarization state of the light beam when the system is under environmental disturbance. While the fiber-based PS-OCT has been demonstrated previously, it remains a challenge for the traditional fiber-based PS-OCT to obtain a stable measurement when the optic fibers are disturbed by the environment. This important issue is addressed, paving the path for clinical translation of PS-OCT, which can provide a unique perspective of the biological samples. AIM Polarization maintaining common-path (CP) interferometer is fabricated with the goal of providing a stable fiber-based PS-OCT imaging system that is only responsive to the polarization changes generated by the sample, immune to environmental conditions. APPROACH The system is implemented by incorporating a CP interferometer together with polarization maintaining (PM) fibers. The PM fibers are used to preserve the two orthogonal linearly polarized components of the light during propagation. By sharing the CP in the sample and reference arms, any variations in phase retardation can be eliminated between the two channels in the PM fibers. The combination of the PM fiber and the CP interferometer ensures the stability of the output polarization state. RESULTS The stability of the proposed PS-OCT system is tested when a periodically stressed disturbance is applied to the fibers within the system. Stable in vivo PS-OCT images of the mouse thigh are demonstrated. CONCLUSIONS We have demonstrated a stable fiber-based PS-OCT system that combined the PM fiber and the CP configuration together. We have shown that the output polarization states and the system sensitivity can keep stable over time under the environmental disturbances to the system.
Collapse
Affiliation(s)
- Peijun Tang
- University of Washington, Department of Bioengineering, Seattle, Washington, United States
| | - Ruikang K. Wang
- University of Washington, Department of Bioengineering, Seattle, Washington, United States
| |
Collapse
|
33
|
Otsuka K, Villiger M, Nadkarni SK, Bouma BE. Intravascular Polarimetry: Clinical Translation and Future Applications of Catheter-Based Polarization Sensitive Optical Frequency Domain Imaging. Front Cardiovasc Med 2020; 7:146. [PMID: 33005632 PMCID: PMC7485575 DOI: 10.3389/fcvm.2020.00146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Optical coherence tomography (OCT) and optical frequency domain imaging (OFDI) visualize the coronary artery wall and plaque morphology in great detail. The advent of these high-resolution intracoronary imaging modalities has propelled our understanding of coronary atherosclerosis and provided enhanced guidance for percutaneous coronary intervention. Yet, the lack of contrast between distinct tissue types and plaque compositions impedes further elucidation of the complex mechanisms that contribute to acute coronary syndrome (ACS) and hinders the prospective identification of plaques susceptible to rupture. Intravascular polarimetry with polarization-sensitive OFDI measures polarization properties of the coronary arterial wall using conventional intravascular imaging catheters. The quantitative polarization metrics display notable image contrast between several relevant coronary plaque microstructures that are difficult to identify with conventional OCT and OFDI. Tissues rich in collagen and smooth muscle cells exhibit birefringence, while lipid and macrophages cause depolarization. In this review, we describe the basic principles of intravascular polarimetry, discuss the interpretation of the polarization signatures, and outline promising avenues for future research and clinical implications.
Collapse
Affiliation(s)
- Kenichiro Otsuka
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Brett E Bouma
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| |
Collapse
|
34
|
LEE HWIDON, KIM GYEONGHUN, VILLIGER MARTIN, JANG HANSOL, BOUMA BRETTE, KIM CHANGSEOK. Linear-in-wavenumber actively-mode-locked wavelength-swept laser. OPTICS LETTERS 2020; 45:5327-5330. [PMID: 33001885 PMCID: PMC7574329 DOI: 10.1364/ol.397715] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
We report on an akinetic actively-mode-locked wavelength-swept laser (ASL) with a sweep that is highly linear in wavenumber. By tailoring the drive waveform of the intracavity modulator, the wavenumber sweep was further linearized to enable high fidelity frequency-domain interferometric ranging without resampling of the acquired data. Used for catheter-based optical coherence tomography, the ASL showed comparable imaging performance to a state-of-the-art polygon-based wavelength-swept source at a matching sweep rate of 103.6 kHz, a duty cycle of 95%, and a bandwidth of 100 nm, centered at 1330 nm.
Collapse
Affiliation(s)
- HWI DON LEE
- Harvard Medical School, Boston, Massachusetts (MA) 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
| | - GYEONG HUN KIM
- Harvard Medical School, Boston, Massachusetts (MA) 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
- Department of Cogno-Mechatronics Engineering, Pusan National University, 2 Busandaehak-ro 63beon-gil, Busan, 46241, South Korea
| | - MARTIN VILLIGER
- Harvard Medical School, Boston, Massachusetts (MA) 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
| | - HANSOL JANG
- Department of Cogno-Mechatronics Engineering, Pusan National University, 2 Busandaehak-ro 63beon-gil, Busan, 46241, South Korea
| | - BRETT E. BOUMA
- Harvard Medical School, Boston, Massachusetts (MA) 02115, USA
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - CHANG-SEOK KIM
- Department of Cogno-Mechatronics Engineering, Pusan National University, 2 Busandaehak-ro 63beon-gil, Busan, 46241, South Korea
| |
Collapse
|
35
|
Liu X, Ke M, Yao X, Chua J, Schmetterer L, Tan B. Stable complex conjugate artifact removal in OCT using circularly polarized light as reference. OPTICS LETTERS 2020; 45:3977-3980. [PMID: 32667332 DOI: 10.1364/ol.395860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
In Fourier domain optical coherence tomography (FDOCT), the depth profile is mirrored about the zero delay between the sample and reference optical paths, limiting the imaging depth to half of the entire ranging space and undermining the optimal sensitivity window. We present a new method, to the best of our knowledge, to remove the complex conjugate artifact by using circularly polarized light as reference. Quadrature detection of the complex fringe is achieved by utilizing the intrinsic λ/4 delay between two polarization channels. We use passive broadband polarization optics to control the polarization state of the light in the reference and sample arms and a balanced polarization diversity detection unit to simultaneously detect phase-shifted fringes. We demonstrate a 40 dB artifact suppression ratio with a swept-source optical coherence tomography system. Our proposed method is immune to sample motion and laser phase noise, and imposes no restrictions to the source bandwidth, imaging speed, or computational power. In vivo images of the human finger, as well as the cornea and retina of a non-human primate, were demonstrated.
Collapse
|
36
|
Haindl R, Duelk M, Gloor S, Dahdah J, Ojeda J, Sturtzel C, Deng S, Joyce Deloria A, Li Q, Liu M, Distel M, Drexler W, Leitgeb R. Ultra-high-resolution SD-OCM imaging with a compact polarization-aligned 840 nm broadband combined-SLED source. BIOMEDICAL OPTICS EXPRESS 2020; 11:3395-3406. [PMID: 32637262 PMCID: PMC7316001 DOI: 10.1364/boe.394229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/12/2020] [Accepted: 05/16/2020] [Indexed: 05/15/2023]
Abstract
We analyze the influence of intrinsic polarization alignment on image quality and axial resolution employing a broadband 840 nm light source with an optical bandwidth of 160 nm and an output power of 12 mW tailored for spectral-domain optical coherence microscopy (SD-OCM) applications. Three superluminescent diodes (SLEDs) are integrated into a 14-pin butterfly module using a free-space micro-optical bench architecture, maintaining a constant polarization state across the full spectral output. We demonstrate superior imaging performance in comparison to traditionally coupled-SLED broadband light sources in a teleost model organism in-vivo.
Collapse
Affiliation(s)
- Richard Haindl
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Marcus Duelk
- EXALOS AG, Wagistrasse 21, 8952 Schlieren, Switzerland
| | - Stefan Gloor
- EXALOS AG, Wagistrasse 21, 8952 Schlieren, Switzerland
| | - Jean Dahdah
- EXALOS AG, Wagistrasse 21, 8952 Schlieren, Switzerland
| | - Jose Ojeda
- EXALOS AG, Wagistrasse 21, 8952 Schlieren, Switzerland
| | - Caterina Sturtzel
- Innovative Cancer Models, Children’s Cancer Research Institute, Vienna, Austria
| | - Shiyu Deng
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Abigail Joyce Deloria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Qian Li
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Mengyang Liu
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Martin Distel
- Innovative Cancer Models, Children’s Cancer Research Institute, Vienna, Austria
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Rainer Leitgeb
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory OPTRAMED, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
37
|
Gräfe MGO, van de Kreeke JA, Willemse J, Braaf B, de Jong Y, Tan HS, Verbraak FD, de Boer JF. Subretinal Fibrosis Detection Using Polarization Sensitive Optical Coherence Tomography. Transl Vis Sci Technol 2020; 9:13. [PMID: 32818100 PMCID: PMC7396173 DOI: 10.1167/tvst.9.4.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose Subretinal fibrosis (SRFib) is an important cause of permanent loss-of-vision diseases with submacular neovascularization, but a reliable diagnostic method is currently missing. This study uses polarization-sensitive optical coherence tomography (PS-OCT) to detect SRFib within retinal lesions by measurement of its birefringent collagen fibers. Methods Twenty-five patients were enrolled with retinal pathology in one or both eyes containing (1) suspected SRFib, (2) lesions suspected not to be fibrotic, or (3) lesions with doubtful presence of SRFib. All eyes were evaluated for SRFIb using conventional diagnostics by three retinal specialists. PS-OCT images were visually evaluated for SRFib based on cumulative phase retardation, local birefringence, and optic axis uniformity. Results Twenty-nine eyes from 22 patients were scanned successfully. In 13 eyes, SRFib was diagnosed by all retinal specialists; of these, 12 were confirmed by PS-OCT and one was inconclusive. In nine eyes, the retinal specialists expected no SRFib, which was confirmed by PS-OCT in all cases. In seven eyes, the retinal specialists’ evaluations were inconsistent with regard to the presence of SRFib. PS-OCT confirmed the presence of SRFib in four of these eyes and the absence of SRFib in two eyes and was inconclusive in one eye. Conclusions In 21 out of 22 eyes, PS-OCT confirmed the evaluation of retinal specialists regarding the presence of SRFib. PS-OCT provided additional information to distinguish SRFib from other tissues within subretinal neovascular lesions in 6 out of 7 eyes. Translational Relevance PS-OCT can identify and quantify SRFib in doubtful cases for which a reliable diagnosis is currently lacking.
Collapse
Affiliation(s)
- Maximilian G O Gräfe
- LaserLaB Amsterdam, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Joy Willemse
- LaserLaB Amsterdam, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
| | - Boy Braaf
- LaserLaB Amsterdam, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
| | - Yvonne de Jong
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands
| | - H Stevie Tan
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Frank D Verbraak
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Johannes F de Boer
- LaserLaB Amsterdam, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands
| |
Collapse
|
38
|
Adams DC, Szabari MV, Lagares D, McCrossan AF, Hariri LP, Tager AM, Suter MJ. Assessing the progression of systemic sclerosis by monitoring the tissue optic axis using PS-OCT. Sci Rep 2020; 10:2561. [PMID: 32054932 PMCID: PMC7018967 DOI: 10.1038/s41598-020-59330-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/27/2020] [Indexed: 12/31/2022] Open
Abstract
The clinical assessment of fibrosis is critical to the diagnosis and management of patients with systemic sclerosis. Current clinical standards for patient assessment is to use skin fibrosis as an indicator of organ involvement, though this approach is highly subjective and relies on manual palpation. The development of a new method for accurately quantifying collagen content may therefore significantly improve the accuracy of the traditional skin score in patients with systemic sclerosis and may additionally aid in the monitoring of anti-fibrotic therapies in clinical practice. Polarization-sensitive optical coherence tomography (PS-OCT) is a high-speed volumetric imaging modality that can be used to assess birefringent tissues including collagen. In this work we demonstrate a novel computational approach using PS-OCT for the assessment of fibrosis. This approach, based on the measured distribution of optic axis values associated with a given volume of collagen orientation, characterizes fibrotic changes independently from the depth of the region of interest in the tissue. This approach has the potential to accurately quantify collagen content and orientation faster and more robustly compared to traditional PS-OCT metrics. We investigate the viability of this approach for assessing the development of fibrosis in a bleomycin induced skin fibrosis mouse model.
Collapse
Affiliation(s)
- David C Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA.,Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114, USA.,Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115, USA
| | - Margit V Szabari
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA.,Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114, USA.,Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115, USA
| | - David Lagares
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA.,Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115, USA
| | - Andrew F McCrossan
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA
| | - Lida P Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.,Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114, USA.,Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115, USA
| | - Andrew M Tager
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA.,Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115, USA
| | - Melissa J Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 40 Blossom Street, Boston, Massachusetts, 02114, USA. .,Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114, USA. .,Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115, USA.
| |
Collapse
|
39
|
Otsuka K, Villiger M, Nadkarni SK, Bouma BE. Intravascular Polarimetry for Tissue Characterization of Coronary Atherosclerosis. Circ Rep 2019; 1:550-557. [PMID: 32432174 PMCID: PMC7236778 DOI: 10.1253/circrep.cr-19-0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 01/20/2023] Open
Abstract
The microscopic tissue structure and organization influence the polarization of light. Intravascular polarimetry leverages this compelling intrinsic contrast mechanism by using polarization-sensitive optical frequency domain imaging to measure the polarization properties of the coronary arterial wall. Tissues rich in collagen and smooth muscle cells appear birefringent, while the presence of lipid causes depolarization, offering quantitative metrics related to the presence of important components of coronary atherosclerosis. Here, we review the basic principle, the interpretation of polarization signatures, and first clinical investigations of intravascular polarimetry and discuss how this extension of contemporary intravascular imaging may advance our knowledge and improve clinical practice in the future.
Collapse
Affiliation(s)
- Kenichiro Otsuka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, United States
| |
Collapse
|
40
|
Xiong Q, Wang N, Liu X, Chen S, Braganza CS, Bouma BE, Liu L, Villiger M. Constrained polarization evolution simplifies depth-resolved retardation measurements with polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2019; 10:5207-5222. [PMID: 31646042 PMCID: PMC6788597 DOI: 10.1364/boe.10.005207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/28/2019] [Accepted: 08/31/2019] [Indexed: 05/24/2023]
Abstract
We observed that the polarization state of light after round-trip propagation through a birefringent medium frequently aligns with the employed input polarization state 'mirrored' by the horizontal plane of the Poincaré sphere. We explored the predisposition for this mirror state and evidence that it constrains the evolution of polarization states as a function of the round-trip depth into weakly scattering birefringent samples, as measured with polarization-sensitive optical coherence tomography (PS-OCT). Combined with spectral variations in the polarization state transmitted through system components, we demonstrate how this constraint enables measurement of depth-resolved birefringence using only a single input polarization state, which offers a critical simplification compared to conventional PS-OCT employing two input states.
Collapse
Affiliation(s)
- Qiaozhou Xiong
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
- These authors contributed equally
| | - Nanshuo Wang
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
- These authors contributed equally
| | - Xinyu Liu
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
- Singapore Eye Research Institute, Singapore, 169856, Singapore
- These authors contributed equally
| | - Si Chen
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
| | - Cilwyn S Braganza
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
| | - Brett E Bouma
- Harvard Medical School and Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Linbo Liu
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, 639798, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, 637459, Singapore
- These authors contributed equally
- Corresponding author:
| | - Martin Villiger
- Harvard Medical School and Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114, USA
- These authors contributed equally
- Corresponding author:
| |
Collapse
|
41
|
Rico-Jimenez JJ, Campos-Delgado DU, Buja LM, Vela D, Jo JA. Intravascular optical coherence tomography method for automated detection of macrophage infiltration within atherosclerotic coronary plaques. Atherosclerosis 2019; 290:94-102. [PMID: 31604172 DOI: 10.1016/j.atherosclerosis.2019.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Significant macrophages infiltration in advanced atherosclerotic plaques promotes acute coronary events. Hence, the clinical imaging of macrophage content in coronary atherosclerotic plaques could potentially aid in identifying patients most at risk of future acute coronary events. The aim of this study was to introduce and validate a simple intravascular optical coherence tomography (IV-OCT) image processing method for automated, accurate and fast detection of macrophage infiltration within coronary atherosclerotic plaques. METHODS This method calculates the ratio of the normalized-intensity standard deviation (NSD) values estimated over two axially-adjacent regions of interest in an IV-OCT cross-sectional image (B-scan). When applied to entire IV-OCT B-scans, this method highlights plaque areas with high NSD ratio values (NSDRatio), which was demonstrated to be correlated with the degree of coronary plaque macrophage infiltration. RESULTS Using an optimized NSDRatio threshold value, coronary plaque macrophage infiltration could be detected with ~88% sensitivity and specificity in a database of 28 IV-OCT scans from postmortem coronary segments. For comparison, using an optimized NSD threshold value, considered the standard IV-OCT signature for macrophages, coronary plaque macrophage infiltration could be detected with only ~55% sensitivity and specificity. CONCLUSIONS The proposed NSDRatio method significantly increases the sensitivity and specificity for the detection of coronary plaque macrophage infiltration compared to the standard NSD method. This computationally efficient method can be seamlessly implemented within standard IV-OCT imaging systems for in-vivo real-time imaging of macrophage content in coronary plaques, which could potentially aid in identifying patients most at risk of future acute coronary events.
Collapse
Affiliation(s)
- Jose J Rico-Jimenez
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | | | | | | | - Javier A Jo
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA; School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA.
| |
Collapse
|
42
|
Islam MM, Sharifi R, Mamodaly S, Islam R, Nahra D, Abusamra DB, Hui PC, Adibnia Y, Goulamaly M, Paschalis EI, Cruzat A, Kong J, Nilsson PH, Argüeso P, Mollnes TE, Chodosh J, Dohlman CH, Gonzalez-Andrades M. Effects of gamma radiation sterilization on the structural and biological properties of decellularized corneal xenografts. Acta Biomater 2019; 96:330-344. [PMID: 31284096 PMCID: PMC7043233 DOI: 10.1016/j.actbio.2019.07.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/21/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022]
Abstract
To address the shortcomings associated with corneal transplants, substantial efforts have been focused on developing new modalities such as xenotransplantion. Xenogeneic corneas are anatomically and biomechanically similar to the human cornea, yet their applications require prior decellularization to remove the antigenic components to avoid rejection. In the context of bringing decellularized corneas into clinical use, sterilization is a crucial step that determines the success of the transplantation. Well-standardized sterilization methods, such as gamma irradiation (GI), have been applied to decellularized porcine corneas (DPC) to avoid graft-associated infections in human recipients. However, little is known about the effect of GI on decellularized corneal xenografts. Here, we evaluated the radiation effect on the ultrastructure, optical, mechanical and biological properties of DPC. Transmission electron microscopy revealed that gamma irradiated decellularized porcine cornea (G-DPC) preserved its structural integrity. Moreover, the radiation did not reduce the optical properties of the tissue. Neither DPC nor G-DPC led to further activation of complement system compared to native porcine cornea when exposed to plasma. Although, DPC were mechanically comparable to the native tissue, GI increased the mechanical strength, tissue hydrophobicity and resistance to enzymatic degradation. Despite these changes, human corneal epithelial, stromal, endothelial and hybrid neuroblastoma cells grew and differentiated on DPC and G-DPC. Thus, GI may achieve effective tissue sterilization without affecting critical properties that are essential for corneal transplant survival.
Collapse
Affiliation(s)
- Mohammad Mirazul Islam
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Roholah Sharifi
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Shamina Mamodaly
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Rakibul Islam
- Department of Immunology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Daniel Nahra
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Dina B Abusamra
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Pui Chuen Hui
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Yashar Adibnia
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Yeditepe University School of Medicine, Istanbul, Turkey
| | - Mehdi Goulamaly
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Eleftherios I Paschalis
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Andrea Cruzat
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jing Kong
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Per H Nilsson
- Department of Immunology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway; Linnaeus Center for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Pablo Argüeso
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway; Research Laboratory, Nordland Hospital, Bodø, and Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - James Chodosh
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Claes H Dohlman
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Miguel Gonzalez-Andrades
- Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain.
| |
Collapse
|
43
|
Hariri LP, Adams DC, Applegate MB, Miller AJ, Roop BW, Villiger M, Bouma BE, Suter MJ. Distinguishing Tumor from Associated Fibrosis to Increase Diagnostic Biopsy Yield with Polarization-Sensitive Optical Coherence Tomography. Clin Cancer Res 2019; 25:5242-5249. [PMID: 31175092 DOI: 10.1158/1078-0432.ccr-19-0566] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/09/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE With recent advancements in personalized medicine, biopsies must contain sufficient tumor for histologic diagnosis and molecular testing. However, inadvertent biopsy of tumor-associated fibrosis compromises tumor yield, resulting in delayed diagnoses and/or repeat procedures when additional tumor is needed. The ability to differentiate tumor from fibrosis intraprocedurally during biopsy could significantly increase tumor yield. Polarization-sensitive optical coherence tomography (PS-OCT) is an imaging modality that is endoscope- and/or needle-compatible, and provides large volumetric views of tissue microstructure with high resolution (∼10 μm) while simultaneously measuring birefringence of organized tissues such as collagen. We aim to determine whether PS-OCT can accurately detect and distinguish tumor-associated fibrosis from tumor. EXPERIMENTAL DESIGN PS-OCT was obtained ex vivo in 64 lung nodule samples. PS-OCT birefringence was measured and correlated to collagen content in precisely matched histology, quantified on picrosirius red (PSR) staining. RESULTS There was a strong positive correlation between PS-OCT measurement of birefringent fibrosis and total collagen content by PSR (r = 0.793; P < 0.001). In addition, PS-OCT was able to accurately classify tumor regions with >20% fibrosis from those with low fibrosis (≤20%) that would likely yield higher tumor content (P < 0.0001). CONCLUSIONS PS-OCT enables accurate fibrosis detection and can distinguish tumor regions with low fibrosis. PS-OCT has significant potential for clinical impact, as the ability to differentiate tumor from fibrosis could be used to guide intraprocedural tissue sampling in vivo, or for rapid biopsy adequacy assessment ex vivo, to increase diagnostic tumor yield essential for patient care and research.
Collapse
Affiliation(s)
- Lida P Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts. .,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - David C Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Matthew B Applegate
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Alyssa J Miller
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Benjamin W Roop
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Melissa J Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts. .,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
44
|
Feroldi F, Willemse J, Davidoiu V, Gräfe MGO, van Iperen DJ, Goorsenberg AWM, Annema JT, Daniels JMA, Bonta PI, de Boer JF. In vivo multifunctional optical coherence tomography at the periphery of the lungs. BIOMEDICAL OPTICS EXPRESS 2019; 10:3070-3091. [PMID: 31259075 PMCID: PMC6583343 DOI: 10.1364/boe.10.003070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 05/04/2023]
Abstract
Remodeling of tissue, such as airway smooth muscle (ASM) and extracellular matrix, is considered a key feature of airways disease. No clinically accepted diagnostic method is currently available to assess airway remodeling or the effect of treatment modalities such as bronchial thermoplasty in asthma, other than invasive airway biopsies. Optical coherence tomography (OCT) generates cross-sectional, near-histological images of airway segments and enables identification and quantification of airway wall layers based on light scattering properties only. In this study, we used a custom motorized OCT probe that combines standard and polarization sensitive OCT (PS-OCT) to visualize birefringent tissue in vivo in the airway wall of a patient with severe asthma in a minimally invasive manner. We used optic axis uniformity (OAxU) to highlight the presence of uniformly arranged fiber-like tissue, helping visualizing the abundance of ASM and connective tissue structures. Attenuation coefficient images of the airways are presented for the first time, showing superior architectural contrast compared to standard OCT images. A novel segmentation algorithm was developed to detect the surface of the endoscope sheath and the surface of the tissue. PS-OCT is an innovative imaging technique that holds promise to assess airway remodeling including ASM and connective tissue in a minimally invasive, real-time manner.
Collapse
Affiliation(s)
- Fabio Feroldi
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| | - Joy Willemse
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
- These authors contributed equally
| | - Valentina Davidoiu
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
- These authors contributed equally
| | - Maximilian G. O. Gräfe
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| | - Dirck J. van Iperen
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| | - Annika W. M. Goorsenberg
- Amsterdam University Medical Center, Department of Pulmonology, University of Amsterdam, Amsterdam, the Netherlands
| | - Jouke T. Annema
- Amsterdam University Medical Center, Department of Pulmonology, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes M. A. Daniels
- Amsterdam University Medical Center, Department of Pulmonology, VUmc Location, Amsterdam, the Netherlands
| | - Peter I. Bonta
- Amsterdam University Medical Center, Department of Pulmonology, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes F. de Boer
- LaserLaB Amsterdam and Department of Physics and Astronomy, VU University Amsterdam, de Boelelaan 1081, 1081HV, Amsterdam, the Netherlands
| |
Collapse
|
45
|
Tao K, Sun K, Ding Z, Ma Y, Kuang H, Zhao H, Lai T, Zhou Y, Liu T. Catheter-Based Polarization Sensitive Optical Coherence Tomography Using Similar Mueller Matrix Method. IEEE Trans Biomed Eng 2019; 67:60-68. [PMID: 30932827 DOI: 10.1109/tbme.2019.2908031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Research of catheter-based polarization sensitive optical coherence tomography (PS-OCT) is a challenging field. In this paper, we present a new polarization determination method, similar Mueller matrix (SMM) method, for a catheter-based PS-OCT system using a standard clinical catheter probe with an outer diameter of 0.9 mm. METHODS The SMM method can remove the diattenuation and depolarization compositions by polar decomposition. By constructing the similarity between the measured Mueller matrices and sample matrices, the phase retardance of the sample can be determined from the trace of the measured matrices. RESULTS In the experiments, we find that images processed by the SMM method without any averaging or phase correction have a better polarization contrast of multiple biological tissues than those by the Jones matrix based method. We also preliminarily achieve phase retardance imaging of the ex vivo porcine cardiac blood vessel. CONCLUSION Compared with the Jones matrix based method, the presented SMM method can provide a more robust birefringence imaging of biological tissues under low signal-to-noise ratio, depolarization, diattenuation, and phase instability. SIGNIFICANCE The SMM method has a potential to become a widely accepted polarization determination method for catheter-based PS-OCT.
Collapse
|
46
|
Walther J, Li Q, Villiger M, Farah CS, Koch E, Karnowski K, Sampson DD. Depth-resolved birefringence imaging of collagen fiber organization in the human oral mucosa in vivo. BIOMEDICAL OPTICS EXPRESS 2019; 10:1942-1956. [PMID: 31086712 PMCID: PMC6484997 DOI: 10.1364/boe.10.001942] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/02/2018] [Accepted: 01/09/2019] [Indexed: 05/18/2023]
Abstract
Stromal collagen organization has been identified as a potential prognostic indicator in a variety of cancers and other diseases accompanied by fibrosis. Changes in the connective tissue are increasingly considered for grading dysplasia and progress of oral squamous cell carcinoma, investigated mainly ex vivo by histopathology. In this study, polarization-sensitive optical coherence tomography (PS-OCT) with local phase retardation imaging is used for the first time to visualize depth-resolved (i.e., local) birefringence of healthy human oral mucosa in vivo. Depth-resolved birefringence is shown to reveal the expected local collagen organization. To demonstrate proof-of-principle, 3D image stacks were acquired at labial and lingual locations of the oral mucosa, chosen as those most commonly affected by cancerous alterations. To enable an intuitive evaluation of the birefringence images suitable for clinical application, color depth-encoded en-face projections were generated. Compared to en-face views of intensity or conventional cumulative phase retardation, we show that this novel approach offers improved visualization of the mucosal connective tissue layer in general, and reveals the collagen fiber architecture in particular. This study provides the basis for future prospective pathological and comparative in vivo studies non-invasively assessing stromal changes in conspicuous and cancerous oral lesions at different stages.
Collapse
Affiliation(s)
- Julia Walther
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Department of Medical Physics and Biomedical Engineering, 01307 Dresden, Germany
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, 01307 Dresden, Germany
| | - Qingyun Li
- Optical + Biomedical Engineering Laboratory, Department of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - Martin Villiger
- Harvard Medical School and Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, MA, USA
| | - Camile S. Farah
- UWA Dental School, The University of Western Australia, Perth, WA 6009, Australia
- Australian Centre for Oral Oncology Research and Education, Perth, WA 6009, Australia
| | - Edmund Koch
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, 01307 Dresden, Germany
| | - Karol Karnowski
- Optical + Biomedical Engineering Laboratory, Department of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
| | - David D. Sampson
- Optical + Biomedical Engineering Laboratory, Department of Electrical, Electronic & Computer Engineering, The University of Western Australia, Perth, WA 6009, Australia
- University of Surrey, Guilford, Surrey GU2 7XH, United Kingdom
| |
Collapse
|
47
|
Xiong Q, Wang N, Liu X, Chen S, Liang H, Chen S, Liu L. Single input state polarization-sensitive optical coherence tomography with high resolution and polarization distortion correction. OPTICS EXPRESS 2019; 27:6910-6924. [PMID: 30876266 DOI: 10.1364/oe.27.006910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/23/2019] [Indexed: 06/09/2023]
Abstract
In single input state polarization-sensitive optical coherence tomography (PS-OCT) with high resolution, the imperfections of quarter-wave plate (QWP) and the sensitivity roll-off mismatch between the two detection channels cause unpredictable polarization distortion. We present a correction method based on the Jones matrix modeling of the system. In a single input PS-OCT system working at 840 nm with an axial resolution of ~2.3 μm, the method yielded better estimation of retardation and optic axis orientation with significantly reduced noise level, especially in weakly birefringent samples. Numerical simulations and quantitative imaging of a sample of known birefringence were performed to validate the performance. We further demonstrate the advantages of our approach with birefringence imaging of swine retina, rat aortic wall, and rat esophageal mucosa for potential clinical applications.
Collapse
|
48
|
Shen S, Wang H, Qu Y, Huang K, Liu G, Chen Z, Ma C, Shao P, Hong J, Lemaillet P, Dong E, Xu RX. Simulating orientation and polarization characteristics of dense fibrous tissue by electrostatic spinning of polymeric fibers. BIOMEDICAL OPTICS EXPRESS 2019; 10:571-583. [PMID: 30800500 PMCID: PMC6377871 DOI: 10.1364/boe.10.000571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Phantoms simulating polarization characteristics of soft tissue play an important role in the development, calibration, and validation of diagnostic polarized imaging devices and of therapeutic strategy, in both laboratory and clinical settings. We propose to fabricate optical phantoms that simulate polarization characteristics of dense fibrous tissues by bonding electrospun polylactic acid (PLA) fibers between polydimethylsiloxane (PDMS) substrate with a groove. Increasing the rotational speed of an electrospinning collector helps improve the orientation of the electrospun fibers. The phantoms simulate the polarization characteristics of dense fibrous tissue of collagenous fibroma and healthy skin with high fidelity. Our experiments demonstrate the technical potential of using such phantoms for validation and calibration of polarimetric medical devices.
Collapse
Affiliation(s)
- Shuwei Shen
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Haili Wang
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Yingjie Qu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Kuiming Huang
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Guangli Liu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Zexin Chen
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Canzhen Ma
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Pengfei Shao
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Jin Hong
- Key Laboratory of Environmental Optics and Technology, Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Hefei 230031, China
| | - Paul Lemaillet
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA
| | - Erbao Dong
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Ronald X. Xu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH 43210, USA
| |
Collapse
|
49
|
Villiger M, Otsuka K, Karanasos A, Doradla P, Ren J, Lippok N, Shishkov M, Daemen J, Diletti R, van Geuns RJ, Zijlstra F, van Soest G, Libby P, Regar E, Nadkarni SK, Bouma BE. Coronary Plaque Microstructure and Composition Modify Optical Polarization: A New Endogenous Contrast Mechanism for Optical Frequency Domain Imaging. JACC Cardiovasc Imaging 2018; 11:1666-1676. [PMID: 29248662 PMCID: PMC5994172 DOI: 10.1016/j.jcmg.2017.09.023] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This study aimed to evaluate whether polarimetry, performed using a modified optical frequency domain imaging (OFDI) system, can improve the assessment of histological features relevant to characterizing human coronary atherosclerosis. BACKGROUND The microscopic structure and organization of the arterial wall influence the polarization of the infrared light used by OFDI. Modification of the OFDI apparatus, along with recently developed image reconstruction methods, permits polarimetric measurements simultaneously with conventional OFDI cross-sectional imaging through standard intravascular imaging catheters. METHODS The main coronary arteries of 5 cadaveric human hearts were imaged with an OFDI system capable of providing polarimetric assessment. Cross-sectional views of tissue birefringence, measured in refractive index units, and depolarization, expressed as the ratio of depolarized signal to total intensity, were reconstructed, together with conventional OFDI images. Following imaging, the vessels underwent histological evaluation to enable interpretation of the observed polarization features of individual tissue components. RESULTS Birefringence in fibrous tissue was significantly higher than in intimal tissue with minimal abnormality (0.44 × 10-3 vs. 0.33 × 10-3; p < 0.0001). Birefringence was highest in the tunica media (p < 0.0001), consistent with its high smooth muscle cell content, cells known to associate with birefringence. In fibrous areas, birefringence showed fine spatial features and close correspondence with the histological appearance of collagen. In contrast, necrotic cores and regions rich in lipid elicited significant depolarization (p < 0.0001). Depolarization was also evident in locations of cholesterol crystals and macrophages. CONCLUSIONS Intravascular measurements of birefringence and depolarization can be obtained using conventional OFDI catheters in conjunction with a modified console and signal processing algorithms. Polarimetric measurements enhance conventional OFDI by providing additional information related to the tissue composition and offer quantitative metrics enabling characterization of plaque features.
Collapse
Affiliation(s)
- Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Kenichiro Otsuka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Antonios Karanasos
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Pallavi Doradla
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jian Ren
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Norman Lippok
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Milen Shishkov
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joost Daemen
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Roberto Diletti
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Robert-Jan van Geuns
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Felix Zijlstra
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Gijs van Soest
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter Libby
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Evelyn Regar
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Seemantini K Nadkarni
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts
| |
Collapse
|
50
|
Improving Plaque Classification With Optical Coherence Tomography. JACC Cardiovasc Imaging 2018; 11:1677-1678. [DOI: 10.1016/j.jcmg.2017.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 11/13/2017] [Accepted: 11/14/2017] [Indexed: 11/21/2022]
|