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Hou H, Tang Y, Coole JB, Kortum A, Schwarz RA, Carns J, Gillenwater AM, Ramalingam P, Milbourne A, Salcedo MP, Schmeler KM, Richards-Kortum RR. Scanning darkfield high-resolution microendoscope for label-free microvascular imaging. BIOMEDICAL OPTICS EXPRESS 2023; 14:5097-5112. [PMID: 37854554 PMCID: PMC10581811 DOI: 10.1364/boe.498584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023]
Abstract
Characterization of microvascular changes during neoplastic progression has the potential to assist in discriminating precancer and early cancer from benign lesions. Here, we introduce a novel high-resolution microendoscope that leverages scanning darkfield reflectance imaging to characterize angiogenesis without exogenous contrast agents. Scanning darkfield imaging is achieved by coupling programmable illumination with a complementary metal-oxide semiconductor (CMOS) camera rolling shutter, eliminating the need for complex optomechanical components and making the system portable, low-cost (<$5,500) and simple to use. Imaging depth is extended by placing a gradient-index (GRIN) lens at the distal end of the imaging fiber to resolve subepithelial microvasculature. We validated the capability of the scanning darkfield microendoscope to visualize microvasculature at different anatomic sites in vivo by imaging the oral cavity of healthy volunteers. Images of cervical specimens resected for suspected neoplasia reveal distinct microvascular patterns in columnar and squamous epithelium with different grades of precancer, indicating the potential of scanning darkfield microendoscopy to aid in efforts to prevent cervical cancer through early diagnosis.
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Affiliation(s)
- Huayu Hou
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Yubo Tang
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Jackson B. Coole
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Alex Kortum
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | | | - Jennifer Carns
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Ann M. Gillenwater
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Preetha Ramalingam
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Andrea Milbourne
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mila P. Salcedo
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Obstetrics and Gynecology, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Santa Casa Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Kathleen M. Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Villard A, Breuskin I, Casiraghi O, Asmandar S, Laplace-Builhe C, Abbaci M, Moya Plana A. Confocal laser endomicroscopy and confocal microscopy for head and neck cancer imaging: Recent updates and future perspectives. Oral Oncol 2022; 127:105826. [DOI: 10.1016/j.oraloncology.2022.105826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/18/2022] [Accepted: 03/15/2022] [Indexed: 02/06/2023]
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Kulkarni N, Masciola A, Nishant A, Kim KJ, Choi H, Gmitro A, Freeman EE, Semeere A, Nakalembe M, Kang D. Low-cost, chromatic confocal endomicroscope for cellular imaging in vivo. BIOMEDICAL OPTICS EXPRESS 2021; 12:5629-5643. [PMID: 34692205 PMCID: PMC8515984 DOI: 10.1364/boe.434892] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 05/06/2023]
Abstract
We have developed a low-cost, chromatic confocal endomicroscope (CCE) that can image a cross-section of the tissue at cellular resolution. In CCE, a custom miniature objective lens was used to focus different wavelengths into different tissue depths. Therefore, each tissue depth was encoded with the wavelength. A custom miniature spectrometer was used to spectrally-disperse light reflected from the tissue and generate cross-sectional confocal images. The CCE prototype had a diameter of 9.5 mm and a length of 68 mm. Measured resolution was high, 2 µm and 4 µm for lateral and axial directions, respectively. Effective field size was 468 µm. Preliminary results showed that CCE can visualize cellular details from cross-sections of the tissue in vivo down to the tissue depth of 100 µm.
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Affiliation(s)
- Nachiket Kulkarni
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Andrew Masciola
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Abhinav Nishant
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Kyung-Jo Kim
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Heejoo Choi
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Arthur Gmitro
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Aggrey Semeere
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94143, USA
| | - Miriam Nakalembe
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Dongkyun Kang
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
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Tang Y, Kortum A, Vohra I, Schwarz RA, Carns J, Kannady CR, Clavell-Hernandez J, Hu Z, Dhanani N, Richards-Kortum R. Initial Results of First In Vivo Imaging of Bladder Lesions Using a High-Resolution Confocal Microendoscope. J Endourol 2021; 35:1190-1197. [PMID: 33307957 DOI: 10.1089/end.2020.0757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Purpose: Conventional cystoscopy plays an important role in detection of bladder cancer; however, it is difficult to differentiate benign and neoplastic lesions based on cystoscopic appearance alone. Advanced microscopic modalities, such as confocal laser endomicroscopy and optical coherence tomography, have been shown to provide critical histopathologic information to help identify neoplastic bladder lesions in real time, but their availability and clinical adoption are limited due to a high cost. In this study, we present the first use of a novel and low-cost ($ <5000) confocal high-resolution microendoscope (confocal HRME) for in vivo imaging of bladder lesions. Materials and Methods: In a cohort of 15 patients undergoing white light cystoscopy as part of their standard of care, high-resolution images of proflavine-stained bladder lesions were acquired in vivo using the confocal HRME. Based on these images, we evaluated the ability of the confocal HRME to visualize uroepithelium with subcellular resolution and high contrast. Furthermore, we analyzed the cellular architecture and staining patterns of benign and neoplastic bladder lesions in confocal HRME images and compared results to that of standard cystoscopy and histopathology. Results: In vivo imaging in the pilot study demonstrates that the confocal HRME resolved subcellular structures of bladder uroepithelium with high contrast. In a wide range of clinical conditions from normal bladder wall to benign and neoplastic lesions, confocal HRME images revealed important diagnostic features that correlated to histopathology. Conclusions: The confocal HRME provides an affordable, portable, and easy-to-use tool to allow real-time and high-contrast subcellular characterization of bladder lesions, well suited for bladder cancer detection in community and resource-constrained settings. The ClinicalTrials.gov Identifier: NCT02340650.
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Affiliation(s)
- Yubo Tang
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Alex Kortum
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Imran Vohra
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | - Jennifer Carns
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Christopher R Kannady
- Department of Surgery and University of Texas Health Science Center at Houston, Houston, Texas, USA
| | | | - Zhihong Hu
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Nadeem Dhanani
- Department of Surgery and University of Texas Health Science Center at Houston, Houston, Texas, USA
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Tang Y, Kortum A, Parra SG, Vohra I, Milbourne A, Ramalingam P, Toscano PA, Schmeler KM, Richards-Kortum RR. In vivo imaging of cervical precancer using a low-cost and easy-to-use confocal microendoscope. BIOMEDICAL OPTICS EXPRESS 2020; 11:269-280. [PMID: 32010516 PMCID: PMC6968771 DOI: 10.1364/boe.381064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 05/08/2023]
Abstract
Cervical cancer incidence and mortality rates remain high in medically underserved areas. In this study, we present a low-cost (<$5,000), portable and user-friendly confocal microendoscope, and we report on its clinical use to image precancerous lesions in the cervix. The confocal microendoscope employs digital apertures on a digital light projector and a CMOS sensor to implement line-scanning confocal imaging. Leveraging its versatile programmability, we describe an automated aperture alignment algorithm to ensure clinical ease-of-use and to facilitate technology dissemination in low-resource settings. Imaging performance is then evaluated in ex vivo and in vivo pilot studies; results demonstrate that the confocal microendoscope can enhance visualization of nuclear morphology, contributing to significantly improved recognition of clinically important features for detection of cervical precancer.
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Affiliation(s)
- Yubo Tang
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
- The authors contributed equally to this work
| | - Alex Kortum
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
- The authors contributed equally to this work
| | - Sonia G. Parra
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - Imran Vohra
- Department of Bioengineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - Andrea Milbourne
- The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX 77057, USA
| | - Preetha Ramalingam
- The University of Texas MD Anderson Cancer Center, Department of Pathology, Houston, TX 77030, USA
| | - Paul A. Toscano
- The University of Texas Health Science Center at Houston, School of Public Health, Brownsville, TX 78520, USA
| | - Kathleen M. Schmeler
- The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX 77057, USA
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Tang Y, Kortum A, Vohra I, Carns J, Anandasabapathy S, Richards-Kortum R. Simple differential digital confocal aperture to improve axial response of line-scanning confocal microendoscopes. OPTICS LETTERS 2019; 44:4519-4522. [PMID: 31517920 PMCID: PMC6959477 DOI: 10.1364/ol.44.004519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/13/2019] [Indexed: 05/24/2023]
Abstract
Line-scanning confocal microendoscopy offers video-rate cellular imaging of scattering tissue with relatively simple hardware, but its axial response is inferior to that of point-scanning systems. Based on Fourier optics theory, we designed differential confocal apertures with a simple subtraction technique to improve the line-scanning sectioning performance. Taking advantage of digital slit apertures on a digital light projector and a CMOS rolling shutter, we demonstrate real-time optical sectioning performance comparable to point scanning in a dual-camera microendoscope (<$6,000). We validate the background rejection capability when imaging porcine columnar epithelium stained with fluorescent contrast agents with different uptake mechanisms and staining properties.
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