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Yan F, Wang C, Yan Y, Zhang Q, Yu Z, Patel SG, Fung KM, Tang Q. Polarization-sensitive optical coherence tomography for renal tumor detection in ex vivo human kidneys. OPTICS AND LASERS IN ENGINEERING 2024; 173:107900. [PMID: 37982078 PMCID: PMC10653339 DOI: 10.1016/j.optlaseng.2023.107900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Kidney cancer is a kind of high mortality cancer because of the difficulty in early diagnosis and the high metastatic dissemination in treatments. The surgical resection of tumors is the most effective treatment for renal cancer patients. However, precise assessment of tumor margins is a challenge during surgical resection. The objective of this study is to demonstrate an optical imaging tool in precisely distinguishing kidney tumor borders and identifying tumor zones from normal tissues to assist surgeons in accurately resecting tumors from kidneys during the surgery. 30 samples from six human kidneys were imaged using polarization-sensitive optical coherence tomography (PS-OCT). Cross-sectional, enface, and spatial information of kidney samples were obtained for microenvironment reconstruction. Polarization parameters (phase retardation, optic axis direction, and degree of polarization uniformity (DOPU) and Stokes parameters (Q, U, and V) were utilized for multi-parameter analysis. To verify the detection accuracy of PS-OCT, H&E histology staining and dice-coefficient was utilized to quantify the performance of PS-OCT in identifying tumor borders and regions. In this study, tumor borders were clearly identified by PS-OCT imaging, which outperformed the conventional intensity-based OCT. With H&E histological staining as golden standard, PS-OCT precisely identified the tumor regions and tissue distributions at different locations and different depths based on polarization and Stokes parameters. Compared to the traditional attenuation coefficient quantification method, PS-OCT demonstrated enhanced contrast of tissue characteristics between normal and cancerous tissues due to the birefringence effects. Our results demonstrated that PS-OCT was promising to provide imaging guidance for the surgical resection of kidney tumors and had the potential to be used for other human kidney surgeries in clinics such as renal biopsy.
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Affiliation(s)
- Feng Yan
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA
| | - Chen Wang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA
| | - Yuyang Yan
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA
| | - Qinghao Zhang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA
| | - Zhongxin Yu
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Sanjay G. Patel
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kar-Ming Fung
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Qinggong Tang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA
- Institute for Biomedical Engineering, Science, and Technology (IBEST), University of Oklahoma, Norman, OK 73019, USA
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2
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Zhang W, Zhou H, Tao Y, Zhu F, He B, Liu N, Chen J, Xue P. Size correction and deep image optimization in optical coherence tomography angiography with structural image-assisted common parts extraction method. JOURNAL OF BIOPHOTONICS 2024; 17:e202300259. [PMID: 37755063 DOI: 10.1002/jbio.202300259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 09/28/2023]
Abstract
Tail artifact elimination is essential in optical coherence tomography angiography (OCTA) for the artifacts will prevent the reconstruction of the 3D vessel image. The tail artifacts of superficial vessels obscure the deep vascular signals and cause the signals at different depths to mix with each other. Most tail artifact elimination methods can shorten the tails but have difficulty in determining the lower boundary of the vessels. In this letter, we introduce a technique to extract vascular signals with more accurate vascular boundaries. With the help of structural image, our method can reconstruct the 3D image of the vascular network more precisely and perform better in deep areas. The images of vessels of palm are used to compare our new technique with previous common parts extraction method experimentally. The results show that our method removes the tail artifacts more thoroughly and has a significant advantage in imaging deep vessels.
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Affiliation(s)
- Wenxin Zhang
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, China
| | - Hong Zhou
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yuxiu Tao
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Fu Zhu
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Bin He
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, China
| | - Ning Liu
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Junyi Chen
- Jiangsu Kunpeng Shengteng Ecological Innovation Center, Nanjing, Jiangsu, China
| | - Ping Xue
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, China
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3
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Fan Y, Liu S, Gao E, Guo R, Dong G, Li Y, Gao T, Tang X, Liao H. The LMIT: Light-mediated minimally-invasive theranostics in oncology. Theranostics 2024; 14:341-362. [PMID: 38164160 PMCID: PMC10750201 DOI: 10.7150/thno.87783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/18/2023] [Indexed: 01/03/2024] Open
Abstract
Minimally-invasive diagnosis and therapy have gradually become the trend and research hotspot of current medical applications. The integration of intraoperative diagnosis and treatment is a development important direction for real-time detection, minimally-invasive diagnosis and therapy to reduce mortality and improve the quality of life of patients, so called minimally-invasive theranostics (MIT). Light is an important theranostic tool for the treatment of cancerous tissues. Light-mediated minimally-invasive theranostics (LMIT) is a novel evolutionary technology that integrates diagnosis and therapeutics for the less invasive treatment of diseased tissues. Intelligent theranostics would promote precision surgery based on the optical characterization of cancerous tissues. Furthermore, MIT also requires the assistance of smart medical devices or robots. And, optical multimodality lay a solid foundation for intelligent MIT. In this review, we summarize the important state-of-the-arts of optical MIT or LMIT in oncology. Multimodal optical image-guided intelligent treatment is another focus. Intraoperative imaging and real-time analysis-guided optical treatment are also systemically discussed. Finally, the potential challenges and future perspectives of intelligent optical MIT are discussed.
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Affiliation(s)
- Yingwei Fan
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Shuai Liu
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Enze Gao
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Rui Guo
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Guozhao Dong
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Yangxi Li
- Dept. of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, 100084
| | - Tianxin Gao
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Xiaoying Tang
- School of Medical Technology, Beijing Institute of Technology, Beijing, China, 100081
| | - Hongen Liao
- Dept. of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, 100084
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4
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Bayhaqi YA, Hamidi A, Navarini AA, Cattin PC, Canbaz F, Zam A. Real-time closed-loop tissue-specific laser osteotomy using deep-learning-assisted optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:2986-3002. [PMID: 37342720 PMCID: PMC10278623 DOI: 10.1364/boe.486660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023]
Abstract
This article presents a real-time noninvasive method for detecting bone and bone marrow in laser osteotomy. This is the first optical coherence tomography (OCT) implementation as an online feedback system for laser osteotomy. A deep-learning model has been trained to identify tissue types during laser ablation with a test accuracy of 96.28 %. For the hole ablation experiments, the average maximum depth of perforation and volume loss was 0.216 mm and 0.077 mm3, respectively. The contactless nature of OCT with the reported performance shows that it is becoming more feasible to utilize it as a real-time feedback system for laser osteotomy.
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Affiliation(s)
- Yakub. A. Bayhaqi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Arsham Hamidi
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Alexander A. Navarini
- Digital Dermatology Group, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Philippe C. Cattin
- Center for medical Image Analysis and Navigation (CIAN), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Ferda Canbaz
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Azhar Zam
- Biomedical Laser and Optics Group (BLOG), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
- Division of Engineering, New York University Abu Dhabi, Abu Dhabi, 129188, United Arab Emirates
- Tandon School of Engineering, New York University, Brooklyn, NY, 11201, USA
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5
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Hutfilz A, Theisen-Kunde D, Bonsanto MM, Brinkmann R. Pulsed thulium laser blood vessel haemostasis as an alternative to bipolar forceps during neurosurgical tumour resection. Lasers Med Sci 2023; 38:94. [PMID: 36973553 PMCID: PMC10042905 DOI: 10.1007/s10103-023-03747-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/23/2023] [Indexed: 03/29/2023]
Abstract
Due to wavelength-specific water absorption, infrared lasers like the thulium laser emitting at 1940 nm wavelength proved to be suitable for coagulation in neurosurgery. Commonly bipolar forceps used for intraoperative haemostasis can cause mechanical and thermal tissue damage, whilst thulium laser can provide a tissue-gentle haemostasis through non-contact coagulation. The aim of this work is a less-damaging blood vessel coagulation by pulsed thulium laser radiation in comparison to standard bipolar forceps haemostasis. Ex vivo porcine blood vessels in brain tissue (0.34 ± 0.20 mm diameter) were irradiated in non-contact with a thulium laser in pulsed mode (1940 nm wavelength, 15 W power, 100-500 ms pulse duration), with a CO2 gas flow provided simultaneously at the distal fibre tip (5 L/min). In comparison, a bipolar forceps was used at various power levels (20-60 W). Tissue coagulation and ablation were evaluated by white light images and vessel occlusion was visualised by optical coherence tomography (OCT) B-scans at a wavelength of 1060 nm. Coagulation efficiency was calculated by means of the quotient of the difference between the coagulation and ablation radius to the coagulation radius. Pulsed laser application achieved blood vessel occlusion rate of 92% at low pulse duration of 200 ms with no occurrence of ablation (coagulation efficiency 100%). Bipolar forceps showed an occlusion rate of 100%, however resulted in tissue ablation. Tissue ablation depth with laser application is limited to 40 μm and by a factor of 10 less traumatising than with bipolar forceps. Pulsed thulium laser radiation achieved blood vessel haemostasis up to 0.3 mm in diameter without tissue ablation and has proven to be a tissue-gentle method compared to bipolar forceps.
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Affiliation(s)
| | | | - Matteo Mario Bonsanto
- Department of Neurosurgery, University Medical Center Schleswig-Holstein, 23562, Lübeck, Germany
| | - Ralf Brinkmann
- Medical Laser Center Lübeck, 23562, Lübeck, Germany
- Institute of Biomedical Optics, University of Lübeck, 23562, Lübeck, Germany
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6
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Gunalan A, Mattos LS. Towards OCT-Guided Endoscopic Laser Surgery-A Review. Diagnostics (Basel) 2023; 13:diagnostics13040677. [PMID: 36832167 PMCID: PMC9955820 DOI: 10.3390/diagnostics13040677] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Optical Coherence Tomography (OCT) is an optical imaging technology occupying a unique position in the resolution vs. imaging depth spectrum. It is already well established in the field of ophthalmology, and its application in other fields of medicine is growing. This is motivated by the fact that OCT is a real-time sensing technology with high sensitivity to precancerous lesions in epithelial tissues, which can be exploited to provide valuable information to clinicians. In the prospective case of OCT-guided endoscopic laser surgery, these real-time data will be used to assist surgeons in challenging endoscopic procedures in which high-power lasers are used to eradicate diseases. The combination of OCT and laser is expected to enhance the detection of tumors, the identification of tumor margins, and ensure total disease eradication while avoiding damage to healthy tissue and critical anatomical structures. Therefore, OCT-guided endoscopic laser surgery is an important nascent research area. This paper aims to contribute to this field with a comprehensive review of state-of-the-art technologies that may be exploited as the building blocks for achieving such a system. The paper begins with a review of the principles and technical details of endoscopic OCT, highlighting challenges and proposed solutions. Then, once the state of the art of the base imaging technology is outlined, the new OCT-guided endoscopic laser surgery frontier is reviewed. Finally, the paper concludes with a discussion on the constraints, benefits and open challenges associated with this new type of surgical technology.
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Affiliation(s)
- Ajay Gunalan
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, 16163 Genoa, Italy
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, 16145 Genoa, Italy
| | - Leonardo S. Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, 16163 Genoa, Italy
- Correspondence:
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Andrés Sanz JA, Marrone S, Cacciotti G, Carpineta E, Scavo CG, Roperto R, Iacopino DG, Sufianov R, Safarov A, Sufianov A, Mastronardi L. Safeness and efficacy of 2-µm handheld thulium laser during microsurgical resection of supratentorial and infratentorial meningiomas: Experience of a single center. Front Surg 2022; 9:1021019. [PMID: 36589622 PMCID: PMC9800793 DOI: 10.3389/fsurg.2022.1021019] [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: 08/16/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022] Open
Abstract
Aims We performed a retrospective nonrandomized study to analyze the results of a microsurgery of intracranial meningiomas using 2-μm thulium flexible handheld laser fiber (Revolix jr). Methods From February 2014 to December 2021, 75 nonconsecutive patients suffering from intracranial meningiomas, admitted in our department, have been operated on with microsurgical technique assisted by 2-μm thulium flexible handheld laser. We have reviewed demographic and clinical data to evaluate safety and efficacy of the technique. Results There were no complications related to the use of the 2-μm thulium laser. We operated on a high percentage of cranial base and tentorial and posterior fossa meningioma in our series. The neurological outcome and degree of resection did not differ from previous series. The neurosurgical team found the laser easy to use and practical for avoiding bleeding and traction. Conclusion The use of 2-μm thulium fiber handheld flexible laser in microsurgery of intracranial meningiomas seems to be safe and to facilitate tumor resection, especially in "difficult" conditions (e.g., deep seated, highly vascularized, and hard tumors). Even if in this limited retrospective trial the good functional outcome following conventional microsurgery had not further improved, nor the surgical time was reduced by laser, focusing its use on "difficult" (large and vascularized) cases may lead to different results in the future.
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Affiliation(s)
- Julio Alberto Andrés Sanz
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy,Department of Neurosurgery, Lozano Blesa Clinical Hospital, Zaragoza, Spain
| | - Salvatore Marrone
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy,Neurosurgical Clinic, AOUP Paolo Giaccone, Department of Biomedicine Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | | | - Ettore Carpineta
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Raffaele Roperto
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Domenico G. Iacopino
- Neurosurgical Clinic, AOUP Paolo Giaccone, Department of Biomedicine Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Rinat Sufianov
- Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University Under Ministry of Health, Moscow, Russia
| | - Aidar Safarov
- Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University Under Ministry of Health, Moscow, Russia,Federal Centre of Neurosurgery, Ministry of Health, Tyunmen, Russia
| | - Albert Sufianov
- Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University Under Ministry of Health, Moscow, Russia
| | - Luciano Mastronardi
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy,Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University Under Ministry of Health, Moscow, Russia
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Zhang W, He B, Wu Y, Tao Y, Zhu F, Cai W, Liu N, Zhao Q, Xue P. Tail artifacts removal of three-dimensional optical coherence tomography angiography with common parts extraction method. JOURNAL OF BIOPHOTONICS 2022; 15:e202200155. [PMID: 36328058 DOI: 10.1002/jbio.202200155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
In optical coherence tomography angiography (OCTA), each blood vessel has a tail artifact. These tails of superficial vessels will shadow underlying the deep vascular images and make it difficult to reconstruct the three-dimensional (3D) image of the vessels. As 3D structure can provide much more information than two-dimensional (2D) images, it is important to develop a method to remove the artifacts. In this letter, we introduce an image processing technique based on common parts extraction to remove the artifacts. With the help of subtraction operation and erode operation, our method can reconstruct the 3D image of vascular network by extracting the common parts of adjacent B-Scan OCTA images. Vessels of palm are used as samples to experimentally demonstrate our technique. In the 3D image, we can see the interesting phenomenon that the ends of the blood vessels which close to the surface of the skin point toward the surface.
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Affiliation(s)
- Wenxin Zhang
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, China
| | - Bin He
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, China
| | - Yangkang Wu
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yuxiu Tao
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Fu Zhu
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Wenchao Cai
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Ning Liu
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Qiang Zhao
- College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Ping Xue
- State Key Laboratory of Low-dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, China
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9
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Katta N, Estrada AD, McElroy AB, Milner TE. Er:YAG laser brain surgery with vascular specific coagulation. Lasers Surg Med 2022; 54:1107-1115. [PMID: 35946396 DOI: 10.1002/lsm.23591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation can effectively resect water-bearing tissues. Application of Er:YAG resection in neurosurgery is complicated by unpredictable bleeding in surgical field. Recently, an integrated theranostic system combining a dual-wavelength laser surgery system using a thulium (Tm) fiber-laser for coagulation and Er:YAG for resection, combined with optical coherence tomography (OCT) guidance was demonstrated for the in vivo resection of tumor tissue. However, lateral thermal spread in the range of 100 seconds of micrometers is common due to lack of vascular specificity using a Tm fiber-laser for coagulation. In this study, a vascular specific ytterbium (Yb) fiber-laser is utilized for enhanced photocoagulation during in vivo neurosurgery improving the precision of Er:YAG tissue resection with minimal lateral thermal spread. METHODS Mice underwent stereotactic laser surgery with the proposed Yb/Er:YAG dual wavelength vascular specific neurosurgery in vivo. An OCT system (wavelength range 1310 ± 70 nm) and OCT derived angiography images were used to record cortical images to confirm the coagulation of blood vessels and guide subsequent Er:YAG resection steps. After the laser surgery, mice were killed, and histological analysis was carried out using hematoxylin and eosin staining and Nissl staining to compare the lateral thermal spread with our previously reported Tm/Er:YAG neurosurgery where a continuous wave Tm fiber-laser was used for coagulation. RESULTS Coagulation scheme using a Yb fiber-laser allowed stoppage of blood flow in disparately sized blood vessels encountered in the mice brain. Histological analysis of murine brain slices post Yb/Er:YAG laser surgery yielded lower thermal spread compared with Tm/Er:YAG laser surgery, maximizing the efficiency in both hemostasis (blood flow stoppage) and maximizing tissue ablation efficiency with minimal residual thermal damage zone. CONCLUSION In this study, a vascular specific coagulation scheme with Yb/Er:YAG dual-wavelength surgery is presented for neurosurgery. Additionally, Yb/Er:YAG study results are compared with that of a tissue coagulation approach in Tm/Er:YAG surgery previously reported to highlight improved coagulation, reduced nonspecific thermal damage and limited lateral thermal spread. Experimental results suggest that the developed dual-wavelength laser system can effectively resect neural tissues with high localization, minimal lateral thermal spread at the micrometer level while maintaining a bloodless surgical field.
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Affiliation(s)
- Nitesh Katta
- Beckman Laser Institute, University of California at Irvine, East Irvine, California, USA
| | - Arnold D Estrada
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Austin B McElroy
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Thomas E Milner
- Beckman Laser Institute, University of California at Irvine, East Irvine, California, USA
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10
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Yang L, Chen Y, Ling S, Wang J, Wang G, Zhang B, Zhao H, Zhao Q, Mao J. Research progress on the application of optical coherence tomography in the field of oncology. Front Oncol 2022; 12:953934. [PMID: 35957903 PMCID: PMC9358962 DOI: 10.3389/fonc.2022.953934] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Optical coherence tomography (OCT) is a non-invasive imaging technique which has become the “gold standard” for diagnosis in the field of ophthalmology. However, in contrast to the eye, nontransparent tissues exhibit a high degree of optical scattering and absorption, resulting in a limited OCT imaging depth. And the progress made in the past decade in OCT technology have made it possible to image nontransparent tissues with high spatial resolution at large (up to 2mm) imaging depth. On the one hand, OCT can be used in a rapid, noninvasive way to detect diseased tissues, organs, blood vessels or glands. On the other hand, it can also identify the optical characteristics of suspicious parts in the early stage of the disease, which is of great significance for the early diagnosis of tumor diseases. Furthermore, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This review summarizes the recent advances in the OCT area, which application in oncological diagnosis and treatment in different types: (1) superficial tumors:OCT could detect microscopic information on the skin’s surface at high resolution and has been demonstrated to help diagnose common skin cancers; (2) gastrointestinal tumors: OCT can be integrated into small probes and catheters to image the structure of the stomach wall, enabling the diagnosis and differentiation of gastrointestinal tumors and inflammation; (3) deep tumors: with the rapid development of OCT imaging technology, it has shown great potential in the diagnosis of deep tumors such in brain tumors, breast cancer, bladder cancer, and lung cancer.
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Affiliation(s)
- Linhai Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Yulun Chen
- School of Medicine, Xiamen University, Xiamen, China
| | - Shuting Ling
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Jing Wang
- Department of Imaging, School of Medicine, Xiamen Cardiovascular Hospital of Xiamen University, Xiamen University, Xiamen, China
| | - Guangxing Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Bei Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Hengyu Zhao
- Department of Imaging, School of Medicine, Xiamen Cardiovascular Hospital of Xiamen University, Xiamen University, Xiamen, China
- *Correspondence: Hengyu Zhao, ; Qingliang Zhao, ; Jingsong Mao,
| | - Qingliang Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
- *Correspondence: Hengyu Zhao, ; Qingliang Zhao, ; Jingsong Mao,
| | - Jingsong Mao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
- Department of Radiology, Xiamen Key Laboratory of Endocrine-Related Cancer Precision Medicine, Xiang’an Hospital of Xiamen University, Xiamen, China
- *Correspondence: Hengyu Zhao, ; Qingliang Zhao, ; Jingsong Mao,
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11
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Laser coagulation and hemostasis of large diameter blood vessels: effect of shear stress and flow velocity. Sci Rep 2022; 12:8375. [PMID: 35589781 PMCID: PMC9120470 DOI: 10.1038/s41598-022-12128-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/29/2022] [Indexed: 11/08/2022] Open
Abstract
Photocoagulation of blood vessels offers unambiguous advantages to current radiofrequency approaches considering the high specificity of blood absorption at available laser wavelengths (e.g., 532 nm and 1.064 µm). Successful treatment of pediatric vascular lesions, such as port-wine stains requiring microvascular hemostasis, has been documented. Although laser treatments have been successful in smaller diameter blood vessels, photocoagulation of larger sized vessels is less effective. The hypothesis for this study is that a primary limitation in laser coagulation of large diameter blood vessels (500-1000 µm) originates from shear stress gradients associated with higher flow velocities along with temperature-dependent viscosity changes. Laser (1.07 µm) coagulation of blood vessels was tested in the chicken chorio-allantoic membrane (CAM). A finite element model is developed that includes hypothetical limitations in laser coagulation during irradiation. A protocol to specify laser dosimetry is derived from OCT imaging and angiography observations as well as finite element model results. Laser dosimetry is applied in the CAM model to test the experimental hypothesis that blood shear stress and flow velocity are important parameters for laser coagulation and hemostasis of large diameter blood vessels (500-1000 µm). Our experimental results suggest that shear stress and flow velocity are fundamental in the coagulation of large diameter blood vessels (500-1000 µm). Laser dosimetry is proposed and demonstrated for successful coagulation and hemostasis of large diameter CAM blood vessels.
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12
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Katta N, Estrada AD, McErloy AB, Milner TE. Fiber-laser platform for precision brain surgery. BIOMEDICAL OPTICS EXPRESS 2022; 13:1985-1994. [PMID: 35519278 PMCID: PMC9045916 DOI: 10.1364/boe.449312] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Minimally invasive neurological surgeries are increasingly being sought after for treatment in neurological pathologies and oncology. A critical limitation in these minimally invasive procedures is lack of specialized tools that allow for space-time controlled delivery of sufficient energy for coagulation and cutting of tissue. Advent of fiber-lasers provide high average power with improved beam quality (lower M2), biocompatible silica fiber delivery, reduced cost of manufacturing, and radiant output stability over long operating periods. Despite these advancements, no fiber-laser based surgical tools are currently available for tissue resection in vivo. Here we demonstrate a first to our knowledge, fiber-laser platform for performing precise brain surgery in a murine brain model. In this study, our primary aims were to first demonstrate efficacy of fiber-lasers in performing precise blood-less surgery in a murine brain with limited non-specific thermal damage. Second, fiber-lasers' ability to deliver radiant energy through biocompatible silica fibers was explored in a murine brain model for blood less resection. A bench-top optical coherence tomography (OCT) guided fiber-laser platform was constructed with a stereotactic stage for performing precision brain surgery. A pulsed quasi-continuous wave ytterbium (Yb) fiber-laser (1.07 µm) was used to perform vascular specific coagulation while a pulsed nanosecond thulium fiber-laser (1.94 µm) was used to conduct bloodless cutting, all under the guidance of a swept-source OCT system centered at 1310 +/- 70 nm. Specialty linear and circular cuts were made in an in vivo murine brain for bloodless brain tissue resection. The two fiber-lasers were combined into a single biocompatible silica fiber to conduct brain surgery resection under the bench-top OCT system's imaging microscope. Vascular specific coagulation was demonstrated in all five mice studied. Bloodless linear cuts and point cuts were demonstrated in vivo. Histologically, thermal injury was measured to be less than 100 µm while a removal rate of close to 5 mm3/s was achieved with an average Tm fiber-laser power of 15 W. To the authors' knowledge, this is the first demonstration of a fiber-laser platform for conducting in vivo bloodless brain tissue resection with a pulsed thulium (Tm) fiber-laser and a quasi-continuous wave (QCW) Yb fiber-laser. The demonstrated fiber-laser platform, if successfully configured for use in the operating room (OR), can provide surgeons a tool for rapid removal of tissue while making surgical resections of brain regions more precise, and can be basis for a flexible cutting tool capable of reaching hard-to-operate regions.
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Affiliation(s)
- Nitesh Katta
- Beckman Laser Institute, University of California at Irvine, East Irvine, CA 92617, USA
| | - Arnoldo D. Estrada
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712, USA
| | - Austin B. McErloy
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712, USA
| | - Thomas E. Milner
- Beckman Laser Institute, University of California at Irvine, East Irvine, CA 92617, USA
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13
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OCT-Guided Surgery for Gliomas: Current Concept and Future Perspectives. Diagnostics (Basel) 2022; 12:diagnostics12020335. [PMID: 35204427 PMCID: PMC8871129 DOI: 10.3390/diagnostics12020335] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
Optical coherence tomography (OCT) has been recently suggested as a promising method to obtain in vivo and real-time high-resolution images of tissue structure in brain tumor surgery. This review focuses on the basics of OCT imaging, types of OCT images and currently suggested OCT scanner devices and the results of their application in neurosurgery. OCT can assist in achieving intraoperative precision identification of tumor infiltration within surrounding brain parenchyma by using qualitative or quantitative OCT image analysis of scanned tissue. OCT is able to identify tumorous tissue and blood vessels detection during stereotactic biopsy procedures. The combination of OCT with traditional imaging such as MRI, ultrasound and 5-ALA fluorescence has the potential to increase the safety and accuracy of the resection. OCT can improve the extent of resection by offering the direct visualization of tumor with cellular resolution when using microscopic OCT contact probes. The theranostic implementation of OCT as a part of intelligent optical diagnosis and automated lesion localization and ablation could achieve high precision, automation and intelligence in brain tumor surgery. We present this review for the increase of knowledge and formation of critical opinion in the field of OCT implementation in brain tumor surgery.
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14
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Hartmann K, Stein KP, Neyazi B, Sandalcioglu IE. Theranostic applications of optical coherence tomography in neurosurgery? Neurosurg Rev 2021; 45:421-427. [PMID: 34398385 PMCID: PMC8827310 DOI: 10.1007/s10143-021-01599-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/11/2021] [Accepted: 06/27/2021] [Indexed: 12/14/2022]
Abstract
In light of our own experiences, we value the existing literature to critically point out possible “near” future applications of optical coherence tomography (OCT) as an intraoperative neurosurgical guidance tool. “Pub Med”, “Cochrane Library”, “Crossref Metadata Search”, and “IEEE Xplore” databases as well as the search engine “Google Scholar” were screened for “optical coherence tomography + neurosurgery”, “optical coherence tomography + intraoperative imaging + neurosurgery”, and “microscope integrated optical coherence tomography + neurosurgery”. n = 51 articles related to the use of OCT as an imaging technique in the field of neurosurgery or neurosurgical research. n = 7 articles documented the intraoperative use of OCT in patients. n = 4 articles documented the use of microscope-integrated optical coherence tomography as a neurosurgical guidance tool. The Results demonstrate that OCT is the first imaging technique to study microanatomy in vivo. Postoperative analysis of intraoperative scans holds promise to enrich our physiological and pathophysiological understanding of the human brain. No data exists to prove that OCT-guided surgery minimizes perioperative morbidity or extends tumor resection. But results suggest that regular use of microscope-integrated OCT could increase security during certain critical microsurgical steps like, e.g., dural dissection at cavernous sinus, transtentorial approaches, or aneurysm clip placement. Endoscopy integration could aid surgery in regions which are not yet accessible to real-time imaging modalities like the ventricles or hypophysis. Theranostic instruments which combine OCT with laser ablation might gain importance in the emerging field of minimal invasive tumor surgery. OCT depicts vessel wall layers and its pathologies uniquely. Doppler OCT could further visualize blood flow in parallel. These abilities shed light on promising future applications in the field of vascular neurosurgery.
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Affiliation(s)
- Karl Hartmann
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
| | - Klaus-Peter Stein
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - Belal Neyazi
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - I Erol Sandalcioglu
- Universitätsklinik Für Neurochirurgie, Otto-Von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
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15
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Li Y, Fan Y, Hu C, Mao F, Zhang X, Liao H. Intelligent optical diagnosis and treatment system for automated image-guided laser ablation of tumors. Int J Comput Assist Radiol Surg 2021; 16:2147-2157. [PMID: 34363584 DOI: 10.1007/s11548-021-02457-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/06/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE For tumor resections near critical structures, accurate identification of tumor boundaries and maximum removal are the keys to improve surgical outcome and patient survival rate, especially in neurosurgery. In this paper, we propose an intelligent optical diagnosis and treatment system for tumor removal, with automated lesion localization and laser ablation. METHODS The proposed system contains a laser ablation module, an optical coherence tomography (OCT) unit, and a robotic arm along with a stereo camera. The robotic arm can move the OCT sample arm and the laser ablation front-end to the suspected lesion area. The corresponding diagnosis and treatment procedures include computer-aided lesion segmentation using OCT, automated ablation planning, and laser control. The ablation process is controlled by a deflectable mirror, and a non-common-path ablation planning algorithm based on the transformation from lesion positions to mirror deflection angles is presented. RESULTS Phantom and animal experiments are carried out for system verification. The robot could reach the planned position with high precision, which is approximately 1.16 mm. Tissue classification with OCT images achieves 91.7% accuracy. The error of OCT-guided automated laser ablation is approximately 0.74 mm. Experiments on mouse brain tumors show that the proposed system is capable of clearing lesions efficiently and precisely. We also conducted an ex vivo porcine brain experiment to verify the whole process of the system. CONCLUSION An intelligent optical diagnosis and treatment system is proposed for tumor removal. Experimental results show that the proposed system and method are promising for precise and intelligent theranostics. Compared to conventional cancer diagnosis and treatment, the proposed system allows for automated operations monitored in real-time, with higher precision and efficiency.
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Affiliation(s)
- Yangxi Li
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Yingwei Fan
- Beijing Institute of Radiation Medicine, Beijing, China
| | - Chengquan Hu
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Fan Mao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Xinran Zhang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Hongen Liao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
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16
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Andleeb F, Katta N, Gruslova A, Muralidharan B, Estrada A, McElroy AB, Ullah H, Brenner AJ, Milner TE. Differentiation of Brain Tumor Microvasculature From Normal Vessels Using Optical Coherence Angiography. Lasers Surg Med 2021; 53:1386-1394. [PMID: 34130353 DOI: 10.1002/lsm.23446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Despite rapid advances and discoveries in medical imaging, monitoring therapeutic efficacy for malignant gliomas and monitoring tumor vasculature remains problematic. The purpose of this study is to utilize optical coherence angiography for vasculature characterization inside and surrounding brain tumors in a murine xenograft brain tumor model. Features included in our analysis include fractional blood volume, vessel tortuosity, diameter, orientation, and directionality. STUDY DESIGN/MATERIALS AND METHODS In this study, five tumorous mice models at 4 weeks of age were imaged. Human glioblastoma cells were injected into the brain and allowed to grow for 4 weeks and then imaged using optical coherence tomography. RESULTS Results suggest that blood vessels outside the tumor contain a greater fractional blood volume as compared with vessels inside the tumor. Vessels inside the tumor are more tortuous as compared with those outside the tumor. Results indicate that vessels near the tumor margin are directed inward towards the tumor while normal vessels show a more random orientation. CONCLUSION Quantification of vascular microenvironments in brain gliomas can provide functional vascular parameters to aid various diagnostic and therapeutic studies. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Farah Andleeb
- Department of Biomedical Engineering, The University of Texas Austin, Austin, Texas, 78712, USA.,Biophotonics Research Lab, Institute of Physics, The Islamia University, Bahawalpur, Bahawalpur, Punjab, 63100, Pakistan.,Department of Physics, Government Sadiq College Women University Bahawalpur, Bahwalpur, Punjab, 63100, Pakistan
| | - Nitesh Katta
- Department of Biomedical Engineering, The University of Texas Austin, Austin, Texas, 78712, USA
| | - Aleksandra Gruslova
- University of Texas Health Science Center at San Antonio, San Antonio, Texas, 78229, USA
| | - Bharadwaj Muralidharan
- Department of Biomedical Engineering, The University of Texas Austin, Austin, Texas, 78712, USA
| | - Arnold Estrada
- Department of Biomedical Engineering, The University of Texas Austin, Austin, Texas, 78712, USA
| | - Austin B McElroy
- Department of Biomedical Engineering, The University of Texas Austin, Austin, Texas, 78712, USA
| | - Hafeez Ullah
- Biophotonics Research Lab, Institute of Physics, The Islamia University, Bahawalpur, Bahawalpur, Punjab, 63100, Pakistan
| | - Andrew J Brenner
- University of Texas Health Science Center at San Antonio, San Antonio, Texas, 78229, USA
| | - Thomas E Milner
- Department of Biomedical Engineering, The University of Texas Austin, Austin, Texas, 78712, USA
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17
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Dolezyczek H, Rapolu M, Niedzwiedziuk P, Karnowski K, Borycki D, Dzwonek J, Wilczynski G, Malinowska M, Wojtkowski M. Longitudinal in-vivo OCM imaging of glioblastoma development in the mouse brain. BIOMEDICAL OPTICS EXPRESS 2020; 11:5003-5016. [PMID: 33014596 PMCID: PMC7510867 DOI: 10.1364/boe.400723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
We present in-vivo imaging of the mouse brain using custom made Gaussian beam optical coherence microscopy (OCM) with 800nm wavelength. We applied new instrumentation to longitudinal imaging of the glioblastoma (GBM) tumor microvasculature in the mouse brain. We have introduced new morphometric biomarkers that enable quantitative analysis of the development of GBM. We confirmed quantitatively an intensive angiogenesis in the tumor area between 3 and 14 days after GBM cells injection confirmed by considerably increased of morphometric parameters. Moreover, the OCM setup revealed heterogeneity and abnormality of newly formed vessels.
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Affiliation(s)
- Hubert Dolezyczek
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, ul. Pasteura 3, 02-093 Warsaw, Poland
- both authors contributed equally
| | - Mounika Rapolu
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland
- both authors contributed equally
| | - Paulina Niedzwiedziuk
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Karol Karnowski
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Dawid Borycki
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Joanna Dzwonek
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, ul. Pasteura 3, 02-093 Warsaw, Poland
| | - Grzegorz Wilczynski
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, ul. Pasteura 3, 02-093 Warsaw, Poland
| | - Monika Malinowska
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, ul. Pasteura 3, 02-093 Warsaw, Poland
| | - Maciej Wojtkowski
- Institute of Physical Chemistry, Polish Academy of Sciences, ul. Kasprzaka 44/52, 01-224 Warsaw, Poland
- Baltic Institute of Technology, Al. Zwycięstwa 96/98, 81-451 Gdynia, Poland
- Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Gagarina 11, 87-100 Toruń, Poland
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18
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Keating MF, Zhang J, Feider CL, Retailleau S, Reid R, Antaris A, Hart B, Tan G, Milner TE, Miller K, Eberlin LS. Integrating the MasSpec Pen to the da Vinci Surgical System for In Vivo Tissue Analysis during a Robotic Assisted Porcine Surgery. Anal Chem 2020; 92:11535-11542. [PMID: 32786489 DOI: 10.1021/acs.analchem.0c02037] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Minimally invasive robotic-assisted surgeries have been increasingly used as a first-line of treatment for patients undergoing oncologic surgeries. In-situ tissue identification is critical to guide tissue resection and assist decision-making. Traditional intraoperative histopathologic analysis of frozen tissue sections can be time-consuming and present logistical challenges which interrupt surgical workflows. We report the development and implementation of a laparoscopic, drop-in version of the MasSpec Pen device integrated into the da Vinci Xi Surgical system for in vivo tissue analysis in a robotic-assisted porcine surgery. We evaluated the performance of the drop-in MasSpec Pen during surgery by introducing the device into the animal upper gastrointestinal system and performing in vivo analyses of the stomach and liver, including charred and bloody tissues after electrocauterization. The molecular profiles obtained included ions tentatively identified as metabolites and lipids typically observed with MasSpec Pen analysis, without causing observable tissue damage. Statistical classifiers built to distinguish porcine liver and stomach tissues using the in vivo data yielded an overall tissue identification accuracy of 98% (n = 53 analyses). The results provide evidence that the drop-in MasSpec Pen developed can be used to acquire mass spectra in vivo during a robotic-assisted surgery and might be used as an in vivo tissue assessment tool to help guide surgical resections and streamline surgical workflows.
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Affiliation(s)
- Michael F Keating
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78751, United States
| | - Jialing Zhang
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78751, United States
| | - Clara L Feider
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78751, United States
| | | | - Robert Reid
- Intuitive Surgical, Sunnyvale, California 94086, United States
| | | | - Bradley Hart
- Thermo Fisher Scientific, San Jose, California 95134, United States
| | - Gina Tan
- Thermo Fisher Scientific, San Jose, California 95134, United States
| | - Thomas E Milner
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas 78751, United States
| | - Kyle Miller
- Intuitive Surgical, Sunnyvale, California 94086, United States
| | - Livia S Eberlin
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78751, United States
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19
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Choi WJ, Paulson B, Yu S, Wang RK, Kim JK. Mean-Subtraction Method for De-shadowing of Tail Artifacts in Cerebral OCTA Images: A Proof of Concept. MATERIALS 2020; 13:ma13092024. [PMID: 32357466 PMCID: PMC7254351 DOI: 10.3390/ma13092024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 01/25/2023]
Abstract
When imaging brain vasculature with optical coherence tomography angiography (OCTA), volumetric analysis of cortical vascular networks in OCTA datasets is frequently challenging due to the presence of artifacts, which appear as multiple-scattering tails beneath superficial large vessels in OCTA images. These tails shadow underlying small vessels, making the assessment of vascular morphology in the deep cortex difficult. In this work, we introduce an image processing technique based on mean subtraction of the depth profile that can effectively reduce these tails to better reveal small hidden vessels compared to the current tail removal approach. With the improved vascular image quality, we demonstrate that this simple method can provide better visualization of three-dimensional vascular network topology for quantitative cerebrovascular studies.
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Affiliation(s)
- Woo June Choi
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea; (W.J.C.); (S.Y.)
| | - Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea;
| | - Sungwook Yu
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea; (W.J.C.); (S.Y.)
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA;
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea;
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
- Correspondence: ; Tel.: +82-2-3010-8619
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20
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Gardner MR, Baruah V, Vargas G, Motamedi M, Milner TE, Rylander HG. Scattering Angle Resolved Optical Coherence Tomography Detects Early Changes in 3xTg Alzheimer's Disease Mouse Model. Transl Vis Sci Technol 2020; 9:18. [PMID: 32821490 PMCID: PMC7401921 DOI: 10.1167/tvst.9.5.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/02/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose Clinical intensity-based optical coherence tomographic retinal imaging is unable to resolve some of the earliest changes to Alzheimer's disease (AD) neurons. The aim of this pilot study was to demonstrate that scattering-angle-resolved optical coherence tomography (SAR-OCT), which is sensitive to changes in light scattering angle, is a candidate retinal imaging modality for early AD detection. SAR-OCT signal data may be sensitive to changes in intracellular constituent morphology that are not detectable with conventional OCT. Methods In this cross-sectional study, retinas of a triple transgenic mouse model of AD (3xTg-AD) were imaged alongside age-matched control mice (C57BL/6J) using SAR-OCT. A total of 32 mice (12 control, 20 3xTg-Ad) at four ages (10, 20, 30, and 45 weeks) were included in this cross-sectional study, and three retinal feature sets (scattering, thickness, and angiography) were examined between the disease and control groups. Results AD mice had significantly increased scattering diversity (lower SAR-OCT C parameter) at the earliest imaging time (10 weeks). Differences in the C parameter between AD and control mice were diminished at later times when both groups showed increased scattering diversity. AD mice have reduced retinal thickness compared to controls, particularly in central regions and superficial layers. No differences in vascular density or fractional blood volume between groups were detected. Conclusions SAR-OCT is sensitive to scattering angle changes in a 3xTg-AD mouse model and could provide early-stage biomarkers for neurodegenerative diseases such as AD. Translational Relevance Clinical OCT systems may be modified to record SAR-OCT images for non-invasive retinal diagnostic imaging of patients with neurodegenerative diseases such as AD.
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Affiliation(s)
- Michael R Gardner
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.,Department of Biomedical Engineering, King Faisal University, Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Vikram Baruah
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Gracie Vargas
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, TX, USA
| | - Massoud Motamedi
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, TX, USA
| | - Thomas E Milner
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Henry G Rylander
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
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21
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Periyasamy V, Özsoy Ç, Reiss M, Deán-Ben XL, Razansky D. In vivo optoacoustic monitoring of percutaneous laser ablation of tumors in a murine breast cancer model. OPTICS LETTERS 2020; 45:2006-2009. [PMID: 32236054 DOI: 10.1364/ol.386360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/23/2020] [Indexed: 06/11/2023]
Abstract
Laser ablation (LA) is a promising approach for minimally invasive cancer treatments. Its in vivo applicability is often impeded by the lack of efficient monitoring tools that can help to minimize collateral tissue damage and aid in determining the optimal treatment end-points. We have devised a new, to the best of our knowledge, hybrid LA approach combining simultaneous volumetric optoacoustic (OA) imaging to monitor the lesion progression accurately in real time and 3D. Time-lapse imaging of laser ablation of solid tumors was performed in a murine breast cancer model in vivo by irradiation of subcutaneous tumors with a 100 mJ short-pulsed (${\sim}{5}\;{\rm ns}$∼5ns) laser operating at 1064 nm and 100 Hz pulse repetition frequency. Local changes in the OA signal intensity ascribed to structural alterations in the tumor vasculature were clearly observed, while the OA volumetric projections recorded in vivo appeared to correlate with cross sections of the excised tumors.
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22
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Zeng Y, Xu S, Chapman WC, Li S, Alipour Z, Abdelal H, Chatterjee D, Mutch M, Zhu Q. Real-time colorectal cancer diagnosis using PR-OCT with deep learning. Theranostics 2020; 10:2587-2596. [PMID: 32194821 PMCID: PMC7052898 DOI: 10.7150/thno.40099] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/08/2019] [Indexed: 12/24/2022] Open
Abstract
Prior reports have shown optical coherence tomography (OCT) can differentiate normal colonic mucosa from neoplasia, potentially offering an alternative technique to endoscopic biopsy - the current gold-standard colorectal cancer screening and surveillance modality. To help clinical translation limited by processing the large volume of generated data, we designed a deep learning-based pattern recognition (PR) OCT system that automates image processing and provides accurate diagnosis potentially in real-time. Method: OCT is an emerging imaging technique to obtain 3-dimensional (3D) "optical biopsies" of biological samples with high resolution. We designed a convolutional neural network to capture the structure patterns in human colon OCT images. The network is trained and tested using around 26,000 OCT images acquired from 20 tumor areas, 16 benign areas, and 6 other abnormal areas. Results: The trained network successfully detected patterns that identify normal and neoplastic colorectal tissue. Experimental diagnoses predicted by the PR-OCT system were compared to the known histologic findings and quantitatively evaluated. A sensitivity of 100% and specificity of 99.7% can be reached. Further, the area under the receiver operating characteristic (ROC) curves (AUC) of 0.998 is achieved. Conclusions: Our results demonstrate that PR-OCT can be used to give an accurate real-time computer-aided diagnosis of colonic neoplastic mucosa. Future development of this system as an "optical biopsy" tool to assist doctors in real-time for early mucosal neoplasms screening and treatment evaluation following initial oncologic therapy is planned.
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Affiliation(s)
- Yifeng Zeng
- Department of Biomedical Engineering, Washington University in St. Louis
| | - Shiqi Xu
- Department of Electrical & System Engineering, Washington University in St. Louis
| | - William C. Chapman
- Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine
| | - Shuying Li
- Department of Biomedical Engineering, Washington University in St. Louis
| | - Zahra Alipour
- Department of Pathology and Immunology, Washington University School of Medicine
| | - Heba Abdelal
- Department of Pathology and Immunology, Washington University School of Medicine
| | - Deyali Chatterjee
- Department of Pathology and Immunology, Washington University School of Medicine
| | - Matthew Mutch
- Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine
| | - Quing Zhu
- Department of Biomedical Engineering, Washington University in St. Louis
- Department of Radiology, Washington University School of Medicine
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