1
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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
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2
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Adams DC, Majid A, Suter MJ. Polarization mode dispersion correction in endoscopic polarization-sensitive optical coherence tomography with incoherent polarization input states. Biomed Opt 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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3
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Nandy S, Raphaely RA, Muniappan A, Shih A, Roop BW, Sharma A, Keyes CM, Colby TV, Auchincloss HG, Gaissert HA, Lanuti M, Morse CR, Ott HC, Wain JC, Wright CD, Garcia-Moliner ML, Smith ML, VanderLaan PA, Berigei SR, Mino-Kenudson M, Horick NK, Liang LL, Davies DL, Szabari MV, Caravan P, Medoff BD, Tager AM, Suter MJ, Hariri LP. Reply to Kalverda et al.: Endobronchial Optical Coherence Tomography: Shining New Light on Diagnosing Usual Interstitial Pneumonitis? Am J Respir Crit Care Med 2022; 205:968-971. [PMID: 35148493 PMCID: PMC9838623 DOI: 10.1164/rccm.202112-2737le] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Sreyankar Nandy
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Rebecca A. Raphaely
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Ashok Muniappan
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Angela Shih
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | | | - Amita Sharma
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Colleen M. Keyes
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | | | - Hugh G. Auchincloss
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Henning A. Gaissert
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Michael Lanuti
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Christopher R. Morse
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Harald C. Ott
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - John C. Wain
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts,St. Elizabeth’s Medical CenterBoston, Massachusetts
| | - Cameron D. Wright
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | | | | | - Paul A. VanderLaan
- Harvard Medical SchoolBoston, Massachusetts,Beth Israel Deaconess Medical CenterBoston, Massachusetts
| | | | - Mari Mino-Kenudson
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Nora K. Horick
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | | | | | - Margit V. Szabari
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Peter Caravan
- Harvard Medical SchoolBoston, Massachusetts,Athinoula A. Martinos Center for Biomedical ImagingCharlestown, Massachusetts,Massachusetts General HospitalCharlestown, Massachusetts
| | - Benjamin D. Medoff
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Andrew M. Tager
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Melissa J. Suter
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts
| | - Lida P. Hariri
- Massachusetts General HospitalBoston, Massachusetts,Harvard Medical SchoolBoston, Massachusetts,Corresponding author (e-mail: )
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4
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Pahlevaninezhad M, Huang YW, Pahlevani M, Bouma B, Suter MJ, Capasso F, Pahlevaninezhad H. Metasurface-based bijective illumination collection imaging provides high-resolution tomography in three dimensions. Nat Photonics 2022; 16:203-211. [PMID: 35937091 PMCID: PMC9355264 DOI: 10.1038/s41566-022-00956-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/10/2022] [Indexed: 06/08/2023]
Abstract
Microscopic imaging in three dimensions enables numerous biological and clinical applications. However, high-resolution optical imaging preserved in a relatively large depth range is hampered by the rapid spread of tightly confined light due to diffraction. Here, we show that a particular disposition of light illumination and collection paths liberates optical imaging from the restrictions imposed by diffraction. This arrangement, realized by metasurfaces, decouples lateral resolution from depth-of-focus by establishing a one-to-one correspondence (bijection) along a focal line between the incident and collected light. Implementing this approach in optical coherence tomography, we demonstrate tissue imaging at 1.3 μm wavelength with ~ 3.2 μm lateral resolution, maintained nearly intact over 1.25 mm depth-of-focus, with no additional acquisition or computation burden. This method, termed bijective illumination collection imaging, is general and might be adapted across various existing imaging modalities.
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Affiliation(s)
- Masoud Pahlevaninezhad
- Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
- Department of Electrical and Computer Engineering, Queen’s University, Kingston, Ontario, Canada
- Department of Mechanical and Materials Engineering, Queen’s University, Kingston, Ontario, Canada
| | - Yao-Wei Huang
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Majid Pahlevani
- Department of Electrical and Computer Engineering, Queen’s University, Kingston, Ontario, Canada
| | - Brett Bouma
- Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
- Harvard-MIT Health Science and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Melissa J. Suter
- Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Federico Capasso
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Hamid Pahlevaninezhad
- Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
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5
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Nandy S, Raphaely RA, Muniappan A, Shih A, Roop BW, Sharma A, Keyes CM, Colby TV, Auchincloss HG, Gaissert HA, Lanuti M, Morse CR, Ott HC, Wain JC, Wright CD, Garcia-Moliner ML, Smith ML, VanderLaan PA, Berigei SR, Mino-Kenudson M, Horick NK, Liang LL, Davies DL, Szabari MV, Caravan P, Medoff BD, Tager AM, Suter MJ, Hariri LP. Diagnostic Accuracy of Endobronchial Optical Coherence Tomography for the Microscopic Diagnosis of Usual Interstitial Pneumonia. Am J Respir Crit Care Med 2021; 204:1164-1179. [PMID: 34375171 PMCID: PMC8759308 DOI: 10.1164/rccm.202104-0847oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
Rationale: Early, accurate diagnosis of interstitial lung disease (ILD) informs prognosis and therapy, especially in idiopathic pulmonary fibrosis (IPF). Current diagnostic methods are imperfect. High-resolution computed tomography has limited resolution, and surgical lung biopsy (SLB) carries risks of morbidity and mortality. Endobronchial optical coherence tomography (EB-OCT) is a low-risk, bronchoscope-compatible modality that images large lung volumes in vivo with microscopic resolution, including subpleural lung, and has the potential to improve the diagnostic accuracy of bronchoscopy for ILD diagnosis. Objectives: We performed a prospective diagnostic accuracy study of EB-OCT in patients with ILD with a low-confidence diagnosis undergoing SLB. The primary endpoints were EB-OCT sensitivity/specificity for diagnosis of the histopathologic pattern of usual interstitial pneumonia (UIP) and clinical IPF. The secondary endpoint was agreement between EB-OCT and SLB for diagnosis of the ILD fibrosis pattern. Methods: EB-OCT was performed immediately before SLB. The resulting EB-OCT images and histopathology were interpreted by blinded, independent pathologists. Clinical diagnosis was obtained from the treating pulmonologists after SLB, blinded to EB-OCT. Measurements and Main Results: We enrolled 31 patients, and 4 were excluded because of inconclusive histopathology or lack of EB-OCT data. Twenty-seven patients were included in the analysis (16 men, average age: 65.0 yr): 12 were diagnosed with UIP and 15 with non-UIP ILD. Average FVC and DlCO were 75.3% (SD, 18.5) and 53.5% (SD, 16.4), respectively. Sensitivity and specificity of EB-OCT was 100% (95% confidence interval, 75.8-100.0%) and 100% (79.6-100%), respectively, for both histopathologic UIP and clinical diagnosis of IPF. There was high agreement between EB-OCT and histopathology for diagnosis of ILD fibrosis pattern (weighted κ: 0.87 [0.72-1.0]). Conclusions: EB-OCT is a safe, accurate method for microscopic ILD diagnosis, as a complement to high-resolution computed tomography and an alternative to SLB.
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Affiliation(s)
- Sreyankar Nandy
- Division of Pulmonary and Critical Care Medicine
- Wellman Center for Photomedicine
- Harvard Medical School, Boston, Massachusetts
| | - Rebecca A. Raphaely
- Division of Pulmonary and Critical Care Medicine
- Harvard Medical School, Boston, Massachusetts
| | - Ashok Muniappan
- Division of Thoracic Surgery
- Harvard Medical School, Boston, Massachusetts
| | - Angela Shih
- Department of Pathology
- Harvard Medical School, Boston, Massachusetts
| | - Benjamin W. Roop
- Division of Pulmonary and Critical Care Medicine
- Wellman Center for Photomedicine
| | - Amita Sharma
- Department of Radiology, and
- Harvard Medical School, Boston, Massachusetts
| | - Colleen M. Keyes
- Division of Pulmonary and Critical Care Medicine
- Harvard Medical School, Boston, Massachusetts
| | - Thomas V. Colby
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, Arizona
| | | | | | - Michael Lanuti
- Division of Thoracic Surgery
- Harvard Medical School, Boston, Massachusetts
| | | | - Harald C. Ott
- Division of Thoracic Surgery
- Harvard Medical School, Boston, Massachusetts
| | - John C. Wain
- Division of Thoracic Surgery
- Harvard Medical School, Boston, Massachusetts
- St. Elizabeth’s Medical Center, Boston, Massachusetts
| | - Cameron D. Wright
- Division of Thoracic Surgery
- Harvard Medical School, Boston, Massachusetts
| | - Maria L. Garcia-Moliner
- Department of Pathology, Rhode Island Hospital and Alpert Medical School, Providence, Rhode Island
| | - Maxwell L. Smith
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Paul A. VanderLaan
- Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Sarita R. Berigei
- Division of Pulmonary and Critical Care Medicine
- Wellman Center for Photomedicine
| | | | - Nora K. Horick
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | | | - Margit V. Szabari
- Division of Pulmonary and Critical Care Medicine
- Wellman Center for Photomedicine
- Harvard Medical School, Boston, Massachusetts
| | - Peter Caravan
- Harvard Medical School, Boston, Massachusetts
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts; and
- Institute for Innovation in Imaging (i), Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Benjamin D. Medoff
- Division of Pulmonary and Critical Care Medicine
- Harvard Medical School, Boston, Massachusetts
| | - Andrew M. Tager
- Division of Pulmonary and Critical Care Medicine
- Harvard Medical School, Boston, Massachusetts
| | - Melissa J. Suter
- Division of Pulmonary and Critical Care Medicine
- Wellman Center for Photomedicine
- Harvard Medical School, Boston, Massachusetts
| | - Lida P. Hariri
- Division of Pulmonary and Critical Care Medicine
- Wellman Center for Photomedicine
- Department of Pathology
- Harvard Medical School, Boston, Massachusetts
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6
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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. Biomed Opt 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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7
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Adams DC, Holz JA, Szabari MV, Hariri LP, Mccrossan AF, Manley CJ, Fleury S, O'Shaughnessy S, Weiner J, Suter MJ. In vivo assessment of changes to canine airway smooth muscle following bronchial thermoplasty with OR-OCT. J Appl Physiol (1985) 2021; 130:1814-1821. [PMID: 33886383 DOI: 10.1152/japplphysiol.00914.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The inability to assess and measure changes to the airway smooth muscle (ASM) in vivo is a major challenge to evaluating asthma and its clinical outcomes. Bronchial thermoplasty (BT) is a therapy for asthma that aims to reduce the severity of excessive bronchoconstriction by ablating ASM. Although multiple long-term clinical studies of BT have produced encouraging results, the outcomes of BT treatment in practice have been variable, and questions remain regarding the selection of patients. Previously, we have demonstrated an imaging platform called orientation-resolved optical coherence tomography that can assess ASM endoscopically using an imaging catheter compatible with bronchoscopy. In this work, we present results obtained from a longitudinal BT study performed using a canine model (n = 8) and with the goal of investigating the use of orientation-resolved optical coherence tomography (OR-OCT) for measuring the effects of BT on ASM. We demonstrate that we are capable of accurately assessing ASM both before and in the weeks following the BT procedure using blinded matching to histological samples stained with Masson's trichrome (P < 0.0001, r2 = 0.79). Analysis of volumetric ASM distributions revealed significant decreases in ASM in treated airways (average cross-sectional ASM area: 0.245 ± 0.145 mm2 pre-BT and 0.166 ± 0.112 mm2 6 wk following BT). These results demonstrate that OR-OCT can provide clinicians with the feedback necessary to better evaluate ASM and its response to BT, and may potentially play an important role in phenotyping asthma and predicting which patients are most likely to respond to BT treatment.NEW & NOTEWORTHY The inability to assess ASM in vivo is a significant hurdle in advancing our understanding of airway diseases such as asthma, as well as evaluating potential treatments and therapies. In this study, we demonstrate that endoscopic OR-OCT can be used to accurately measure changes to ASM structure following BT. Our results demonstrate how this technology could occupy an important role in asthma treatments targeting ASM.
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Affiliation(s)
- David C Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jasmin A Holz
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Margit V Szabari
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lida P Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew F Mccrossan
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher J Manley
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sean Fleury
- Boston Scientific, Marlborough, Massachusetts
| | | | | | - Melissa J Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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8
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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9
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Adams DC, Miller AJ, Applegate MB, Cho JL, Hamilos DL, Chee A, Holz JA, Szabari MV, Hariri LP, Harris RS, Griffith JW, Luster AD, Medoff BD, Suter MJ. Quantitative assessment of airway remodelling and response to allergen in asthma. Respirology 2019; 24:1073-1080. [PMID: 30845351 PMCID: PMC6732047 DOI: 10.1111/resp.13521] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE In vivo evaluation of the microstructural differences between asthmatic and non-asthmatic airways and their functional consequences is relevant to understanding and, potentially, treating asthma. In this study, we use endobronchial optical coherence tomography to investigate how allergic airways with asthma differ from allergic non-asthmatic airways in baseline microstructure and in response to allergen challenge. METHODS A total of 45 subjects completed the study, including 20 allergic, mildly asthmatic individuals, 22 non-asthmatic allergic controls and 3 healthy controls. A 3-cm airway segment in the right middle and right upper lobe were imaged in each subject immediately before and 24 h following segmental allergen challenge to the right middle lobe. Relationships between optical airway measurements (epithelial and mucosal thicknesses, mucosal buckling and mucus) and airway obstruction (FEV1 /FVC (forced expiratory volume in 1 s/forced vital capacity) and FEV1 % (FEV1 as a percentage of predictive value)) were investigated. RESULTS Significant increases at baseline and in response to allergen were observed for all four of our imaging metrics in the asthmatic airways compared to the non-asthmatic airways. Epithelial thickness and mucosal buckling exhibited a significant relationship to FEV1 /FVC in the asthmatic group. CONCLUSION Simultaneous assessments of airway microstructure, buckling and mucus revealed both structural and functional differences between the mildly asthmatic and control groups, with airway buckling seeming to be the most relevant factor. The results of this study demonstrate that a comprehensive, microstructural approach to assessing the airways may be important in future asthma studies as well as in the monitoring and treatment of asthma.
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Affiliation(s)
- David C Adams
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alyssa J Miller
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew B Applegate
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Josalyn L Cho
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel L Hamilos
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Chee
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmin A Holz
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Margit V Szabari
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lida P Hariri
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - R Scott Harris
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jason W Griffith
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew D Luster
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin D Medoff
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Melissa J Suter
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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10
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Hariri LP, Adams DC, Wain JC, Lanuti M, Muniappan A, Sharma A, Colby TV, Mino-Kenudson M, Mark EJ, Kradin RL, Goulart H, Tager AM, Suter MJ. Endobronchial Optical Coherence Tomography for Low-Risk Microscopic Assessment and Diagnosis of Idiopathic Pulmonary Fibrosis In Vivo. Am J Respir Crit Care Med 2019; 197:949-952. [PMID: 28934552 DOI: 10.1164/rccm.201707-1446le] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Lida P Hariri
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - David C Adams
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - John C Wain
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Michael Lanuti
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Ashok Muniappan
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Amita Sharma
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | | | - Mari Mino-Kenudson
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Eugene J Mark
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Richard L Kradin
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | | | - Andrew M Tager
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Melissa J Suter
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
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11
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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12
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Adams DC, Suter MJ. Processing-based approach for resolving the sample optic axis in endoscopic polarization-sensitive optical coherence tomography. Opt Express 2018; 26:24917-24927. [PMID: 30469600 PMCID: PMC6238824 DOI: 10.1364/oe.26.024917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Fiber-based polarization-sensitive optical coherence tomography (PS-OCT) that utilizes a rotationally-scanning catheter has a variety of potential biomedical applications in luminal organ systems due to its ability to provide intrinsic contrast for birefringent tissue. Incorporating the optic axis (OA) of the tissue greatly enhances this potential by also permitting information about the orientation of the tissue to be extracted; however, measurement distortion that occurs has up to this point made it impossible to obtain accurate sample OA measurements. In this paper we present a straightforward calibration technique that allows the sample OA to be recovered. This technique requires no hardware modifications making it generally applicable, and as a result has tremendous potential in improving the utility of endoscopic PS-OCT image data.
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Affiliation(s)
- David C. Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 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
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13
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Pahlevaninezhad H, Khorasaninejad M, Huang YW, Shi Z, Hariri LP, Adams DC, Ding V, Zhu A, Qiu CW, Capasso F, Suter MJ. Nano-optic endoscope for high-resolution optical coherence tomography in vivo. Nat Photonics 2018; 12:540-547. [PMID: 30713581 PMCID: PMC6350822 DOI: 10.1038/s41566-018-0224-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/04/2018] [Indexed: 05/19/2023]
Abstract
Acquisition of high-resolution images from within internal organs using endoscopic optical imaging has numerous clinical applications. However, difficulties associated with optical aberrations and the trade-off between transverse resolution and depth-of-focus significantly limit the scope of applications. Here, we integrate a metalens, with the ability to modify the phase of incident light at sub-wavelength level, into the design of an endoscopic optical coherence tomography catheter (termed nano-optic endoscope) to achieve near diffraction-limited imaging through negating non-chromatic aberrations. Remarkably, the tailored chromatic dispersion of the metalens in the context of spectral interferometry is utilized to maintain high-resolution imaging beyond the input field Rayleigh range, easing the trade-off between transverse resolution and depth-of-focus. We demonstrate endoscopic imaging both in resected human lung specimens and in sheep airways in vivo. The combination of the superior resolution and higher imaging depth-of-focus of the nano-optic endoscope will likely increase the clinical utility of endoscopic optical imaging.
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Affiliation(s)
- Hamid Pahlevaninezhad
- Harvard Medical School and Massachusetts General Hospital, Boston MA 02114, United States
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge MA 02138, United States
| | - Mohammadreza Khorasaninejad
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge MA 02138, United States
| | - Yao-Wei Huang
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge MA 02138, United States
- Department of Electrical and Computer Engineering, National University of Singapore, 117583 Singapore, Singapore
| | - Zhujun Shi
- Department of Physics, Harvard University, Cambridge, MA 02138, United States
| | - Lida P. Hariri
- Harvard Medical School and Massachusetts General Hospital, Boston MA 02114, United States
| | - David C. Adams
- Harvard Medical School and Massachusetts General Hospital, Boston MA 02114, United States
| | - Vivien Ding
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge MA 02138, United States
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo Ontario N2L 3G1, Canada
| | - Alexander Zhu
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge MA 02138, United States
| | - Cheng-Wei Qiu
- Department of Electrical and Computer Engineering, National University of Singapore, 117583 Singapore, Singapore
| | - Federico Capasso
- John A. Paulson School of Engineering and Applied Science, Harvard University, Cambridge MA 02138, United States
- Corresponding author: ,
| | - Melissa J. Suter
- Harvard Medical School and Massachusetts General Hospital, Boston MA 02114, United States
- Corresponding author: ,
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14
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Hariri LP, Adams DC, Wain JC, Lanuti M, Muniappan A, Sharma A, Colby TV, Mino-Kenudson M, Mark EJ, Kradin RL, Goulart H, Suter MJ. Reply to Wijmans et al.: Optical Coherence Tomography: A Valuable Novel Tool for Assessing the Alveolar Compartment in Interstitial Lung Disease? Am J Respir Crit Care Med 2018; 197:1232-1233. [PMID: 29244521 DOI: 10.1164/rccm.201711-2347le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Lida P Hariri
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - David C Adams
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - John C Wain
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Michael Lanuti
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Ashok Muniappan
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Amita Sharma
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | | | - Mari Mino-Kenudson
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Eugene J Mark
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | - Richard L Kradin
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
| | | | - Melissa J Suter
- 1 Massachusetts General Hospital Boston, Massachusetts.,2 Harvard Medical School Boston, Massachusetts and
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15
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Cho JL, Ling MF, Adams DC, Faustino L, Islam SA, Afshar R, Griffith JW, Harris RS, Ng A, Radicioni G, Ford AA, Han AK, Xavier R, Kwok WW, Boucher R, Moon JJ, Hamilos DL, Kesimer M, Suter MJ, Medoff BD, Luster AD. Allergic asthma is distinguished by sensitivity of allergen-specific CD4+ T cells and airway structural cells to type 2 inflammation. Sci Transl Med 2017; 8:359ra132. [PMID: 27708065 DOI: 10.1126/scitranslmed.aag1370] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/19/2016] [Indexed: 01/08/2023]
Abstract
Despite systemic sensitization, not all allergic individuals develop asthma symptoms upon airborne allergen exposure. Determination of the factors that lead to the asthma phenotype in allergic individuals could guide treatment and identify novel therapeutic targets. We used segmental allergen challenge of allergic asthmatics (AA) and allergic nonasthmatic controls (AC) to determine whether there are differences in the airway immune response or airway structural cells that could drive the development of asthma. Both groups developed prominent allergic airway inflammation in response to allergen. However, asthmatic subjects had markedly higher levels of innate type 2 receptors on allergen-specific CD4+ T cells recruited into the airway. There were also increased levels of type 2 cytokines, increased total mucin, and increased mucin MUC5AC in response to allergen in the airways of AA subjects. Furthermore, type 2 cytokine levels correlated with the mucin response in AA but not AC subjects, suggesting differences in the airway epithelial response to inflammation. Finally, AA subjects had increased airway smooth muscle mass at baseline measured in vivo using novel orientation-resolved optical coherence tomography. Our data demonstrate that the development of allergic asthma is dependent on the responsiveness of allergen-specific CD4+ T cells to innate type 2 mediators as well as increased sensitivity of airway epithelial cells and smooth muscle to type 2 inflammation.
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Affiliation(s)
- Josalyn L Cho
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Morris F Ling
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - David C Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Lucas Faustino
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Sabina A Islam
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Roshi Afshar
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Jason W Griffith
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Robert S Harris
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Aylwin Ng
- Center for Computational and Integrative Biology and Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA
| | - Giorgia Radicioni
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Amina A Ford
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Andre K Han
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Ramnik Xavier
- Center for Computational and Integrative Biology and Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA
| | - William W Kwok
- Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USA
| | - Richard Boucher
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - James J Moon
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Daniel L Hamilos
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Mehmet Kesimer
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Melissa J Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Benjamin D Medoff
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Andrew D Luster
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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16
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Adams DC, Hariri LP, Miller AJ, Wang Y, Cho JL, Villiger M, Holz JA, Szabari MV, Hamilos DL, Scott Harris R, Griffith JW, Bouma BE, Luster AD, Medoff BD, Suter MJ. Birefringence microscopy platform for assessing airway smooth muscle structure and function in vivo. Sci Transl Med 2017; 8:359ra131. [PMID: 27708064 DOI: 10.1126/scitranslmed.aag1424] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 08/19/2016] [Indexed: 12/30/2022]
Abstract
The inability to visualize airway smooth muscle (ASM) cells in vivo is a major obstacle in understanding their role in normal physiology and diseases. At present, there is no imaging modality available to assess ASM in vivo. Confocal endomicroscopy lacks the penetration depth and field of view, and conventional optical coherence tomography (OCT) does not have sufficient contrast to differentiate ASM from surrounding tissues. We have developed a birefringence microscopy platform that leverages the micro-organization of tissue to add further dimension to traditional OCT. We have used this technology to validate ASM measurements in ex vivo swine and canine studies, visualize and characterize volumetric representations of ASM in vivo, and quantify and predict ASM contractile force as a function of optical retardation. We provide in vivo images and volumetric assessments of ASM in living humans and document structural disease variations in subjects with mild asthma. The opportunity to link inflammatory responses to ASM responses and to link ASM responses to clinical responses and outcomes could lead to an increased understanding of diseases of the airway and, ultimately, to improved patient outcomes.
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Affiliation(s)
- David C Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Lida P Hariri
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Alyssa J Miller
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Yan Wang
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Josalyn L Cho
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, 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
| | - Jasmin A Holz
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Margit V Szabari
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Daniel L Hamilos
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - R Scott Harris
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Jason W Griffith
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Andrew D Luster
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Benjamin D Medoff
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 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. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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17
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Adams DC, Pahlevaninezhad H, Szabari MV, Cho JL, Hamilos DL, Kesimer M, Boucher RC, Luster AD, Medoff BD, Suter MJ. Automated segmentation and quantification of airway mucus with endobronchial optical coherence tomography. Biomed Opt Express 2017; 8:4729-4741. [PMID: 29082098 PMCID: PMC5654813 DOI: 10.1364/boe.8.004729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 05/31/2023]
Abstract
We propose a novel suite of algorithms for automatically segmenting the airway lumen and mucus in endobronchial optical coherence tomography (OCT) data sets, as well as a novel approach for quantifying the contents of the mucus. Mucus and lumen were segmented using a robust, multi-stage algorithm that requires only minimal input regarding sheath geometry. The algorithm performance was highly accurate in a wide range of airway and noise conditions. Mucus was classified using mean backscattering intensity and grey level co-occurrence matrix (GLCM) statistics. We evaluated our techniques in vivo in asthmatic and non-asthmatic volunteers.
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Affiliation(s)
- David C. Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Hamid Pahlevaninezhad
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Equal contribution
| | - Margit V. Szabari
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Equal contribution
| | - Josalyn L. Cho
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Daniel L. Hamilos
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Mehmet Kesimer
- Marsico Lung Institute, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Richard C. Boucher
- Marsico Lung Institute, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Andrew D. Luster
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Benjamin D. Medoff
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 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
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18
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Gora MJ, Suter MJ, Tearney GJ, Li X. Endoscopic optical coherence tomography: technologies and clinical applications [Invited]. Biomed Opt Express 2017; 8:2405-2444. [PMID: 28663882 PMCID: PMC5480489 DOI: 10.1364/boe.8.002405] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 05/07/2023]
Abstract
In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.
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Affiliation(s)
- Michalina J Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- ICube Laboratory, CNRS, Strasbourg University, 1 Place de l'Hopital, Strasbourg 67091, France
| | - Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Department of Medicine, Division of Pulmonary and Critical Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Xingde Li
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, and Department of Oncology, Johns Hopkins University, 720 Rutland Avenue, Traylor 710, Baltimore, MD 21205, USA
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Gerbaud E, Weisz G, Tanaka A, Kashiwagi M, Shimizu T, Wang L, Souza C, Bouma BE, Suter MJ, Shishkov M, Ughi GJ, Halpern EF, Rosenberg M, Waxman S, Moses JW, Mintz GS, Maehara A, Tearney GJ. Multi-laboratory inter-institute reproducibility study of IVOCT and IVUS assessments using published consensus document definitions. Eur Heart J Cardiovasc Imaging 2015; 17:756-64. [PMID: 26377904 DOI: 10.1093/ehjci/jev229] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 08/26/2015] [Indexed: 10/23/2022] Open
Abstract
AIMS The aim of this study was to investigate the reproducibility of intravascular optical coherence tomography (IVOCT) assessments, including a comparison to intravascular ultrasound (IVUS). Intra-observer and inter-observer variabilities of IVOCT have been previously described, whereas inter-institute reliability in multiple laboratories has never been systematically studied. METHODS AND RESULTS In 2 independent laboratories with intravascular imaging expertise, 100 randomized matched data sets of IVOCT and IVUS images were analysed by 4 independent observers according to published consensus document definitions. Intra-observer, inter-observer, and inter-institute variabilities of IVOCT qualitative and quantitative measurements vs. IVUS measurements were assessed. Minor inter- and intra-observer variability of both imaging techniques was observed for detailed qualitative and geometric analysis, except for inter-observer mixed plaque identification on IVUS (κ = 0.70) and for inter-observer fibrous cap thickness measurement reproducibility on IVOCT (ICC = 0.48). The magnitude of inter-institute measurement differences for IVOCT was statistically significantly less than that for IVUS concerning lumen cross-sectional area (CSA), maximum and minimum lumen diameters, stent CSA, and maximum and minimum stent diameters (P < 0.001, P < 0.001, P < 0.001, P = 0.02, P < 0.001, and P = 0.01, respectively). Minor inter-institute measurement variabilities using both techniques were also found for plaque identification. CONCLUSION In the measurement of lumen CSA, maximum and minimum lumen diameters, stent CSA, and maximum and minimum stent diameters by analysts from two different laboratories, reproducibility of IVOCT was more consistent than that of IVUS.
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Affiliation(s)
- Edouard Gerbaud
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Giora Weisz
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Atsushi Tanaka
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Manabu Kashiwagi
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Takehisa Shimizu
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Lin Wang
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Christiano Souza
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Brett E Bouma
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Melissa J Suter
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Milen Shishkov
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Giovanni J Ughi
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Elkan F Halpern
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA, USA
| | - Mireille Rosenberg
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA
| | - Sergio Waxman
- Department of Cardiology, Lahey Clinic Medical Center, Burlington, MA, USA
| | - Jeffrey W Moses
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Gary S Mintz
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Akiko Maehara
- Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA
| | - Guillermo J Tearney
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, BHX604A, Boston, MA 02114, USA Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
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20
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Suter MJ, Kashiwagi M, Gallagher KA, Nadkarni SK, Asanani N, Tanaka A, Conditt GB, Tellez A, Milewski K, Kaluza GL, Granada JF, Bouma BE, Tearney GJ. Optimizing flushing parameters in intracoronary optical coherence tomography: an in vivo swine study. Int J Cardiovasc Imaging 2015; 31:1097-106. [PMID: 25922149 DOI: 10.1007/s10554-015-0668-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 04/20/2015] [Indexed: 11/26/2022]
Abstract
Intracoronary optical frequency domain imaging (OFDI), requires the displacement of blood for clear visualization of the artery wall. Radiographic contrast agents are highly effective at displacing blood however, may increase the risk of contrast-induced nephropathy. Flushing media viscosity, flow rate, and flush duration influence the efficiency of blood displacement necessary for obtaining diagnostic quality OFDI images. The aim of this work was to determine the optimal flushing parameters necessary to reliably perform intracoronary OFDI while reducing the volume of administered radiographic contrast, and assess the influence of flushing media choice on vessel wall measurements. 144 OFDI pullbacks were acquired together with synchronized EKG and intracoronary pressure wire recordings in three swine. OFDI images were graded on diagnostic quality and quantitative comparisons of flushing efficiency and intracoronary cross-sectional area with and without precise refractive index calibration were performed. Flushing media with higher viscosities resulted in rapid and efficient blood displacement. Media with lower viscosities resulted in increased blood-media transition zones, reducing the pullback length of diagnostic quality images obtained. Flushing efficiency was found to increase with increases in flow rate and duration. Calculations of lumen area using different flushing media were significantly different, varying up to 23% (p < 0.0001). This error was eliminated with careful refractive index calibration. Flushing media viscosity, flow rate, and flush duration influence the efficiency of blood displacement necessary for obtaining diagnostic quality OFDI images. For patients with sensitivity to contrast, to reduce the risk of contrast induced nephrotoxicity we recommend that intracoronary OFDI be conducted with flushing solutions containing little or no radiographic contrast. In addition, our findings show that careful refractive index compensation should be performed, taking into account the specific contrast agent used, in order to obtain accurate intravascular OFDI measurements.
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Affiliation(s)
- Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA,
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21
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Hariri LP, Mino-Kenudson M, Applegate MB, Mark EJ, Tearney GJ, Lanuti M, Channick CL, Chee A, Suter MJ. Toward the guidance of transbronchial biopsy: identifying pulmonary nodules with optical coherence tomography. Chest 2014; 144:1261-1268. [PMID: 23828441 DOI: 10.1378/chest.13-0534] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Solitary pulmonary nodules (SPNs) frequently require transbronchial needle aspiration (TBNA) or biopsy to determine malignant potential, but have variable diagnostic yields. Confirming needle placement within SPNs during TBNA could significantly increase diagnostic yield. Optical coherence tomography (OCT) provides nondestructive, high-resolution, microstructural imaging with potential to distinguish SPN from parenchyma. We have developed needle-based OCT probes compatible with TBNA. Before OCT can play any significant role in guiding clinical TBNA, OCT interpretation criteria for differentiating SPN from lung parenchyma must be developed and validated. METHODS OCT of SPN and parenchyma was performed on 111 ex vivo resection specimens. OCT criteria for parenchyma and SPN were developed and validated in a blinded assessment. Six blinded readers (two pulmonologists, two pathologists, and two OCT experts) were trained on imaging criteria in a 15-min training session prior to interpreting the validation data set. RESULTS OCT of lung parenchyma displayed evenly spaced signal-void alveolar spaces, signal-intense backreflections at tissue-air interfaces, or both. SPNs lacked both of these imaging features. Independent validation of OCT criteria by the six blinded readers demonstrated sensitivity and specificity of 95.4% and 98.2%, respectively. CONCLUSIONS We have developed and validated OCT criteria for lung parenchyma and SPN with sensitivity and specificity > 95% in this ex vivo study. We anticipate that OCT could be a useful complementary imaging modality to confirm needle placement during TBNA to potentially increase diagnostic yield.
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Affiliation(s)
- Lida P Hariri
- Departments of Pathology, Massachusetts General Hospital, Boston, MA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Mari Mino-Kenudson
- Departments of Pathology, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Matthew B Applegate
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
| | - Eugene J Mark
- Departments of Pathology, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Guillermo J Tearney
- Departments of Pathology, Massachusetts General Hospital, Boston, MA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Harvard-MIT Division of Health Sciences and Technology, Boston, MA
| | - Michael Lanuti
- Department of Thoracic Surgery, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Colleen L Channick
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Alex Chee
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
| | - Melissa J Suter
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
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22
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Hariri LP, Villiger M, Applegate MB, Mino-Kenudson M, Mark EJ, Bouma BE, Suter MJ. Seeing beyond the bronchoscope to increase the diagnostic yield of bronchoscopic biopsy. Am J Respir Crit Care Med 2013; 187:125-9. [PMID: 23322794 DOI: 10.1164/rccm.201208-1483oe] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Lida P Hariri
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
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23
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Hariri LP, Applegate MB, Mino-Kenudson M, Mark EJ, Medoff BD, Luster AD, Bouma BE, Tearney GJ, Suter MJ. Volumetric optical frequency domain imaging of pulmonary pathology with precise correlation to histopathology. Chest 2013; 143:64-74. [PMID: 22459781 DOI: 10.1378/chest.11-2797] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer-related mortality. Radiology and bronchoscopy techniques do not have the necessary resolution to evaluate lung lesions on the microscopic scale, which is critical for diagnosis. Bronchial biopsy specimens can be limited by sampling error and small size. Optical frequency domain imaging (OFDI) provides volumetric views of tissue microstructure at near-histologic resolution and may be useful for evaluating pulmonary lesions to increase diagnostic accuracy. Bronchoscopic OFDI has been evaluated in vivo, but a lack of correlated histopathology has limited the ability to develop accurate image interpretation criteria. METHODS We performed OFDI through two approaches (airway-centered and parenchymal imaging) in 22 ex vivo lung specimens, using tissue dye to precisely correlate imaging and histology. RESULTS OFDI of normal airway allowed visualization of epithelium, lamina propria, cartilage, and alveolar attachments. Carcinomas exhibited architectural disarray, loss of normal airway and alveolar structure, and rapid light attenuation. Squamous cell carcinomas showed nested architecture. Atypical glandular formation was appreciated in adenocarcinomas, and uniform trabecular gland formation was seen in salivary gland carcinomas. Mucinous adenocarcinomas showed alveolar wall thickening with intraalveolar mucin. Interstitial fibrosis was visualized as signal-dense tissue, with an interstitial distribution in mild interstitial fibrotic disease and a diffuse subpleural pattern with cystic space formation in usual interstitial pneumonitis. CONCLUSIONS To our knowledge, this study is the first demonstration of volumetric OFDI with precise correlation to histopathology in lung pathology. We anticipate that OFDI may play a role in assessing airway and parenchymal pathology, providing fresh insights into the volumetric features of pulmonary disease.
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Affiliation(s)
- Lida P Hariri
- Department of Pathology, Boston; Wellman Center for Photomedicine, Boston; Harvard Medical School, Cambridge
| | - Matthew B Applegate
- Pulmonary and Critical Care Unit, Boston; Wellman Center for Photomedicine, Boston
| | | | - Eugene J Mark
- Department of Pathology, Boston; Harvard Medical School, Cambridge
| | - Benjamin D Medoff
- Pulmonary and Critical Care Unit, Boston; Harvard Medical School, Cambridge
| | - Andrew D Luster
- Rheumatology, Allergy and Immunology Division, Massachusetts General Hospital, Boston; Harvard Medical School, Cambridge
| | - Brett E Bouma
- Wellman Center for Photomedicine, Boston; Harvard Medical School, Cambridge; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA
| | - Guillermo J Tearney
- Department of Pathology, Boston; Wellman Center for Photomedicine, Boston; Harvard Medical School, Cambridge; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA
| | - Melissa J Suter
- Pulmonary and Critical Care Unit, Boston; Wellman Center for Photomedicine, Boston; Harvard Medical School, Cambridge.
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Abstract
Optical coherence tomography (OCT) is a nondestructive, high-resolution imaging modality, providing cross-sectional, architectural images at near histologic resolutions, with penetration depths up to a few millimeters. Optical frequency domain imaging is a second-generation OCT technology that has equally high resolution with significantly increased image acquisition speeds and allows for large area, high-resolution tissue assessments. These features make OCT and optical frequency domain imaging ideal imaging techniques for surface and endoscopic imaging, specifically when tissue is unsafe to obtain and/or suffers from biopsy sampling error. This review focuses on the clinical impact of OCT in coronary, esophageal, and pulmonary imaging and the role of the pathologist in interpreting high-resolution OCT images as a complement to standard tissue pathology.
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Affiliation(s)
- Lida P Hariri
- Department of Pathology, Massachusetts General Hospital, Boston, USA.
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25
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Hariri LP, Applegate MB, Mino-Kenudson M, Mark EJ, Bouma BE, Tearney GJ, Suter MJ. Optical frequency domain imaging of ex vivo pulmonary resection specimens: obtaining one to one image to histopathology correlation. J Vis Exp 2013:3855. [PMID: 23381470 DOI: 10.3791/3855] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths. Squamous cell and small cell cancers typically arise in association with the conducting airways, whereas adenocarcinomas are typically more peripheral in location. Lung malignancy detection early in the disease process may be difficult due to several limitations: radiological resolution, bronchoscopic limitations in evaluating tissue underlying the airway mucosa and identifying early pathologic changes, and small sample size and/or incomplete sampling in histology biopsies. High resolution imaging modalities, such as optical frequency domain imaging (OFDI), provide non-destructive, large area 3-dimensional views of tissue microstructure to depths approaching 2 mm in real time (Figure 1). OFDI has been utilized in a variety of applications, including evaluation of coronary artery atherosclerosis and esophageal intestinal metaplasia and dysplasia. Bronchoscopic OCT/OFDI has been demonstrated as a safe in vivo imaging tool for evaluating the pulmonary airways (Animation). OCT has been assessed in pulmonary airways and parenchyma of animal models and in vivo human airway. OCT imaging of normal airway has demonstrated visualization of airway layering and alveolar attachments, and evaluation of dysplastic lesions has been found useful in distinguishing grades of dysplasia in the bronchial mucosa. OFDI imaging of bronchial mucosa has been demonstrated in a short bronchial segment (0.8 cm). Additionally, volumetric OFDI spanning multiple airway generations in swine and human pulmonary airways in vivo has been described. Endobronchial OCT/OFDI is typically performed using thin, flexible catheters, which are compatible with standard bronchoscopic access ports. Additionally, OCT and OFDI needle-based probes have recently been developed, which may be used to image regions of the lung beyond the airway wall or pleural surface. While OCT/OFDI has been utilized and demonstrated as feasible for in vivo pulmonary imaging, no studies with precisely matched one-to-one OFDI:histology have been performed. Therefore, specific imaging criteria for various pulmonary pathologies have yet to be developed. Histopathological counterparts obtained in vivo consist of only small biopsy fragments, which are difficult to correlate with large OFDI datasets. Additionally, they do not provide the comprehensive histology needed for registration with large volume OFDI. As a result, specific imaging features of pulmonary pathology cannot be developed in the in vivo setting. Precisely matched, one-to-one OFDI and histology correlation is vital to accurately evaluate features seen in OFDI against histology as a gold standard in order to derive specific image interpretation criteria for pulmonary neoplasms and other pulmonary pathologies. Once specific imaging criteria have been developed and validated ex vivo with matched one-to-one histology, the criteria may then be applied to in vivo imaging studies. Here, we present a method for precise, one to one correlation between high resolution optical imaging and histology in ex vivo lung resection specimens. Throughout this manuscript, we describe the techniques used to match OFDI images to histology. However, this method is not specific to OFDI and can be used to obtain histology-registered images for any optical imaging technique. We performed airway centered OFDI with a specialized custom built bronchoscopic 2.4 French (0.8 mm diameter) catheter. Tissue samples were marked with tissue dye, visible in both OFDI and histology. Careful orientation procedures were used to precisely correlate imaging and histological sampling locations. The techniques outlined in this manuscript were used to conduct the first demonstration of volumetric OFDI with precise correlation to tissue-based diagnosis for evaluating pulmonary pathology. This straightforward, effective technique may be extended to other tissue types to provide precise imaging to histology correlation needed to determine fine imaging features of both normal and diseased tissues.
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Affiliation(s)
- Lida P Hariri
- Department of Pathology, Harvard Medical School, USA
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26
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Abstract
There is ongoing interest in the emerging field of pulmonary photonic-based diagnostics. Potential clinical need areas that are being actively investigated at this time include airway and peripheral lung cancer diagnostics, pulmonary parenchymal and interstitial disorders, alveolar structure function, inhalation injury, ciliary function analysis, asthma and obstructive lung diseases.
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Affiliation(s)
- Melissa J Suter
- Harvard Medical School, Pulmonary and Critical Care Unit, Wellman Center for Photomedicine, Massachusetts General Hospital, 55 Fruit Street, Warren 408, Boston, MA 02114, USA
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Gora M, Yoo H, Suter MJ, Gallagher KA, Bouma BE, Nishioka NS, Tearney GJ. Optical frequency domain imaging system and catheters for volumetric imaging of the human esophagus. Photonics Lett Pol 2011; 3:144-146. [PMID: 22924122 PMCID: PMC3425351 DOI: 10.4302/plp.2011.4.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Barrett's esophagus (BE) is a metaplastic disorder that can undergo dysplastic progression, leading to esophageal adenocarcinoma. Upper endoscopy is the standard of care for screening for BE, but this technique has a relatively low diagnostic accuracy and high cost due to the requirement of conscious sedation. Optical frequency domain imaging (OFDI) is a high-speed imaging modality that generates cross-sectional images of tissues with a resolution of approximately 10μm that is sufficient for detecting microscopic tissue architecture. In combination with a balloon-centering catheter, this method enables BE diagnosis over the entire distal esophagus.
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Affiliation(s)
- Michalina Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
- Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Hongki Yoo
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
- Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
- Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Kevin A Gallagher
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
- Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston MA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge MA
| | - Norman S Nishioka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
- Gastrointestinal Unit, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston MA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge MA
- Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston MA
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Suter MJ, Nadkarni SK, Weisz G, Tanaka A, Jaffer FA, Bouma BE, Tearney GJ. Intravascular optical imaging technology for investigating the coronary artery. JACC Cardiovasc Imaging 2011; 4:1022-39. [PMID: 21920342 PMCID: PMC3583353 DOI: 10.1016/j.jcmg.2011.03.020] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 03/04/2011] [Accepted: 03/14/2011] [Indexed: 12/14/2022]
Abstract
There is an ever-increasing demand for new imaging methods that can provide additional information about the coronary wall to better characterize and stratify high-risk plaques, and to guide interventional and pharmacologic management of patients with coronary artery disease. While there are a number of imaging modalities that facilitate the assessment of coronary artery pathology, this review paper focuses on intravascular optical imaging modalities that provide information on the microstructural, compositional, biochemical, biomechanical, and molecular features of coronary lesions and stents. The optical imaging modalities discussed include angioscopy, optical coherence tomography, polarization sensitive-optical coherence tomography, laser speckle imaging, near-infrared spectroscopy, time-resolved laser induced fluorescence spectroscopy, Raman spectroscopy, and near-infrared fluorescence molecular imaging. Given the wealth of information that these techniques can provide, optical imaging modalities are poised to play an increasingly significant role in the evaluation of the coronary artery in the future.
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Affiliation(s)
- Melissa J. Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seemantini K. Nadkarni
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Giora Weisz
- Center for Interventional Vascular Therapy, New York-Presbyterian Hospital, Columbia University, and Cardiovascular Research Foundation, New York, New York
| | - Atsushi Tanaka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Farouc A. Jaffer
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Cardiovascular Research Center, Cardiology Division, and Center for Molecular Imaging Research, Massachusetts General Hospital, Harvard Medical School, Boston Massachusetts
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
| | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Choma MA, Suter MJ, Vakoc BJ, Bouma BE, Tearney GJ. Physiological homology between Drosophila melanogaster and vertebrate cardiovascular systems. Dis Model Mech 2010; 4:411-20. [PMID: 21183476 PMCID: PMC3097462 DOI: 10.1242/dmm.005231] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The physiology of the Drosophila melanogaster cardiovascular system remains poorly characterized compared with its vertebrate counterparts. Basic measures of physiological performance remain unknown. It also is unclear whether subtle physiological defects observed in the human cardiovascular system can be reproduced in D. melanogaster. Here we characterize the cardiovascular physiology of D. melanogaster in its pre-pupal stage by using high-speed dye angiography and optical coherence tomography. The heart has vigorous pulsatile contractions that drive intracardiac, aortic and extracellular-extravascular hemolymph flow. Several physiological measures, including weight-adjusted cardiac output, body-length-adjusted aortic velocities and intracardiac shear forces, are similar to those in the closed vertebrate cardiovascular systems, including that of humans. Extracellular-extravascular flow in the pre-pupal D. melanogaster circulation drives convection-limited fluid transport. To demonstrate homology in heart dysfunction, we showed that, at the pre-pupal stage, a troponin I mutant, held-up2 (hdp2), has impaired systolic and diastolic heart wall velocities. Impaired heart wall velocities occur in the context of a non-dilated phenotype with a mildly depressed fractional shortening. We additionally derive receiver operating characteristic curves showing that heart wall velocity is a potentially powerful discriminator of systolic heart dysfunction. Our results demonstrate physiological homology and support the use of D. melanogaster as an animal model of complex cardiovascular disease.
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Kang DK, Suter MJ, Boudoux C, Yachimski PS, Puricelli WP, Nishioka NS, Mino-Kenudson M, Lauwers GY, Bouma BE, Tearney GJ. Co-registered spectrally encoded confocal microscopy and optical frequency domain imaging system. J Microsc 2010; 239:87-91. [PMID: 20629914 DOI: 10.1111/j.1365-2818.2010.03367.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Spectrally encoded confocal microscopy and optical frequency domain imaging are two non-contact optical imaging technologies that provide images of tissue cellular and architectural morphology, which are both used for histopathological diagnosis. Although spectrally encoded confocal microscopy has better transverse resolution than optical frequency domain imaging, optical frequency domain imaging can penetrate deeper into tissues, which potentially enables the visualization of different morphologic features. We have developed a co-registered spectrally encoded confocal microscopy and optical frequency domain imaging system and have obtained preliminary images from human oesophageal biopsy samples to compare the capabilities of these imaging techniques for diagnosing oesophageal pathology.
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Affiliation(s)
- D K Kang
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Waxman S, Freilich MI, Suter MJ, Shishkov M, Bilazarian S, Virmani R, Bouma BE, Tearney GJ. A case of lipid core plaque progression and rupture at the edge of a coronary stent: elucidating the mechanisms of drug-eluting stent failure. Circ Cardiovasc Interv 2010; 3:193-6. [PMID: 20407116 DOI: 10.1161/circinterventions.109.917955] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sergio Waxman
- Tufts University School of Medicine, Boston, MA, USA
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Choma MA, Suter MJ, Vakoc BJ, Bouma BE, Tearney GJ. Heart wall velocimetry and exogenous contrast-based cardiac flow imaging in Drosophila melanogaster using Doppler optical coherence tomography. J Biomed Opt 2010; 15:056020. [PMID: 21054114 PMCID: PMC2994925 DOI: 10.1117/1.3503418] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 08/31/2010] [Accepted: 08/31/2010] [Indexed: 05/22/2023]
Abstract
Drosophila melanogaster (fruit fly) is a central organism in biology and is becoming increasingly important in the cardiovascular sciences. Prior work in optical imaging of the D. melanogaster heart has focused on static and dynamic structural anatomy. In the study, it is demonstrated that Doppler optical coherence tomography can quantify dynamic heart wall velocity and hemolymph flow in adult D. melanogaster. Since hemolymph is optically transparent, a novel exogenous contrast technique is demonstrated to increase the backscatter-based intracardiac Doppler flow signal. The results presented here open up new possibilities for functional cardiovascular phenotyping of normal and mutant D. melanogaster.
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Affiliation(s)
- Michael A Choma
- Children's Hospital Boston, and Harvard Medical School, Department of Pediatrics, Boston, Massachusetts 02115, USA.
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Hariri LP, Bouma BE, Waxman S, Shishkov M, Vakoc BJ, Suter MJ, Freilich MI, Oh WY, Rosenberg M, Tearney GJ. An automatic image processing algorithm for initiating and terminating intracoronary
OFDI pullback. Biomed Opt Express 2010; 1:566-573. [PMID: 21258490 PMCID: PMC3017988 DOI: 10.1364/boe.1.000566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 07/28/2010] [Accepted: 08/08/2010] [Indexed: 05/30/2023]
Abstract
Intracoronary optical frequency domain imaging (OFDI) provides high resolution, three-dimensional views of coronary artery microstructure, but requires a non-occlusive saline/contrast purge to displace blood for clear artery views. Recent studies utilized manual pullback initiation/termination based on real-time image observation. Automated pullback initiation/termination by real-time OFDI signal analysis would enable more efficient data acquisition. We evaluate the use of simple imaging parameters to automatically and robustly differentiate between diagnostic-quality clear artery wall (CAW) versus blood-obstructed fields (BOF). Algorithms are tested using intracoronary OCT human data retrospectively and intracoronary OFDI swine and human data prospectively. In prospective analysis of OFDI swine data, the sensitivity and specificity of the ratio of second and first moments (contrast parameter) were 99.6% and 97.2%, respectively. In prospective analysis of OFDI clinical data, the contrast parameter yielded 96.0% sensitivity and 94.5% specificity. Accuracy improved further by analyzing sequential frames. These results indicate the algorithm may be utilized with intracoronary OFDI for initiating and terminating automated pullback and digital data recording.
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Affiliation(s)
- Lida P. Hariri
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- MIT-Harvard Division of Health Sciences and Technology, USA
| | - Sergio Waxman
- Department of Cardiology, Lahey Clinic, Burlington, Massachusetts 01803 USA
| | - Milen Shishkov
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- MIT-Harvard Division of Health Sciences and Technology, USA
| | - Melissa J. Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
| | - Mark I. Freilich
- Department of Cardiology, Lahey Clinic, Burlington, Massachusetts 01803 USA
| | - Wang-Yul Oh
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
| | - Mireille Rosenberg
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
| | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts 02114 USA
- MIT-Harvard Division of Health Sciences and Technology, USA
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Meyerholz DK, Stoltz DA, Namati E, Ramachandran S, Pezzulo AA, Smith AR, Rector MV, Suter MJ, Kao S, McLennan G, Tearney GJ, Zabner J, McCray PB, Welsh MJ. Loss of cystic fibrosis transmembrane conductance regulator function produces abnormalities in tracheal development in neonatal pigs and young children. Am J Respir Crit Care Med 2010; 182:1251-61. [PMID: 20622026 DOI: 10.1164/rccm.201004-0643oc] [Citation(s) in RCA: 147] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
RATIONALE Although airway abnormalities are common in patients with cystic fibrosis (CF), it is unknown whether they are all secondary to postnatal infection and inflammation, which characterize the disease. OBJECTIVES To learn whether loss of the cystic fibrosis transmembrane conductance regulator (CFTR) might affect major airways early in life, before the onset of inflammation and infection. METHODS We studied newborn CFTR⁻(/)⁻ pig trachea, using computed tomography (CT) scans, pathology, and morphometry. We retrospectively analyzed trachea CT scans in young children with CF and also previously published data of infants with CF. MEASUREMENTS AND MAIN RESULTS We discovered three abnormalities in the porcine CF trachea. First, the trachea and mainstem bronchi had a uniformly small caliber and cross-sections of trachea were less circular than in controls. Second, trachealis smooth muscle had an altered bundle orientation and increased transcripts in a smooth muscle gene set. Third, submucosal gland units occurred with similar frequency in the mucosa of CF and control airways, but CF submucosal glands were hypoplastic and had global reductions in tissue-specific transcripts. To learn whether any of these changes occurred in young patients with CF, we examined CT scans from children 2 years of age and younger, and found that CF tracheas were less circular in cross-section, but lacked differences in lumen area. However, analysis of previously published morphometric data showed reduced tracheal lumen area in neonates with CF. CONCLUSIONS Our findings in newborn CF pigs and young patients with CF suggest that airway changes begin during fetal life and may contribute to CF pathogenesis and clinical disease during postnatal life.
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Suter MJ, Jillella PA, Vakoc BJ, Halpern EF, Mino-Kenudson M, Lauwers GY, Bouma BE, Nishioka NS, Tearney GJ. Image-guided biopsy in the esophagus through comprehensive optical frequency domain imaging and laser marking: a study in living swine. Gastrointest Endosc 2010; 71:346-53. [PMID: 19879573 PMCID: PMC2857407 DOI: 10.1016/j.gie.2009.07.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 07/03/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Random biopsy esophageal surveillance can be subject to sampling errors, resulting in diagnostic uncertainty. Optical frequency domain imaging (OFDI) is a high-speed, 3-dimensional endoscopic microscopy technique. When deployed through a balloon-centering catheter, OFDI can automatically image the entire distal esophagus (6.0 cm length) in approximately 2 minutes. OBJECTIVE To test a new platform for guided biopsy that allows the operator to select target regions of interest on an OFDI dataset, and then use a laser to mark the esophagus at corresponding locations. The specific goals include determining the optimal laser parameters, testing the accuracy of the laser marking process, evaluating the endoscopic visibility of the laser marks, and assessing the amount of mucosal damage produced by the laser. DESIGN Experimental study conducted in 5 swine in vivo. SETTING Massachusetts General Hospital. MAIN OUTCOME MEASUREMENTS Success rate, including endoscopic visibility of laser marks and accuracy of the laser marking process for selected target sites, and extent of the thermal damage caused by the laser marks. RESULTS All of the laser-induced marks were visible by endoscopy. Target locations were correctly marked with a success rate of 97.07% (95% confidence interval, 89.8%-99.7%). Thermal damage was limited to the superficial layers of the mucosa and was observed to partially heal within 2 days. LIMITATIONS An animal study with artificially placed targets to simulate pathology. CONCLUSIONS The study demonstrates that laser marking of esophageal sites identified in comprehensive OFDI datasets is feasible and can be performed with sufficient accuracy, precision, and visibility to guide biopsy in vivo.
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Kang D, Suter MJ, Boudoux C, Yoo H, Yachimski PS, Puricelli WP, Nishioka NS, Mino-Kenudson M, Lauwers GY, Bouma BE, Tearney GJ. Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy. Gastrointest Endosc 2010; 71:35-43. [PMID: 19922916 PMCID: PMC3135336 DOI: 10.1016/j.gie.2009.08.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Accepted: 08/23/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique that has the potential to be used for acquiring comprehensive images of the entire distal esophagus endoscopically with subcellular resolution. OBJECTIVE The goal of this study was to demonstrate large-area SECM in upper GI tissues and to determine whether the images contain microstructural information that is useful for pathologic diagnosis. DESIGN A feasibility study. SETTING Gastrointestinal Unit, Massachusetts General Hospital. PATIENTS Fifty biopsy samples from 36 patients undergoing routine EGD were imaged by SECM, in their entirety, immediately after their removal. RESULTS The microstructure seen in the SECM images was similar to that seen by histopathology. Gastric cardia mucosa was clearly differentiated from squamous mucosa. Gastric fundic/body type mucosa showed more tightly packed glands than gastric cardia mucosa. Fundic gland polyps showed cystically dilated glands lined with cuboidal epithelium. The presence of intraepithelial eosinophils was detected with the cells demonstrating a characteristic bilobed nucleus. Specialized intestinal metaplasia was identified by columnar epithelium and the presence of goblet cells. Barrett's esophagus (BE) with dysplasia was differentiated from specialized intestinal metaplasia by the loss of nuclear polarity and disorganized glandular architecture. LIMITATIONS Ex vivo, descriptive study. CONCLUSIONS Large-area SECM images of gastroesophageal biopsy samples enabled the visualization of both subcellular and architectural features of various upper GI mucosal types and were similar to the corresponding histopathologic slides. These results suggest that the development of an endoscopic SECM probe is merited.
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Goldberg BD, Vakoc BJ, Oh WY, Suter MJ, Waxman S, Freilich MI, Bouma BE, Tearney GJ. Performance of reduced bit-depth acquisition for optical frequency domain imaging. Opt Express 2009; 17:16957-68. [PMID: 19770914 PMCID: PMC2785457 DOI: 10.1364/oe.17.016957] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
High-speed optical frequency domain imaging (OFDI) has enabled practical wide-field microscopic imaging in the biological laboratory and clinical medicine. The imaging speed of OFDI, and therefore the field of view, of current systems is limited by the rate at which data can be digitized and archived rather than the system sensitivity or laser performance. One solution to this bottleneck is to natively digitize OFDI signals at reduced bit depths, e.g., at 8-bit depth rather than the conventional 12-14 bit depth, thereby reducing overall bandwidth. However, the implications of reduced bit-depth acquisition on image quality have not been studied. In this paper, we use simulations and empirical studies to evaluate the effects of reduced depth acquisition on OFDI image quality. We show that image acquisition at 8-bit depth allows high system sensitivity with only a minimal drop in the signal-to-noise ratio compared to higher bit-depth systems. Images of a human coronary artery acquired in vivo at 8-bit depth are presented and compared with images at higher bit-depth acquisition.
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Affiliation(s)
- Brian D. Goldberg
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114
- Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114
- Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Wang-Yuhl Oh
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114
| | - Melissa J. Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114
| | - Sergio Waxman
- Department of Cardiology, Lahey Clinic, 41 Mall Road, Burlington, MA 0180
| | - Mark I. Freilich
- Department of Cardiology, Lahey Clinic, 41 Mall Road, Burlington, MA 0180
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114
- Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114
- Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
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Desjardins AE, Vakoc BJ, Suter MJ, Yun SH, Tearney GJ, Bouma BE. Real-time FPGA processing for high-speed optical frequency domain imaging. IEEE Trans Med Imaging 2009; 28:1468-72. [PMID: 19336296 PMCID: PMC2883772 DOI: 10.1109/tmi.2009.2017740] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
We present a novel algorithm for reconstructing interferograms acquired in optical frequency domain imaging (OFDI). The algorithm was developed specifically for processing in field programmable gate arrays (FPGAs) and featured the use of a finite-impulse-response (FIR) filter implementation of B-spline interpolation for efficiently re-sampling k-space. When implemented in FPGAs, the algorithm allowed for real-time processing of interferograms acquired with a high-speed OFDI system at 54 kHz and a sampling rate of 100 MS/s.
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Affiliation(s)
| | - Benjamin J. Vakoc
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Melissa J. Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Seok-Hyun Yun
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Brett E. Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114 USA
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Tearney GJ, Waxman S, Shishkov M, Vakoc BJ, Suter MJ, Freilich MI, Desjardins AE, Oh WY, Bartlett LA, Rosenberg M, Bouma BE. Three-dimensional coronary artery microscopy by intracoronary optical frequency domain imaging. JACC Cardiovasc Imaging 2009; 1:752-61. [PMID: 19356512 DOI: 10.1016/j.jcmg.2008.06.007] [Citation(s) in RCA: 252] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 05/22/2008] [Accepted: 06/03/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We present the first clinical experience with intracoronary optical frequency domain imaging (OFDI) in human patients. BACKGROUND Intracoronary optical coherence tomography (OCT) is a catheter-based optical imaging modality that is capable of providing microscopic (approximately 7-microm axial resolution, approximately 30-microm transverse resolution), cross-sectional images of the coronary wall. Although the use of OCT has shown substantial promise for imaging coronary microstructure, blood attenuates the OCT signal, necessitating prolonged, proximal occlusion to screen long arterial segments. OFDI is a second-generation form of OCT that is capable of acquiring images at much higher frame rates. The increased speed of OFDI enables rapid, 3-dimensional imaging of long coronary segments after a brief, nonocclusive saline purge. METHODS Volumetric OFDI images were obtained in 3 patients after intracoronary stent deployment. Imaging was performed in the left anterior descending and right coronary arteries with the use of a nonocclusive saline purge rates ranging from 3 to 4 ml/s and for purge durations of 3 to 4 s. After imaging, the OFDI datasets were segmented using previously documented criteria and volume rendered. RESULTS Good visualization of the artery wall was obtained in all cases, with clear viewing lengths ranging from 3.0 to 7.0 cm at pullback rates ranging from 5 to 20 mm/s. A diverse range of microscopic features were identified in 2 and 3 dimensions, including thin-capped fibroatheromas, calcium, macrophages, cholesterol crystals, bare stent struts, and stents with neointimal hyperplasia. There were no complications of the OFDI procedure. CONCLUSIONS Our results demonstrate that OFDI is a viable method for imaging the microstructure of long coronary segments in patients. Given its ability to provide microscopic information in a practical manner, this technology may be useful for studying human coronary pathophysiology in vivo and as a clinical tool for guiding the management of coronary artery disease.
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Affiliation(s)
- Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Pathology, Harvard Medical School, Boston, Massachusetts 02114, USA.
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Bouma BE, Yun SH, Vakoc BJ, Suter MJ, Tearney GJ. Fourier-domain optical coherence tomography: recent advances toward clinical utility. Curr Opin Biotechnol 2009; 20:111-8. [PMID: 19264475 DOI: 10.1016/j.copbio.2009.02.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 02/09/2009] [Accepted: 02/10/2009] [Indexed: 12/20/2022]
Abstract
With the advent of Fourier-domain techniques, optical coherence tomography (OCT) has advanced from high-resolution 'point' imaging over small fields-of-view to comprehensive microscopic imaging over three-dimensional volumes that are comparable to the dimensions of luminal internal organs. This advance has required the development of new lasers, improved spectrometers, minimally invasive catheters and endoscopes, and novel optical and signal processing strategies. In recent cardiovascular, ophthalmic, and gastrointestinal clinical studies, the capabilities of Fourier-domain OCT have enabled a new paradigm for diagnostic screening of large tissue areas, which addresses the shortcomings of existing technologies and focal biopsy.
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Affiliation(s)
- Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Harvard-MIT Division of Health Sciences and Technology, Boston, MA 02114, USA.
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Boudoux C, Leuin SC, Oh WY, Suter MJ, Desjardins AE, Vakoc BJ, Bouma BE, Hartnick CJ, Tearney GJ. Optical Microscopy of the Pediatric Vocal Fold. ACTA ACUST UNITED AC 2009; 135:53-64. [DOI: 10.1001/archoto.2008.518] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Suter MJ, Vakoc BJ, Yachimski PS, Shishkov M, Lauwers GY, Mino-Kenudson M, Bouma BE, Nishioka NS, Tearney GJ. Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging. Gastrointest Endosc 2008; 68:745-53. [PMID: 18926183 PMCID: PMC2715833 DOI: 10.1016/j.gie.2008.05.014] [Citation(s) in RCA: 151] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Accepted: 05/05/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND Optical coherence tomography (OCT) is a cross-sectional, high-resolution imaging modality that has been shown to accurately differentiate esophageal specialized intestinal metaplasia (SIM) from gastric cardia at the squamocolumnar junction (SCJ) and diagnose high-grade dysplasia and intramucosal carcinoma in patients with SIM. The clinical utility of OCT has been limited, however, by its inability to acquire images over large areas. OBJECTIVE The aim of this study was to use recently developed high-speed OCT technology, termed optical frequency domain imaging (OFDI), and a new balloon-centering catheter (2.5 cm diameter) to demonstrate the feasibility of large area, comprehensive optical microscopy of the entire distal esophagus (approximately 6.0 cm) in patients. DESIGN A pilot feasibility study. SETTING Massachusetts General Hospital. PATIENTS Twelve patients undergoing routine EGD. RESULTS Comprehensive microscopy of the distal esophagus was successfully performed in 10 patients with the OFDI system and balloon catheter. There were no complications resulting from the imaging procedure. Volumetric data sets were acquired in less than 2 minutes. OFDI images at the SCJ showed a variety of microscopic features that were consistent with histopathologic findings, including squamous mucosa, cardia, SIM with and without dysplasia, and esophageal erosion. LIMITATIONS Inability to obtain direct correlation of OFDI data and histopathologic diagnoses. CONCLUSIONS Comprehensive volumetric microscopy of the human distal esophagus was successfully demonstrated with OFDI and a balloon-centering catheter, providing a wealth of detailed information about the structure of the esophageal wall. This technique will support future studies to compare OFDI image information with histopathologic diagnoses.
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Suter MJ, Reinhardt JM, McLennan G. Integrated CT/bronchoscopy in the central airways: preliminary results. Acad Radiol 2008; 15:786-98. [PMID: 18486014 DOI: 10.1016/j.acra.2008.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Revised: 01/29/2008] [Accepted: 03/07/2008] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Many imaging modalities and methodologies exist for evaluating the pulmonary airways. Individually, each modality provides insight to the state of the airways; however, alone they do not necessarily provide a comprehensive description. The goal of this work is to integrate complementary medical imaging datasets to form a synergistic description of the airways. MATERIALS AND METHODS Two digital bronchoscopic techniques were used to evaluate the pulmonary mucosa. A digital color bronchoscopic system was used to detect mucosal color alterations, and a fluorescence detection system was used to assess the microvasculature of the bronchial mucosa. Study participants were also imaged with a multidetector row computed tomographic (MDCT) scanner. Virtual bronchoscopic and image registration techniques were exploited to combine three-dimensional surface renderings, extracted from the MDCT data, together with the two-dimensional digital bronchoscopic images. Validation of the fusion process was performed on a rubber phantom of an adult airway with 4 embedded metal beads. RESULTS The fusion of the MDCT extracted airway tree and the digital bronchoscopic datasets were presented for three study participants. In addition, the detected accuracy of the registration method to reliably align the MDCT and bronchoscopic image datasets was determined to be 1.98 mm in the phantom airway model. CONCLUSION We have demonstrated that merging of three distinct digital datasets to provide a single synergistic description of the airways is possible. This is a pilot project in the field of eidomics, the process of combining digital image datasets and image-based processes together. We anticipate that in the future eidomics will provide a universal and predictive imaging language that will change health care delivery.
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Affiliation(s)
- Melissa J Suter
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
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Vakoc BJ, Shishko M, Yun SH, Oh WY, Suter MJ, Desjardins AE, Evans JA, Nishioka NS, Tearney GJ, Bouma BE. Comprehensive esophageal microscopy by using optical frequency-domain imaging (with video). Gastrointest Endosc 2007; 65:898-905. [PMID: 17383652 PMCID: PMC2705339 DOI: 10.1016/j.gie.2006.08.009] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 08/07/2006] [Indexed: 12/27/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) has been used for high-resolution endoscopic imaging and diagnosis of specialized intestinal metaplasia, dysplasia, and intramucosal carcinoma of the esophagus. However, the relatively slow image-acquisition rate of the present OCT systems inhibits wide-field imaging and limits the clinical utility of OCT for diagnostic imaging in patients with Barrett's esophagus. OBJECTIVE This study describes a new optical imaging technology, optical frequency-domain imaging (OFDI), derived from OCT, that enables comprehensive imaging of large esophageal segments with microscopic resolution. DESIGN A prototype OFDI system was developed for endoscopic imaging. The system was used in combination with a balloon-centering catheter to comprehensively image the distal esophagus in swine. RESULTS Volumetric images of the mucosa and portions of the muscularis propria were obtained for 4.5-cm-long segments. Image resolution was 7 microm in depth and 30 microm parallel to the lumen, and provided clear delineation of each mucosal layer. The 3-dimensional data sets were used to create cross-sectional microscopic images, as well as vascular maps of the esophagus. Submucosal vessels and capillaries were visualized by using Doppler-flow processing. CONCLUSIONS Comprehensive microscopic imaging of the distal esophagus in vivo by using OFDI is feasible. The unique capabilities of this technology for obtaining detailed information of tissue microstructure over large mucosal areas may open up new possibilities for improving the management of patients with Barrett's esophagus.
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Affiliation(s)
- Benjamin J Vakoc
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts, USA
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Yun SH, Tearney GJ, Vakoc BJ, Shishkov M, Oh WY, Desjardins AE, Suter MJ, Chan RC, Evans JA, Jang IK, Nishioka NS, de Boer JF, Bouma BE. Comprehensive volumetric optical microscopy in vivo. Nat Med 2006; 12:1429-33. [PMID: 17115049 PMCID: PMC2709216 DOI: 10.1038/nm1450] [Citation(s) in RCA: 283] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2006] [Accepted: 06/20/2006] [Indexed: 11/09/2022]
Abstract
Comprehensive volumetric microscopy of epithelial, mucosal and endothelial tissues in living human patients would have a profound impact in medicine by enabling diagnostic imaging at the cellular level over large surface areas. Considering the vast area of these tissues with respect to the desired sampling interval, achieving this goal requires rapid sampling. Although noninvasive diagnostic technologies are preferred, many applications could be served by minimally invasive instruments capable of accessing remote locations within the body. We have developed a fiber-optic imaging technique termed optical frequency-domain imaging (OFDI) that satisfies these requirements by rapidly acquiring high-resolution, cross-sectional images through flexible, narrow-diameter catheters. Using a prototype system, we show comprehensive microscopy of esophageal mucosa and of coronary arteries in vivo. Our pilot study results suggest that this technology may be a useful clinical tool for comprehensive diagnostic imaging for epithelial disease and for evaluating coronary pathology and iatrogenic effects.
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Affiliation(s)
- Seok H Yun
- Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, USA
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Ruckstuhl S, Suter MJ, Giger W. Rapid determination of sulfonated naphthalenes and their formaldehyde condensates in aqueous environmental samples using synchronous excitation fluorimetry. Analyst 2001; 126:2072-7. [PMID: 11763094 DOI: 10.1039/b104090c] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Sulfonated naphthalenes and their formaldehyde condensates (SNFC) were determined in aqueous environmental samples by spectrofluorimetry. A clean-up step using n-hexane to extract possibly interfering nonpolar compounds such as naphthalene is the only preparatory procedure. Synchronous excitation mode with a gammalambda of 105 nm allows the determination of SNFC in environmental samples without additional clean-up or analyte enrichment. Interferences by humic acids and nitrate occurred only at concentrations higher than 1 mg C L(-1) and 10 mg NO3- L(-1), respectively. The limit of detection was 0.2 microg L(-1), the average recovery was 104% and the confidence interval (95% certainty) was 24%. The response factor for the quantitative determination of total SNFC, depending on the distribution of the different SNFC components, was validated for groundwater from two field sites using an HPLC-FD (fluorescence detection) method as a reference method.
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Affiliation(s)
- S Ruckstuhl
- Swiss Federal Institute for Environmental Science and Technology (EAWAG), Dübendorf
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Acero JL, Haderlein SB, Schmidt TC, Suter MJ, von Gunten U. MTBE oxidation by conventional ozonation and the combination ozone/hydrogen peroxide: efficiency of the processes and bromate formation. Environ Sci Technol 2001; 35:4252-4259. [PMID: 11718338 DOI: 10.1021/es010044n] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The present study investigates the oxidation of methyl tert-butyl ether (MTBE) by conventional ozonation and the advanced oxidation process (AOP) ozone/hydrogen peroxide under drinking water treatment conditions. The major degradation products identified were tert-butyl formate (TBF), tert-butyl alcohol (TBA), 2-methoxy-2-methyl propionaldehyde (MMP), acetone (AC), methyl acetate (MA), hydroxyisobutyraldehyde (HiBA), and formaldehyde (FA). The rate constants of the reaction of ozone and OH radicals with MTBE were found to be 0.14 and 1.9 x 10(9) M(-1) s(-1), respectively. The rate constants for the same oxidation processes were also measured for the degradation products TBF, MMP, MA, and HiBA (k(O3-TBF) = 0.78 M(-1) s(-1); k(OH-TBF) = 7.0 x 10(8) M(-1) s(-1); k(O3-MMP) = 5 M(-1) s(-1); k(OH-MMP) = 3 x 10(9) M(-1) s(-1), k(O3-MA) = 0.09 M(-1) s(-1), k(O3-HiBA) = 5 M(-1) s(-1); k(OH-HiBA) = 3 x 10(9) M(-1) s(-1)). Since all compounds reacted slowly with molecular ozone, only the degradation pathway of MTBE with OH radicals has been determined, including the formation of primary degradation products. In experiments performed with several natural waters, the efficiency of MTBE elimination and the formation of bromate as disinfection byproduct have been measured. With a bromide level of 50 microg/L, only 35-50% of MTBE could be eliminated by the AOP O3/H2O2 without exceeding the current drinking water standard of bromate (10 microg/L). The transient concentrations of MTBE and its primary degradation products were modeled using a combination of kinetic parameters (degradation product distribution and rate constants) together with the ozone and OH radical concentration and were in good agreement with the experimental results.
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Affiliation(s)
- J L Acero
- Swiss Federal Institute for Environmental Science and Technology (EAWAG), Dübendorf
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Reichenbecher W, Philipp B, Suter MJ, Schink B. Hydroxyhydroquinone reductase, the initial enzyme involved in the degradation of hydroxyhydroquinone (1,2,4-trihydroxybenzene) by Desulfovibrio inopinatus. Arch Microbiol 2000; 173:206-12. [PMID: 10763753 DOI: 10.1007/s002039900130] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The recently isolated sulfate reducer Desulfovibrio inopinatus oxidizes hydroxyhydroquinone (1,2,4trihydroxybenzene; HHQ) to 2 mol acetate and 2 mol CO2 (mol substrate)-1, with stoichiometric reduction of sulfate to sulfide. None of the key enzymes of fermentative HHQ degradation, i.e. HHQ-1,2,3,5-tetrahydroxybenzene transhydroxylase or phloroglucinol reductase, were detected in cell-free extracts of D. inopinatus, indicating that this bacterium uses a different pathway for anaerobic HHQ degradation. HHQ was reduced with NADH in cell-free extracts to a nonaromatic compound, which was identified as dihydrohydroxyhydroquinone by its retention time in HPLC separation and by HPLC-mass spectrometry. The compound was identical with the product of chemical reduction of HHQ with sodium borohydride. Dihydrohydroxyhydroquinone was converted stoichiometrically to acetate and to an unknown coproduct. HHQ reduction was an enzymatic activity which was present in the cell-free extract at 0.25-0.30 U (mg protein)-1, with a pH optimum at 7.5. The enzyme was sensitive to sodium chloride, potassium chloride, EDTA, and o-phenanthroline, and exhibited little sensitivity towards sulfhydryl group reagents, such as copper chloride or p-chloromercuribenzoate.
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Zipper C, Bolliger C, Fleischmann T, Suter MJ, Angst W, Müller MD, Kohler HP. Fate of the herbicides mecoprop, dichlorprop, and 2,4-D in aerobic and anaerobic sewage sludge as determined by laboratory batch studies and enantiomer-specific analysis. Biodegradation 2000; 10:271-8. [PMID: 10633543 DOI: 10.1023/a:1008396022622] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aerobic degradation experiments with the racemic mixtures of mecoprop and dichlorprop revealed that activated sludge collected from the aeration tank of a municipal waste water treatment plant degraded both enantiomers of mecoprop and dichlorprop within 7 days, albeit in an enantioselective manner; the (S) enantiomers were preferentially degraded. Mecoprop, dichlorprop, and 2,4-D were completely metabolized under aerobic conditions, as shown by the 86-98% elimination of dissolved organic carbon. Under anaerobic conditions, the concentration of 2,4-D decreased exponentially with a first-order reaction rate constant of 0.24 per day and without a lag-phase. After an incubation time of 17 days, 2,4-D was completely removed. 2,4-Dichlorophenol was the main metabolite of anaerobic 2,4-D degradation; only traces of 4-chlorophenol were detected. In contrast, the chiral phenoxypropionic acid herbicides mecoprop and dichlorprop persisted under anaerobic conditions during 49 days of incubation.
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Affiliation(s)
- C Zipper
- Swiss Federal Institute for Environmental Science and Technology, Dübendorf, Switzerland
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Koller-Lucae SK, Suter MJ, Rentsch KM, Schott H, Schwendener RA. Metabolism of the new liposomal anticancer drug N4-octadecyl-1-beta-D-arabinofuranosylcytosine in mice. Drug Metab Dispos 1999; 27:342-50. [PMID: 10064564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Metabolism and excretion of the new antitumor drug N4-octadecyl-1-beta-D-arabinofuranosylcytosine (NOAC) was investigated in mice. Mice were injected i.v. with tritium-labeled liposomal NOAC (4 micromol/mouse). Analysis of HPLC-purified extracts of liver homogenates by liquid chromatography coupled with mass spectrometry revealed only the presence of unmetabolized drug. To study the excretion of the administered drug, mice were injected with tritium-labeled liposomal NOAC or as comparison with 1-beta-D-arabinofuranosylcytosine (ara-C; 4 micromol/mouse) and housed up to 48 h in metabolic cages. Urine and feces were collected at different time points and the kinetics of excreted radioactivity were determined. After 48 h, 39% of the injected [5-3H]NOAC radioactivity was excreted in urine and 16% in feces, whereas ara-C radioactivity was only found in urine with 48% of the injected dose. Feces extracts and urine were purified by HPLC and radioactive fractions were further analyzed by liquid chromatography coupled with mass spectrometry. The radioactivity of feces extracts of NOAC-treated mice was composed of unmetabolized NOAC, hydroxylated NOAC (NOAC + OH), its sulfated derivative (NOAC + OSO3H), and unidentified metabolites, whereas in urine, the hydrophilic molecules ara-C and ara-U were found. During the period of 48 h only 2% of the injected NOAC was eliminated in its unmetabolized form, whereas 25% was identified as main metabolite ara-C. Urine collected during 48 h in ara-C-treated mice contained 33% of the injected dose as unmetabolized drug and 13% as the main metabolite ara-U. Thus, NOAC is metabolized by two major pathways, one leading to the hydrophilic metabolites ara-C and ara-U and the other to hydroxylated and sulfated NOAC.
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Affiliation(s)
- S K Koller-Lucae
- Department of Pathology, Division of Cancer Research, University Hospital, Zurich, Switzerland
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