Screening of Barrett’s Esophagus (BE) for progression to esophageal adenocarcinoma with standard endoscopic biopsy is expensive, invasive, and imprecise due to sampling error and the limited value of histomorphology for predicting cancer risk. We have developed a technology called in vivo laser capture microdissection (IVLCM) that overcomes these issues by using OCT tethered capsule endomicroscopy (OCT-TCE) to image the entire esophagus at the microscopic level. Pilot clinical study results show that IVLCM samples provide sufficient DNA material for genetic sequencing. The comparison of sequencing quality and gene mapping of IVLCM samples and conventional FFPE biopsy samples will be analyzed in the ongoing clinical study.
Despite the large population that suffers from inner ear diseases, there is a limited understanding and capacity to diagnose the cellular origins of inner ear diseases. One major obstacle is difficulty accessing and observing the inner ear in living patients. We developed an ultra-flexible miniature micro-OCT endoscope that can be inserted into the scala tympani through the round window over more than 20 mm and take cellular resolution OCT images. It has the potential to provide physicians with a new diagnostic approach for tailoring next-generation cochlear implants and administering personalized pharmacologic treatments for a wide variety of inner ear diseases.
Cochlear implant is by far the most successful treatment for sensorineural hearing loss (SNHL) - the most common sensory deficit in the world. Although it was generally prescribed, the understanding of the etiology and the cellular structural abnormalities of SNHL is still limited due to the lack of direct imaging of the interior of the inner ear of living human patients. We have developed a micro-OCT probe that can serve as the stylet of a cochlear implant, which can perform cellular-level imaging through the cochlear implant during the surgery, providing diagnostic information and guidance to the surgeons.
Micro-optical coherence tomography (µOCT), is an emerging optical imaging approach enabling visualization of tissue microstructures at near cellular level. Small form-factor fiber-optic probes are needed to enable uOCT devices for minimally invasive diagnostic procedures such as coronary catheterization for atherosclerosis evaluation. Manufacturing complexities associated with miniaturizing current fiber-optic probes limit their optical and mechanical performance. We will present details of the design and construction of these miniaturized µOCT probes comprising TPL-based 3D printed optics, along with pre-clinical imaging results from an animal model. This probe is capable of lateral resolution of 5 µm and EDOF exceeding 850 µm in tissue.
To address the need for less invasive and more accurate upper gastrointestinal biopsy, we have developed a swallowable optical-coherence tomography (OCT) tethered capsule endomicroscopy (TCE) device with image-targeted biopsy capabilities. The laser-captured biopsy can be used for histopathology and genetic analysis that could potentially improve the accuracy and reduce the cost of GI disease surveillance. Ex-vivo and in-vivo experiments on swine were conducted to optimize laser parameters, coating thickness, DNA isolation protocol, and histology of IVLCM samples. Results show that >200 ng of dsDNA can be isolated from the captured sample, which is sufficient for genetic analysis.
To address the unmet need to study the microstructure changes in the cochlea that occur with sensorineural hearing loss, we have constructed a miniature flexible micro-OCT catheter that can be inserted into the human cochlea and acquire images with cellular-level resolution. The OCT catheter was designed, fabricated, and characterized. Crucial mechanical properties (flexibility, insertion force) were measured and found to be comparable to those of commercial cochlear implants. These early results suggest that this new device may provide a viable approach for diagnosing SNHL and selecting the most appropriate treatments on an individual patient basis.
Lymphatic metastasis is a main pathway of dissemination of malignancies. The diagnosis of metastasis in lymph nodes can help stage cancer or help the surgeons make intraoperative decisions. In addition, lymph nodes are more easily confused with other neck tissues during thyroid surgery. Therefore, identification of lymph nodes is very important. Up to now, the gold standard for identification of metastatic lymph nodes is still histological examination, which can only be performed ex vivo and needs a long time. Optical coherence tomography (OCT) is a non-invasive, high-resolution imaging technology that is capable of detecting microstructures in bio-tissues in real time. In this study, we demonstrated a method to identify metastatic lymph nodes automatically by intraoperative OCT imaging. With a home-made swept source OCT system, we obtained OCT images of different resected neck tissues, including lymph nodes with and without metastasis, thyroid, parathyroid, fat and muscle, from 28 patients undertaking thyroidectomy. The automatic identification algorithm was based on texture analysis and back-propagation artificial neural network (BP-ANN). 66 texture features of OCT images were extracted and 14 were selected and used for automatic identification experiments. The trained BP-ANN has an excellent performance in identifying OCT images of lymph nodes with the sensitivity of 98.9 % and specificity of 98.8 %. The accuracy of lymphatic metastasis diagnosis is 90.1 %.
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