SignificanceEndoscopic optical coherence tomography (OCT) enables real-time optical biopsy of human organs. Endoscopic probes require miniaturization of optics, which in turn limits field of view. When larger imaging areas are needed such as in the gastrointestinal tract, the operator must manually scan the probe over the tissue to extend the field of view, often resulting in an imperfect scanning pattern and increased risk of missing lesions. Automatic scanning has the potential to extend the field of view of OCT, allowing the user to focus on image interpretation during real-time observations.AimThis work proposes an automatic scanning using a steerable OCT catheter integrated with a robotized interventional flexible endoscope. The aim is to extend the field of view of a low-profile OCT probe while improving scanning accuracy and maintaining a stable endoscope’s position during minimally invasive treatment of colorectal lesions.ApproachA geometrical model of the steerable OCT catheter was developed for estimating the volume of the accessible workspace. Experimental validation was done using electromagnetic tracking of the catheter’s positions. An exemplary scanning path was then selected within the available workspace to evaluate motion performance with the robotized steerable OCT catheter. Automatic scanning is compared to a teleoperated one and a manual scanning with a nonrobotized flexible endoscope. Spectral arc length, scanning area, spacing between scan trajectories, and time are metrics used to quantify performance.ResultsThe available scanning workspace was experimentally estimated to be 255 cm3. The automatic scanning mode provided the highest accuracy and smoothness of motion with spectral arc length of −3.18, covered area of 10.11 cm2, 1.54 mm spacing between 15 sweep trajectories, maximum translation of 27.99 mm, and time to finish of 3.11s.ConclusionsAutomatic modality improved the accuracy of scanning within a large workspace. The robotic capability provided better control to the user to define spacing resolution of scanning patterns.
Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early stage colorectal cancer that can be performed in teleoperation with a robotized flexible interventional endoscope. However, the tissue elevation step which requires submucosal needle insertion still requires manual operation. In this work we present robotic needle placement using image-guidance that combines white-light camera images to control the alignment of the needle and the OCT catheter. OCT images are used to determine the position of the needle tip during its insertion. This procedure is experimentally tested in an optical phantom that simulates the tissue layers of the colon.
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