Tethered capsule endomicroscopy (TCE) is a recently developed form of in vivo microscopy based on optical coherence tomography (OCT). With TCE, a small tethered pill is swallowed, procuring high resolution microscopic images of the esophageal wall. TCE does not require sedation and is thus a more rapid and convenient procedure comparing to traditional endoscopic examination. Our group and others have successfully conducted OCT-TCE in pilot, single-center studies that demonstrated the potential of this technology for upper GI tract diagnosis. Here, we demonstrate and evaluate the feasibility and safety of a next generation OCT-TCE system and device in patients with Barrett’s esophagus (BE) and report the initial longitudinal analysis of the natural history of BE.
While endoscopy is the most commonly used modality for diagnosing upper GI tract disease, this procedure usually requires patient sedation that increases cost and mandates its operation in specialized settings. In addition, endoscopy only visualizes tissue superfically at the macroscopic scale, which is problematic for many diseases that manifest below the surface at a microscopic scale. Our lab has previously developed technology termed tethered capsule OCT endomicroscopy (TCE) to overcome these diagnostic limitations of endoscopy. The TCE device is a swallowable capsule that contains optomechanical components that circumferentially scan the OCT beam inside the body as the pill traverses the organ via peristalsis. While we have successfully imaged ~100 patients with the TCE device, the optics of our current device have many elements and are complex, comprising a glass ferrule, optical fiber, glass spacer, GRIN lens and prism. As we scale up manufacturing of this device for clinical translation, we must decrease the cost and improve the manufacturability of the capsule’s optical configuration.
In this abstract, we report on the design and development of simplificed TCE optics that replace the GRIN lens-based configuration with an angle-polished ball lens design. The new optics include a single mode optical fiber, a glass spacer and an angle polished ball lens, that are all fusion spliced together. The ball lens capsule has resolutions that are comparable with those of our previous GRIN lens configuration (30µm (lateral) × 7 µm (axial)). Results in human subjects show that OCT-based TCE using the ball lens not only provides rapid, high quality microstructural images of upper GI tract, but also makes it possible to implement this technology inexpensively and on a larger scale.
A novel approach for investigation of human retinal and choroidal blood flow by the means of multi-channel swept
source Doppler optical coherence tomography (SS-D-OCT) system is being developed. We present preliminary in vitro
measurement results for quantification of the 3D velocity vector of scatterers in a flow phantom. The absolute flow
velocity of moving scatterers can be obtained without prior knowledge of flow orientation. In contrast to previous
spectral domain (SD-) D-OCT investigations, that already proved the three-channel D-OCT approach to be suitable for
in vivo retinal blood flow evaluation, this current work aims for a similar functional approach by means of a differing
technique. To the best of our knowledge, this is the first three-channel D-OCT setup featuring a wavelength tunable laser
source. Furthermore, we present a modification of our setup allowing a reduction of the former three active illumination
channels to one active illumination channel and two passive channels, which only probe the illuminated sample. This
joint aperture (JA) approach provides the advantage of not having to divide beam power among three beams to meet
corresponding laser safety limits. The in vitro measurement results regarding the flow phantom show good agreement
between theoretically calculated and experimentally obtained flow velocity values.
We present a three beam optical Doppler tomography (ODT) technique suitable for 3-D velocity and flow measurements to evaluate total retinal blood circulation from and to the optic nerve head (ONH). The system consists of three independent ODT channels. Superluminescent diodes with a central wavelength of 840 nm and a spectral bandwidth of 50 nm were used. The sources are coupled to collimators resting in a specially designed mount to ensure a well-defined beam geometry, necessary for the full reconstruction of the three dimensional velocity vector. The reconstruction works without prior knowledge on the vessel geometry, which is normally required for ODT systems with less than three beams. The beams share a common bulk optics Michelson interferometer, while the detection comprises three identical spectrometers with a line scan rate of 50 kHz. 20 eyes of healthy volunteers were imaged with the 3 beam ODT, employing a circular scan pattern around the ONH. The mean total blood flow was calculated for arteries (47.1 ± 2.4 μl/min (mean ± SD)) and veins (47.1 ± 2.7 μl/min μl/min) independently. The two results showed no significant difference (paired t-test, p < 0.96), rendering both equally reliable for total flow measurements. Furthermore the reproducibility of the method was evaluated for the total flow and flow, velocities within each individual vessel of 6 eyes. The average variation for total flow measurements is sufficiently low to detect deviations of ~ 6% indicating high precision of the proposed method.
We developed a three-beam Doppler optical coherence tomography (OCT) system that enables measurement of the velocity vector of moving particles in three-dimensions (3-D). The spatial orientation as well as the magnitude of motion can be determined without prior knowledge of the geometry of motion. The system combines three spectral-domain OCT interferometers whose sample beams are focused at the sample by a common focusing lens at three different angles. This provides three spatially independent velocity components simultaneously from which the velocity vector can be reconstructed. We demonstrate the system in a simple test object (rotating disc), a flow phantom, and for blood flow measurements in the retina of a healthy human subject. Measurements of blood flow at a venous bifurcation achieve a good agreement between in- and outflow and demonstrate the reliability of the method.
We present a novel, high-speed, polarization-sensitive, optical coherence tomography set-up for retinal imaging operating at a central wavelength of 1060 nm which was tested for in vivo imaging in healthy human volunteers. We use the system in combination with a Fourier domain mode locked laser with active spectral shaping which enables the use of forward and backward sweep in order to double the imaging speed without a buffering stage. With this approach and with a custom designed data acquisition system, we show polarization-sensitive imaging with an A-scan rate of 350 kHz. The acquired three-dimensional data sets of healthy human volunteers show different polarization characteristics in the eye, such as depolarization in the retinal pigment epithelium and birefringence in retinal nerve fiber layer and sclera. The increased speed allows imaging of large volumes with reduced motion artifacts. Moreover, averaging several two-dimensional frames allows the generation of high-definition B-scans without the use of an eye-tracking system. The increased penetration depth of the system, which is caused by the longer probing beam wavelength, is beneficial for imaging choroidal and scleral structures and allows automated segmentation of these layers based on their polarization characteristics.
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