This PDF file contains the front matter associated with SPIE Proceedings Volume 12818, including the Title Page, Copyright information, Table of Contents, and Conference Committee information.

Early diagnosis of ear disorders is difficult in part because patients do not seek out an otologist until they have significant hearing loss. Early detection could happen in the primary care provider’s office, however the sensitivity of an otoscopic examination by a primary care provider during an annual physical is very low. On the other hand, Optical Coherence Tomography (OCT) imaging of the tympanic membrane and middle ear can provide detailed volumetric images of the structure and function. These detailed images can form the basis for an approach for finding early signs of ear disease. Our hypothesis is that asymmetry between the ears could be used for early diagnosis. In order to test this, we need to understand the naturally occurring asymmetry in healthy volunteers. We have collected volumetric OCT images from 8 healthy subjects using a hand-held otoscopic OCT system. As part of a registration algorithm, we crop and down sample the data before finding the transformation matrix that registers the volumes. This matrix is then used to register the original volumes. Then the quantitative analysis of the symmetry between the left and right ears was applied through the similarity coefficient and overall, the left and right ears similarity of 8 healthy subjects has a mean of 0.7892, and a standard deviation of 0.0186. From a scientific perspective, this is the first quantitative measure of how symmetric the right and left ears are in humans. From a diagnostic perspective, this approach could provide a simple method to find early signs of ear disease.

Dynamic optical contrast imaging (DOCI) is an imaging method utilizing fluorescence lifetime that our team has developed for identification of margins in head & neck mucosal malignancies. In this paper we demonstrate the first utilization of DOCI in cutaneous melanoma. We utilized both a 530/30nm band pass filter, as well as a 400nm long pass filter to capture the autofluorescence of tissue fluorophores, after excitation with a 365nm wide field LED light source. Imaging was captured, processed via an established protocol in MatLab, and regions of interest were compared to corresponding histopathology. Patients with biopsy confirmed cutaneous melanoma who were undergoing surgical removal of their malignancy were recruited for in-vivo pre-operative DOCI imaging, intraoperative imaging, then ex-vivo imaging of the tumor after removal. Patients free of disease with benign moles were also recruited for in-vivo DOCI imaging to serve as controls. 11 patients with melanoma and 10 controls were included. DOCI distinguishes between melanoma vs. normal surrounding skin (sensitivity=94% specificity=88%, AUC=0.921) as well as benign nevi vs. melanoma (sensitivity=100% and specificity=80%, AUC=0.953), posing benefit opportunities for both melanoma diagnostics as well as margin determination.

At present, the administration of chemotherapy drugs is largely based on physician experience and clinical guidelines. Clearly, a personalized solution would significantly benefit patients in the improvement of clinical outcomes. In this work, we used a spectroscopic approach in which a water-soluble tetrazolium salt (WST-8) assay was applied to patient-derived slice organoids. WST-8 would react with intracellular dehydrogenase resulting in the formation of formazan dye. The absorption at 450nm can be used to assess the viability of the organoids 5 days after initiation of organoid culture. With additional development, this approach may be used to improve the clinical outcome of patients undergoing chemotherapy.

Oral Mucositis (OM) is an inflammatory alteration of the mucosa primarily due to the damage resulting of cytotoxic effects of radiotherapy, chemotherapy, bone marrow transplantation and stem cell transplantation. The use of photobiomodulation (PBM) therapy for oral mucositis is intended to reduce or prevent lesions from manifesting. However, there is no consensus on the treatment dosimetry based on higher treatment success rates, and no exact cause of treatment success or failure has been found for large groups of patients. Therefore, optimizing treatment protocols and investigating causes affecting treatment outcomes is of paramount importance to decrease pain, hospitalization time, death rates of oncological patients while giving them improved quality of life via nutrition without pain. This case study shows a successful example of the treatment outcome of a new PBM therapy protocol for OM where we concluded that PBM therapy can be used as a potentially effective preventive and curative treatment of OM.

In prosthodontics, 3D printing primarily relies on intraoral scanners equipped with a handheld camera, computer, and software. These scanners capture and reconstruct the three-dimensional geometry of the dental arch. Traditional plaster models of teeth are typically obtained through an impression process, where the choice of appropriate impression material is determined by the desired model type. Subsequently, the dental impression is covered with plaster in the laboratory. Three-dimensional (3D) printing, formerly an industrial technology with a development history spanning over forty years, is based on creating a 3D model of any shape from a digitally prepared scan, employing an addition of selected material. The thickness of the layers in the printing process depends on the technology of the used printer and the quality of the print. The layers are systematically applied, and cured, and, after this process, a complete model is generated. 3D printing can be utilized to prepare models for various applications, including prosthodontics, orthodontics, surgery, and more. Our study aimed to assess stereolithography-printed models in vitro and in vivo over the last three years.

Positive surgical margins in head and neck cancers (HNC) are associated with poor survival. Standard frozen section analysis for intraoperative assessment of margins is limited by processing time and sampling error. Optical imaging technologies may address these limitations. We identified the following techniques in a literature search of optical imaging modalities for the detection of head and neck tumor margins: autofluorescence imaging, dynamic optical contrast imaging, optical coherence tomography, narrow band imaging, hyperspectral imaging, Raman spectroscopy, near-infrared fluorescence imaging, confocal laser endomicroscopy, and high-resolution microendoscopy. Penetration depths range from surface level to 6mm, image acquisition times range from real-time to several minutes, and 3/9 require exogenous contrast agents. Reported sensitivity and specificity range from 71-100% and 43-100%, respectively. Each reviewed modality lends unique strengths such as fast image acquisition times, wide field of view, high native contrast, or seamless integration with existing endoscopes. However, none have yet to replace palpation and frozen section analysis in the operating room.

Tracheal intubation is a crucial procedure performed in airway management to sustain life during head and neck surgery. However, difficult airways can make intubation challenging, which is associated with increased mortality and morbidity. This is particularly important for children who undergo intubation where the situation is difficult. In this study, we developed an augmented reality (AR) system that allows the overlay of intubation tools and internal airways, providing real-time guidance during the procedure. A child manikin was used to develop and test the AR system. Three-dimensional CT images were acquired from the manikin. Different tissues were segmented to generate the 3D models that were imported into Unity to build the holograms. Phantom experiments demonstrated the AR-guided system for potential applications in tracheal intubation guidance.Tracheal intubation is a crucial procedure performed in airway management to sustain life during various procedures. However, difficult airways can make intubation challenging, which is associated with increased mortality and morbidity. This is particularly important for children who undergo intubation where the situation is difficult. Improved airway management will decrease incidences of repeated attempts, decrease hypoxic injuries in patients, and decrease hospital stays, resulting in better clinical outcomes and reduced costs. Currently, 3D printed models based on CT scans and ultrasound-guided intubation are being used or tested for device fitting and procedure guidance to increase the success rate of intubation, but both have limitations. Maintaining a 3D printing facility can be logistically inconvenient, and it can be time consuming and expensive. Ultrasound-guided intubation can be hindered by operator dependence, limited two-dimensional visualization, and potential artifacts. In this study, we developed an augmented reality (AR) system that allows the overlay of intubation tools and internal airways, providing real-time guidance during the procedure. A child manikin was used to develop and test the AR system. Three-dimensional CT images were acquired from the manikin. Different tissues were segmented to generate the 3D models that were imported into Unity to build the holograms. Phantom experiments demonstrated the AR-guided system for potential applications in tracheal intubation guidance.