Thermic injuries are among the most severe injuries in childhood. Burn depth is the most relevant prognostic factor, and still its assessment is both difficult and controversial. This diagnostic uncertainty results in repeated wound assessments over a 10-day period and carries a relevant risk for over- and undertreatment. Precise wound assessment would thus be a significant step toward improved care. Optical coherence tomography (OCT) is a noninvasive laser-based technique with a penetration depth of ∼2 mm. It provides structural images of the skin while dynamic OCT (D-OCT) shows blood vessels. In this study, we investigated burns and scalds in 130 children with OCT and D-OCT to identify patterns of injury related to the depth of the burn wound. OCT and D-OCT images from burned skin differed consistently from normal skin. We observed several not formerly described morphologic patterns associated with burn injuries. Superficial wounds are characterized by a loss of the epidermal layer and a smooth surface. With deeper wounds, surface irregularity, loss of the dermal papillary pattern, disappearance of skin lines, and characteristic changes in the microvascular architecture were observed. This is the first systematic study of D-OCT in the assessment of burn wounds in children. A number of burn-associated patterns of injury were identified. Thus, D-OCT provided an “optical biopsy” of burn wounds that adds significant information about the severity of a burn wound.
Optical coherence tomography (OCT) is a noninvasive diagnostic method that offers a view into the superficial layers of the skin in vivo in real-time. An infrared broadband light source allows the investigation of skin architecture and changes up to a depth of 1 to 2 mm with a resolution between 15 and 3 μm, depending on the system used. Thus OCT enables evaluation of skin lesions, especially nonmelanoma skin cancers and inflammatory diseases, quantification of skin changes, visualization of parasitic infestations, and examination of other indications such as the investigation of nails. OCT provides a quick and useful diagnostic imaging technique for a number of clinical questions and is a valuable addition or complement to other noninvasive imaging tools such as dermoscopy, high-frequency ultrasound, and confocal laser scan microscopy.
The first clinical trial of optical coherence tomography (OCT) combined with multiphoton tomography (MPT) and
dermoscopy is reported. State-of-the-art (i) OCT systems for dermatology (e.g. multibeam swept source OCT), (ii) the
femtosecond laser multiphoton tomograph DermaInspectTM, and (iii) digital dermoscopes were applied to 47 patients
with a diversity of skin diseases and disorders such as skin cancer, psoriasis, hemangioma, connective tissue diseases,
pigmented lesions, and autoimmune bullous skin diseases. Dermoscopy, also called 'epiluminescent microscopy',
provides two-dimensional color images of the skin surface. OCT imaging is based on the detection of optical reflections
within the tissue measured interferometrically whereas nonlinear excitation of endogenous fluorophores and the second
harmonic generation are the bases of MPT images. OCT cross sectional "wide field" image provides a typical field of
view of 5 x 2 mm2 and offers fast information on the depth and the volume of the investigated lesion. In comparison,
multiphoton tomography presents 0.36 x 0.36 mm2 horizontal or diagonal sections of the region of interest within
seconds with submicron resolution and down to a tissue depth of 200 μm. The combination of OCT and MPT provides a
synergistic optical imaging modality for early detection of skin cancer and other skin diseases.
KEYWORDS: Optical coherence tomography, Skin, In vivo imaging, Tissue optics, Signal attenuation, In vitro testing, Melanoma, Tomography, Scattering, Diagnostics
Optical low coherence tomography (OCT) is a promising new method for non invasive, in vivo measurements of biological high scattering tissue. Crossectional images with microscale resolution in a range of about 1 5tm can be produced. A scanning point detection system is realized which combines an interferometric method with an endoscope. A superluminescence diode with a center wavelength of 830nm and a coherence length of l5jtm is coupled into the interferometrical setup. The backscattered light from a tissue sample and the reflected light from the scanning reference mirror is recombined at the detector. Interference occurs only if the pathlength difference is within the coherence length of the light source. Heterodyne detection is used to obtain high speed and high dynamic range measurements of the interferometric signals. We present in vivo OCT skin measurements, where we analyze the borders between the upper skin layers. We describe the influence to the light attenuation inside the skin after treating the skin with oil. We compare in vivo OCT skin measurements with in vitro skin measurements. Additionally first in vivo skin measurements of malignant melanoma show that OCT is a promising diagnostic method in dermatology. Keywords: skin cancer, optical coherence tomography, in vivo skin measurements, endoscope
Optical low coherence tomography (OCT) is a newly developed bioengineering method for noninvasive in-vivo investigation of human skin, especially of the epidermis. Based on the principle of a Michelson interferometer, OCT allows the detection of the path length of an infrared light beam after backscattered inside the skin sample by comparison with a reference beam. The depth resolution is limited by the coherence length of the light source, which is about 15 micrometer. OCT supplies cross-sectional images of the skin with a penetration depth of about 0.5 to 1.5 mm. The stratum corneum can be distinguished from the living epidermis and the upper dermis. We investigated healthy skin of several localizations, inflammatory diseases, intra- and subepidermal blisters and epidermal tumors. First images are presented to demonstrate the possibilities of this promising new method.
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