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.
Despite the technological evolutions that transform the operating rooms nowadays, a major clinical need remains: surgeons need to distinguish healthy from diseased tissues while performing a procedure. Tissue status assessment procedures such as blood perfusion monitoring require objective input that can potentially be obtained with fluorescence imaging and oxygenation imaging. We developed a multimodal imaging platform for performing widefield quantitative oxygenation imaging and fluorescence imaging in a clinical environment. We demonstrate in-vivo the impact of widefield quantitative oxygenation imaging on blood perfusion assessment. Fluorescence imaging provided by the system is used in complement to confirm the outcome of oxygenation imaging.
Tissues-mimicking phantoms are widely used for performance evaluation of imaging systems. Disease specific design of the phantom is necessary for the correct assessment of a system’s parameters. Such phantoms are a key requirement for the continued development of various imaging techniques such as optical coherence tomography (OCT), which has been successfully applied for diagnosis of diseases in the esophagus and preliminary data show that it can be also highly perspective for diagnosis of colorectal cancer. However, in vivo validation of this novel optical approach is often difficult, since the disease model development in large animals, such as pigs, is a quite challenging task. The optimal colorectal cancer phantoms should have the following criteria: 1) realized geometry in three dimensions, 2) customizable material and optical properties, 3) mounting system allowing placement in various locations of the bench-top colon model (plastic or tissue) and removal using standard endoscopic tools, 4) visual appearance compatible with white light endoscopic imaging, and 5) long term stability. To match all these criteria, we propose tissue-mimicking phantoms prepared using 3D printing and PDMS/TiO2 insertions for cancer-like regions that are covered with the layer of Dragon skin to color-match the mucosa appearance, as we believe these materials are the most promising for durable and accurate replication of tissue properties. The polyps are mounted in the colon using small neodymium magnet embedded in the base of the polyp. The developed polyps were evaluated
using optical coherence tomography system.
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