C. David Melville

A full-color scanning fiber endoscope

Minimally invasive medical procedures will benefit from flexible endoscopes that are extremely thin yet produce high quality images. Current devices use fiber bundles or silicon image sensors placed in the distal tip where each pixel in the image is derived from an element in the distal tip, such that improving resolution requires increasing distal tip diameter. The University of Washington has developed the scanning fiber endoscope (SFE) to provide full color, high resolution images from a flexible endoscope with a small distal tip diameter. The SFE uses a single mode fiber vibrating in resonance to scan a focused laser spot over the tissue and a detector to record the time-multiplexed backscatter signal. The SFE contains a 400 micron diameter piezoelectric tube through which a length of singlemode optical fiber is placed. The tube drives the fiber tip at its resonant frequency (currently 5 KHz) in an expanding pattern of 250 spirals (500 pixel diameter image) at a frame rate of 15 Hertz. Imaging parameters are determined by the lens system placed in the 1.06 mm diameter distal tip. Prototype systems with 70 degree field-of-view and 10 micron resolution have been developed. Color images are created with red, green, and blue laser sources coupled into the single scanning fiber. Backscattered light is collected with twelve 250 micron multimode fibers placed around the periphery of the microscanner resulting in a total distal tip diameter of 1.6 mm. Frame sequential color, fluorescence, and continuous color imaging modes have been demonstrated in the non-confocal geometry.

57.1: Near‐to‐Eye Display using Scanning Fiber Display Engine

: A novel near-to-eye display has been demonstrated, using a scanning fiber as the image source. Light is relayed from remote sources to the scanner via singlemode optical fiber. As a replacement for conventional LCD image sources, the fiber scanner reduces weight and power consumption, and enables a water-immersible display.

Scanning Fiber Endoscope with multiple fluorescence-reflectance imaging channels for guiding biopsy

Fluorescence-labeled molecular probes can be used during endoscopy for early cancer detection. As many tumors express multiple cell surface markers and these molecular signatures are heterogeneous across patients, simultaneous imaging of numerous different molecular targets is important for increasing the sensitivity of early cancer diagnosis and personalized treatment. For this purpose, a wide-field, multi-spectral fluorescence-reflectance scanning fiber endoscope (SFE) has been developed. Using a set of calibrated fluorescent test targets at in vivo dye concentration, algorithms and methodologies were developed and demonstrated. Preliminary results showed the promise of fluorescence molecular imaging in clinical applications using the multi-spectral SFE.

P-251L: Late-News Poster: Miniature Wide-Throw-Angle Scanning Fiber Projection Display

Advances in mobile devices have enabled internet access and viewing of images and video, but small screens constrain the experience. We have developed a novel scanning fiber optical projector that is 1.07 mm in diameter and 13 mm long, and can project images at up to a 100° throw angle.

In vivo laser-based imaging of the human fallopian tube for future cancer detection

Inherited mutations in BRCA1 and BRCA2 lead to 20-50% lifetime risk of ovarian, tubal, or peritoneal carcinoma. Clinical recommendations for women with these genetic mutations include the prophylactic removal of ovaries and fallopian tubes by age 40 after child-bearing. Recent findings suggest that many presumed ovarian or peritoneal carcinomas arise in fallopian tube epithelium. Although survival rate is <90% when ovarian cancer is detected early (Stage_I), 70% of women have advanced disease (Stage_III/IV) at presentation when survival is less than 30%. Over the years, effective early detection of ovarian cancer has remained elusive, possibly because screening techniques have mistakenly focused on the ovary as origin of ovarian carcinoma. Unlike ovaries, the fallopian tubes are amenable to direct visual imaging without invasive surgery, using access through the cervix. To develop future screening protocols, we investigated using our 1.2- mm diameter, forward-viewing, scanning fiber endoscope (SFE) to image luminal surfaces of the fallopian tube before laparoscopic surgical removal. Three anesthetized human subjects participated in our protocol development which eventually led to 70-80% of the length of fallopian tubes being imaged in scanning reflectance, using red (632nm), green (532nm), and blue (442nm) laser light. A hysteroscope with saline uterine distention was used to locate the tubal ostia. To facilitate passage of the SFE through the interstitial portion of the fallopian tube, an introducer catheter was inserted 1- cm through each ostia. During insertion, saline was flushed to reduce friction and provide clearer viewing. This is likely the first high-resolution intraluminal visualization of fallopian tubes.

Axial-Stereo 3-D Optical Metrology for Inner Profile of Pipes Using a Scanning Laser Endoscope

As the rapid progress in the development of optoelectronic components and computational power, 3-D optical metrology becomes more and more popular in manufacturing and quality control due to its flexibility and high speed. However, most of the optical metrology methods are limited to external surfaces. This article proposed a new approach to measure tiny internal 3-D surfaces with a scanning fiber endoscope and axial-stereo vision algorithm. A dense, accurate point cloud of internally machined threads was generated to compare with its corresponding X-ray 3-D data as ground truth, and the quantification was analyzed by Iterative Closest Points algorithm.

Image-guided intervention in the human bile duct using scanning fiber endoscope system

Bile duct cancers are increasing in frequency while being difficult to diagnose. Currently available endoscopic imaging devices used in the biliary tree are low resolution with poor image quality, leading to inadequate evaluation of indeterminate biliary strictures. However, a new ultrathin and flexible cholangioscope system has been successfully demonstrated in a human subject. This mini-cholangioscope system uses a scanning fiber endoscope (SFE) as a forward-imaging guidewire, dimensions of 1.2-mm diameter and 3-m length. Full color video (500-line resolution at 30Hz) is the standard SFE imaging mode using spiral scanning of red, green, and blue laser light at low power. Image-guided operation of the biopsy forceps was demonstrated in healthy human bile ducts with and without saline flushing. The laser-based video imaging can be switched to various modes to enhance tissue markers of disease, such as widefield fluorescence and enhanced spectral imaging. In parallel work, biochemical discrimination of tissue health in pig bile duct has been accomplished using fiberoptic delivery of pulsed UV illumination and time-resolved autofluorescence spectroscopic measurements. Implementation of time-resolved fluorescence spectroscopy for biochemical assessment of the bile duct wall is being done through a secondary endoscopic channel. Preliminary results indicate that adequate SNR levels (> 30 dB) can be achieved through a 50 micron fiber, which could serve as an optical biopsy probe. The SFE is an ideal mini-cholangioscope for integration of both tissue and molecular specific image contrast in the future. This will provide the physician with unprecedented abilities to target biopsy locations and perform endoscopically-guided therapies.

Evaluation of a novel, ultrathin, tip-bending endoscope in a synthetic force-sensing pancreas with comparison to medical guide wires

Purpose Direct visualization of pancreatic ductal tissue is critical for early diagnosis of pancreatic diseases and for guiding therapeutic interventions. A novel, ultrathin (5 Fr) scanning fiber endoscope (SFE) with tip-bending capability has been developed specifically to achieve high resolution imaging as a pancreatoscope during endoscopic retrograde cholangiopancreatography (ERCP). This device has potential to dramatically improve both diagnostic and therapeutic capabilities during ERCP by providing direct video feedback and tool guidance to clinicians. Methods Invasiveness of the new tip-bending SFE was evaluated by a performance comparison to ERCP guide wires, which are routinely inserted into the pancreatic duct during ERCP. An in vitro test model with four force sensors embedded in a synthetic pancreas was designed to detect and compare the insertion forces for 0.89 mm and 0.53 mm diameter guide wires as well as the 1.7 mm diameter SFE. Insertions were performed through the working channel of a therapeutic duodenoscope for the two types of guide wires and using a statistically similar direct insertion method for comparison to the SFE. Results Analysis of the forces detected by the sensors showed the smaller diameter 0.53 mm wire produced significantly less average and maximum forces during insertion than the larger diameter 0.89 mm wire. With the use of tip-bending and optical visualization, the 1.7 mm diameter SFE produced significantly less average force during insertion than the 0.89 mm wire at every sensor, despite its larger size. It was further shown that the use of tip-bending with the SFE significantly reduced the forces at all sensors, compared to insertions when tip-bending was not used. Conclusion Combining high quality video imaging with two-axis tip-bending allows a larger diameter guide wire-style device to be inserted into the pancreatic duct during ERCP with improved capacity to perform diagnostics and therapy.

37.1: Invited Paper: 1-mm Diameter, Full-color Scanning Fiber Pico Projector

Media playback capabilities of mobile devices demand a large display in a small package. We have developed a 1-mm x 9-mm scan engine, projecting full-color images through a vibrating optical fiber tip and miniature lens system. Connected by optical fiber, the projection head and RGB light sources can be distributed across the mobile device.

Swallowable capsule with air channel for improved image-guided cancer detection in the esophagus

A new type of endoscope has been developed and tested in the human esophagus, a tethered-capsule endoscope (TCE) that requires no sedation for oral ingestion and esophageal inspection. The TCE uses scanned red, green, and blue laser light to image the upper digestive tract using a swallowable capsule of 6.4mm in diameter and 18mm in length on a 1.4mm diameter tether. The TCE has been modified for image-guided interventions in the lower esophagus, specifically for more effective detection and measurement of the extent of Barretts esophagus, a precursor to esophageal cancer. Three modifications have been tested in vivo: (1) weighting the capsule so it is negatively buoyant in water, (2) increasing the frame rate of 500-line images to 30 Hz (video rate), and (3) adding a 1.0mm inner diameter working channel alongside the tether for distending the lower esophagus with air pressure during endoscopy. All three modifications proved effective for more clearly visualizing the lower esophagus in the first few human subjects. The air channel was especially useful because it did not change tolerability in the first subject for unsedated endoscopy and the air easily removed bubbles obscuring tissue from the field of view. The air provided a non-invasive intervention by stimulating the mechanosensor of the lower esophageal sphincter at the precise time that the TCE was positioned for most informative imaging. All three TCE modifications proved successful for improved visualization of esophageal pathology, such as suspected Barretts esophagus, without the use of sedation.