Debra L. Stamper

Assessment of coronary plaque with optical coherence tomography and high-frequency ultrasound

This study compares the ability of intravascular optical coherence tomography (OCT) and high-frequency intravascular ultrasound (IVUS) to image highly stenotic human coronary arteries in vitro. Current imaging modalities have insufficient resolution to perform risk stratification based on coronary plaque morphology. OCT is a new technology capable of imaging at a resolution of 5 to 20 microm, which has demonstrated the potential for coronary arterial imaging in prior experiments. Human postmortem coronary arteries with severely stenotic segments were imaged with catheter-based OCT and IVUS. The OCT system had an axial resolution of 20 microm and a transverse resolution of 30 microm. OCT was able to penetrate and image near-occlusive coronary plaques. Compared with IVUS, these OCT images demonstrated superior delineation of vessel layers and lack of ring-down artifact, leading to clearer visualization of the vessel plaque and intima. Histology confirmed the accuracy and high contrast of vessel layer boundaries seen on OCT images. Thus, catheter-based OCT systems are able to image near-occlusive coronary plaques with higher resolution than that of IVUS.

Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies

Abstract: Optical coherence tomography (OCT) is a new imaging technology which can perform high-resolution, cross-sectional imaging of the internal microstructure of biological tissues. OCT is analogous to ultrasound, except that it measures the intensity of back-reflected infrared light rather than sound waves. OCT performs two- and three-dimensional imaging of tissue microstructure in situ and in real time. It can achieve image resolutions approaching the cellular level over approximately the same imaging depths as a conventional biopsy. In this article we examine the feasibility of OCT for high-resolution imaging of gastrointestinal malignancies with ex-vivo imaging of normal and pathologic microstructures. Tissue, both normal and neoplastic, was obtained from patients undergoing surgical resection after an initial diagnosis of a gastrointestinal malignancy. The tissue samples were imaged prior to fixation using a laboratory OCT system. The OCT system consists of a fiber optic-based Michelson interferometer, a commercially available amplified superluminscent light source, and a computer for data acquisition. The images were subsequently compared with histological cross-sections corresponding to the imaged areas. The stratified squamous epithelium of the normal esophagus was clearly visible in the OCT images and contrasted to the disorganized and non-uniform nature of the mucosal layers of Barretts esophagus and squamous carcinoma. The columnar epithelial morphology as well as other mucosal structures in normal colon were distinctly visible using OCT. In contrast, disorganization of the normal mucosal layers and ulcerative lesions were identified in tissues from ulcerative colitis and adenocarcinoma of the colon. The ability of OCT to image tissue microstructure at high resolutions makes it a potentially powerful technology for minimally invasive assessment of the gastrointestinal tract and the evaluation of early neoplastic changes.

Review of the ability of optical coherence tomography to characterize plaque, including a comparison with intravascular ultrasound.

Over the last 50 years the introduction of several imaging technologies have been pivotal in reducing mortality associated with coronary artery disease. However coronary disease continues to be the leading cause of mortality in the industrialized world. Optical coherence tomography (OCT) has recently been introduced for micron scale intravascular imaging. It is analogous to ultrasound, measuring the intensity of back-reflected infrared light instead of sound. Some of the advantages of OCT include its resolution, which is higher than any currently available imaging technology and acquisition rates are near video speed. Unlike ultrasound, OCT catheters consist of simple fiber optics and contain no transducers within their frame, thereby making imaging catheters both inexpensive and small. Currently, the smallest catheters have a cross-sectional diameter of 0.014”. OCT systems are compact and portable and can be combined with a range of spectroscopic techniques. We review the application of OCT to intracoronary imaging.

Characterizing of tissue microstructure with single-detector polarization-sensitive optical coherence tomography

Assessing tissue birefringence with imaging modality polarization-sensitive optical coherence tomography (PS-OCT) could improve the characterization of in vivo tissue pathology. Among the birefringent components, collagen may provide invaluable clinical information because of its alteration in disorders ranging from myocardial infarction to arthritis. But the features required of clinical imaging modality in these areas usually include the ability to assess the parameter of interest rapidly and without extensive data analysis, the characteristics that single-detector PS-OCT demonstrates. But beyond detecting organized collagen, which has been previously demonstrated and confirmed with the appropriate histological techniques, additional information can potentially be gained with PS-OCT, including collagen type, form versus intrinsic birefringence, the collagen angle, and the presence of multiple birefringence materials. In part I, we apply the simple but powerful fast-Fourier transform (FFT) to both PS-OCT mathematical modeling and in vitro bovine meniscus for improved PS-OCT data analysis. The FFT analysis yields, in a rapid, straightforward, and easily interpreted manner, information on the presence of multiple birefringent materials, distinguishing the true anatomical structure from patterns in image resulting from alterations in the polarization state and identifying the tissue/phantom optical axes. Therefore the use of the FFT analysis of PS-OCT data provides information on tissue composition beyond identifying the presence of organized collagen in real time and directly from the image without extensive mathematical manipulation or data analysis. In part II, Helistat phantoms (collagen type I) are analyzed with the ultimate goal of improved tissue characterization. This study, along with the data in part I, advance the insights gained from PS-OCT images beyond simply determining the presence or absence of birefringence.

Monitoring osteoarthritis in the rat model using optical coherence tomography

A need exists for an animal model to assess therapeutics for osteoarthritis (OA) without sacrificing the animal. Our goal is to assess the progression of experimentally induced osteoarthritis in the rat knee joint by monitoring articular cartilage thickness, surface abnormalities, and collagen organization using a new technology known as optical coherence tomography (OCT). OA was generated in Wistar Hanover rats via injection of sodium iodoacetate into the left articular joint of the knee while normal saline was injected as a control in the contralateral right knee. Rats were sacrificed at 1-, 2-, 3-, 4-, and 8-week intervals and the knee joints were subsequently harvested and imaged using normal and polarization sensitive OCT (PS-OCT). Treated knees were compared to normal counterparts in the contralateral leg. Following imaging, knees underwent both routine histological processing and picrosirus staining for organized collagen. OCT images indicate that injection of sodium iodoacetate resulted in a progressive decrease in cartilage thickness and loss of the bone-cartilage interface which correlated with histology. In addition, PS-OCT was able to detect collagen disorganization, an early indicator of OA. The use of OCT in combination with the induction of OA in rats is a promising new animal model for assessing articular changes with the goal of monitoring therapeutics longitudinally. Future work will extend the model to in vivo assessments.

Guidance of aortic ablation using optical coherence tomography

Purpose: There is a significant need for an imaging modality that is capable of providing guidance for intravascular procedures, as current technologies suffer from significant limitations. In particular, laser ablation of in-stent restenosis, revascularization of chronic total occlusions, and pulmonary vein ablation could benefit from guidance. Optical coherence tomography (OCT), a recently introduced technology, is similar to ultrasound except that it measures the back-reflection of infrared light instead of sound. This study examines the ability of OCT to guide vascular laser ablation. Methods: Aorta samples underwent laser ablation using an argon laser at varying power outputs and were monitored with OCT collecting images at 4frames. Samples were compared to the corresponding histopathology. Results: Arterial layers could be differentiated in the images sequences. This allowed correlation of changes in the OCT image with power and duration in addition to histopathology. Conclusions: OCT provides real-time guidance of arterial ablation. At 4 frames, OCT was successfully able to show the microstructural changes in the vessel wall during laser ablation. Since current ablation procedures often injure surrounding tissue, the ability to minimize collateral damage to the adjoining tissue represents a useful advantage of this system. This study suggests a possible role for OCT in the guidance of intravascular procedures.

Group velocity dispersion effects with water and lipid in 1.3 µm optical coherence tomography system

Optical coherence tomography (OCT) has been introduced for the diagnosis of vulnerable plaques in the coronary arteries. When an OCT system images through tissue and biological liquids, group velocity dispersion (GVD) will occur, which may be useful in tissue characterization. This study compares the water and lipid induced GVD effects, important constituents in plaque, on the axial resolution. The point-spread function (PSF) was measured when a target mirror was immersed in either water or lipid. A Fourier transform was performed on the PSF data. No significant GVD was observed in oil up to 15 mm thickness. Water depths greater than 6 mm significantly broadened the PSF. This indicates that the distortion of the spectrum can be attributed to the GVD in water. These results suggest that when imaging through tissue (such as when performing intravascular imaging in vivo) one may be able to distinguish different tissue types for diagnostic purposes.

OCT imaging of osteoarthritic cartilage: structure, polarization sensitivity, and clinical feasibility

This work demonstrates the feasibility of OCT for identifying early osteoarthritic pathology. In addition to structural abnormalities, changes in collagen fiber organization, an indicator of very early osteoarthritis, were assessed with a polarization sensitive OCT system. A portable, real time, modular OCT system, suitable for both laboratory and clinical settings, has been developed. Preliminary in vivo imaging results obtained during partial knee replacement surgery are discussed.

Imaging the microstructure of menisci using optical coherence tomography

Using optical coherence tomography, changes in the polarization sensitivity of pig menisci were detected both in healthy and enzymatically degraded samples.

Characterizing of tissue microstructure with single detector polarization sensitive optical coherence tomography

Collagen, the most abundant protein in the body, may provide invaluable clinical information of many major disorders due to its birefringence. Assessing collagen birefringence with polarization sensitive optical coherence tomography (PSOCT) could improve characterization of in vivo tissue pathology. Beyond detecting collagen organization, the information potentially gained from PSOCT include collagen type, form vs. intrinsic birefringence, the local environment, collagen angle, and the presence of multiple birefringence materials. In this work, we applied fast Fourier transform (FFT) analysis to both the mathematical model and in vitro bovine meniscus for improved PS-OCT data analysis. The FFT analysis yielded information on tissue composition in addition to identify the presence of organized collagen. PS-OCT images of Helistat(R) phantoms (collagen type I) were also analyzed with the ultimate goal of improved tissue characterization. This study could advance the insights gained from PS-OCT images beyond simply determining the presence or absence of birefringence.