In our first clinical experience, we have found that Retrograde Tethered Capsule Endomicroscopy (R-TCE) was able to be advanced ~ 30 cm in 3 minutes in the colon of an unsedated study subject. R-TCE imaging enabled full circumferential OCT visualization of 96.60 ± 0.22 (95% CI) of the human colon wall. 3D rendered flythroughs of R-TCE OCT images demonstrate comprehensive visualization behind colonic folds where pre-neoplastic lesions may be missed by colonoscopy. The R-TCE procedure was well-tolerated, there were no complications, and a sigmoidoscopy conducted after the procedure did not show any R-TCE-related mucosal damage.
Our lab has developed a 2-mm-diameter transnasal introduction tube (TNIT) that enables safe and rapid optical coherence tomography (OCT) imaging of the upper gastrointestinal tract in unsedated pregnant women. Here, we report our clinical experience with TNIT-based OCT imaging in unsedated pregnant women (n=5) at Mass General Hospital (MGH). Results show that OCT imaging of the esophagus, stomach, and duodenum can be safely and effectively conducted in pregnant women with this device.
We present the compact SECM system with a 3D-printed tethered endoscopic capsule with a 1060 nm center wavelength. Compared to the previously presented 1310 nm SECM system, the present SECM system theoretically provides 15% improved lateral resolution, 5.2 times faster imaging speed, and two times faster fabrication times. We performed in vivo imaging on the swine esophagus and the SECM images clearly visualized squamous cell nuclei as a bright dot surrounded by dark cytoplasm and bright cell borders. These results indicate that our new SECM endoscopic system making it easier to conduct cellular-level diagnosis of upper GI tract.
We have developed a new self-propelled OCT imaging technology called retrograde Tethered Capsule Endomicroscopy
(R-TCE) for colonic disease screening. We successfully demonstrated that the R-TCE device can be advanced over 1 meter in 5 swine colons in vivo. R-TCE with balloon pullback imaging enabled full circumferential OCT visualization of 95.94 % ± 0.13% of the colon wall. 3D reconstructed colon OCT images and 3D rendered flythroughs showed that R-TCE is feasible for OCT microscopic imaging of the entire colon in vivo. When translated to humans, this R-TCE
technology may provide a less invasive and more efficient alternative to colonoscopy.
Tethered capsule endomicroscopy (TCE) is a recently developed form of in vivo microscopy based on optical coherence tomography (OCT). With TCE, a small tethered pill is swallowed, procuring high resolution microscopic images of the esophageal wall. TCE does not require sedation and is thus a more rapid and convenient procedure comparing to traditional endoscopic examination. Our group and others have successfully conducted OCT-TCE in pilot, single-center studies that demonstrated the potential of this technology for upper GI tract diagnosis. Here, we demonstrate and evaluate the feasibility and safety of a next generation OCT-TCE system and device in patients with Barrett’s esophagus (BE) and report the initial longitudinal analysis of the natural history of BE.
We have previously demonstrated a miniaturized transnasal introduction tube (TNIT) for transnasal endomicroscopy (TNEM) with optical coherence tomography (OCT) for clinical imaging of the small intestine of infants and adults in vivo. Although the TNIT is a convenient and effective way to implement TNEM, OCT probes for imaging through the TNIT had long manufacturing times and low yields, and its multiple cylindrical surfaces caused severe optical aberrations, degrading OCT image quality. Here we introduce a new optical design for 3D-printed microoptics that correct TNIT-induced astigmatism. Preliminary results show that the lens improves resolution and can be reliably manufactured.
We report the use of our multimodal near-infrared fluorescence (NIRF) and OCT imaging system and catheter to perform the first imaging of LUM015 inflammatory activity in rabbit models of atherosclerosis in vivo. Using co-injection and multi-channel intravascular NIRF-OCT, we compared LUM015 (6.2 mg/kg) and preclinical ProSense (VM110, 3.5 mg/kg) fluorescence in the same subject. We found that co-registered fluorescence carpet maps were remarkably similar with a PCC of 0.51 and a Mander’s overlap coefficient of 0.79. Results suggest that LUM015 will be a viable clinical option for intracoronary imaging of plaque inflammatory activity in patients.
KEYWORDS: Optical coherence tomography, Luminescence, Imaging systems, Tissues, Process control, Near infrared, Visualization, Standards development, Lens design, Control systems
We present our next generation clinical dual-modality OCT and near infrared autofluorescence/fluorescence (NIRAF/NIRF) imaging platform. This platform allows combined tissue microstructure visualization (OCT) and obtaining molecular information either by intrinsic tissue near infrared autofluorescence (NIRAF) or by exogenous near infrared fluorescence contrast agents (NIRF). Components of this platform, OCT-NIRAF/NIRF imaging system, rotary junction and catheters, were developed using an industry standard design control processes to enable quality clinical translation. We have identified sources of image degradation in dual-modality catheter-based imaging (e.g. core-cladding crosstalk in OCT, background noise in fluorescence) and present methods to mitigate their effects. We also show catheter fabrication and validation, as well as automated fluorescence sensitivity and distance calibration methods that ensure robust and repeatable system performance.
Celiac disease (CD) is an autoimmune disease that damages the small intestine's villi upon gluten ingestion. Intestinal biopsy via esophagogastroduodenoscopy is the current diagnostic gold standard for CD, but this procedure requires sedation and suffers from sampling error. Here, we conducted a clinical study to test whether image biomarkers derived from duodenal OCT tethered capsule endomicroscopy (TCE) can be used to diagnose CD. Results showed a statistically significant difference in OCT image metrics (villus height & width, contrast, and homogeneity with p<0.0001) among active CD, inactive CD and healthy subjects, demonstrating the potential of TCE for the diagnosis of CD.
We introduce two multimodal extensions of our optical coherence tomography (OCT) based tethered capsule endomicroscopy (TCE) platform, tailored towards an enhanced clinical applicability for upper gastrointestinal tract imaging. The first extension presented – white light (RGB)-OCT-based TCE – provides both, true-color visualization of the tissue surface and depth-resolved sub-surface OCT imaging, co-registered in time and space. The second extension presented – fluorescence (FL)-OCT-based TCE – enables the addition of tissue specific molecular contrast. We present compact, modular, easily portable, plug-and-play system designs for both extensions, as well as imaging results in swine esophagus, in vivo.
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