In vivo optical biopsy using optical coherence tomography

Current clinical practice calls for the development of techniques to diagnose disease in its early stages, when treatment is most effective and significant irreversible damage can either be prevented or postponed. Optical coherence tomography (OCT) is an emerging non-invasive, optical medical diagnostic imaging modality which enables in vivo cross-sectional tomographic visualization of internal microstructure in biological systems, achieving unprecedented image resolutions, approxi-mately 10 times higher than conventional ultrasound. However many of the early changes associ-ated with diseases are still below its detection limit, e.g. subcellular structures such as nuclei or mi-totic figures for early cancer diagnosis or precise, detailed imaging and quantification of intraretinal layers to improve specificity and sensitivity for early ophthalmologic diagnosis. The key objective of this program is to develop optical coherence tomography technology which enables noninvasive in vivo optical biopsy for early diagnosis of neoplastic changes as well as early detection of ocular diseases. This novel version of OCT would enable real time, in situ visualization of tissue microstructure without the need to excisionally remove and process a specimen as in conventional biopsy and histopathology. By improving axial resolution by two orders of magnitude as compared to conventional ultrasound, this will represent a quantum leap in OCT imaging performance. In addition, an extension of this imaging technique will be developed that should provide spatially resolved functional imaging, i.e. spectroscopic as well as Doppler blood flow OCT. This extension should not only improve image contrast, but should also enable the differentiation of tissue pathologies via localized spectroscopic properties or functional state. The hypothesis of this project is that subcellular and intraretinal structures, that are relevant for the diagnosis and monitoring of early dermatologic neoplastic changes as well as early eye diseases, can be resolved by the proposed optical biopsy version of OCT and its extension for functional imaging. It is unlikely that OCT will replace excisional biopsy and histology or other existing diagnostic modalities. However, from the viewpoint of screening and diagnosis of diseases, the proposed version of OCT might enable significantly new insight in the pathogenesis and therapy control of several diseases as well as it might dramatically enhance early cancer diagnosis and the early detection in a variety of ocular pathologies that are worldwide leading causes of blindness.

Current clinical practice calls for the development of techniques to diagnose disease in its early stages, when treatment is most effective and significant irreversible damage can either be prevented or postponed. Optical coherence tomography (OCT) is an emerging non-invasive, optical medical diagnostic imaging modality which enables in vivo cross-sectional tomographic visualization of internal microstructure in biological systems, achieving unprecedented image resolutions, approxi-mately 10 times higher than conventional ultrasound. However many of the early changes associ-ated with diseases are still below its detection limit, e.g. subcellular structures such as nuclei or mi-totic figures for early cancer diagnosis or precise, detailed imaging and quantification of intraretinal layers to improve specificity and sensitivity for early ophthalmologic diagnosis. The key objective of this program is to develop optical coherence tomography technology which enables noninvasive in vivo optical biopsy for early diagnosis of neoplastic changes as well as early detection of ocular diseases. This novel version of OCT would enable real time, in situ visualization of tissue microstructure without the need to excisionally remove and process a specimen as in conventional biopsy and histopathology. By improving axial resolution by two orders of magnitude as compared to conventional ultrasound, this will represent a quantum leap in OCT imaging performance. In addition, an extension of this imaging technique will be developed that should provide spatially resolved functional imaging, i.e. spectroscopic as well as Doppler blood flow OCT. This extension should not only improve image contrast, but should also enable the differentiation of tissue pathologies via localized spectroscopic properties or functional state. The hypothesis of this project is that subcellular and intraretinal structures, that are relevant for the diagnosis and monitoring of early dermatologic neoplastic changes as well as early eye diseases, can be resolved by the proposed optical biopsy version of OCT and its extension for functional imaging. It is unlikely that OCT will replace excisional biopsy and histology or other existing diagnostic modalities. However, from the viewpoint of screening and diagnosis of diseases, the proposed version of OCT might enable significantly new insight in the pathogenesis and therapy control of several diseases as well as it might dramatically enhance early cancer diagnosis and the early detection in a variety of ocular pathologies that are worldwide leading causes of blindness.