Abstract
A dual instrument is assembled to investigate the usefulness of optical coherence tomography (OCT) imaging in an ear, nose and throat (ENT) department. Instrument 1 is dedicated to in vivo laryngeal investigation, based on an endoscope probe head assembled by compounding a miniature transversal flying spot scanning probe with a commercial fiber bundle endoscope. This dual probe head is used to implement a dual channel nasolaryngeal endoscopy-OCT system. The two probe heads are used to provide simultaneously OCT cross section images and en face fiber bundle endoscopic images. Instrument 2 is dedicated to either in vivo imaging of accessible surface skin and mucosal lesions of the scalp, face, neck and oral cavity or ex vivo imaging of the same excised tissues, based on a single OCT channel. This uses a better interface optics in a hand held probe. The two instruments share sequentially, the swept source at 1300 nm, the photo-detector unit and the imaging PC. An aiming red laser is permanently connected to the two instruments. This projects visible light collinearly with the 1300 nm beam and allows pixel correspondence between the en face endoscopy image and the cross section OCT image in Instrument 1, as well as surface guidance in Instrument 2 for the operator. The dual channel instrument was initially tested on phantom models and then on patients with suspect laryngeal lesions in a busy ENT practice. This feasibility study demonstrates the OCT potential of the dual imaging instrument as a useful tool in the testing and translation of OCT technology from the lab to the clinic. Instrument 1 is under investigation as a possible endoscopic screening tool for early laryngeal cancer. Larger size and better quality cross-section OCT images produced by Instrument 2 provide a reference base for comparison and continuing research on imaging freshly excised tissue, as well as in vivo interrogation of more superficial skin and mucosal lesions in the head and neck patient.
Highlights
Head and neck cancer is primarily a mucosal disease of the upper aerodigestive tract with 90% of tumors arising as squamous carcinomas from epithelial membranes of the oral and nasal cavities, the pharynx and larynx
To overcome the size, speed and limited life time issues, we propose and demonstrate the use of a 1.9 mm diameter forward-viewing flexible Optical Coherence Tomography (OCT) endoscope probe in a 1300 nm swept source (SS) - OCT configuration for in vivo endoscopic imaging of human laryngeal mucosa
The fiber from the FC/APC1 end leads to a fiber optical circulator (C) coupled with a 2 x 2 directional coupler (DC) having 95/5 splitting ratio, with 95% of the power from the swept source directed to the sample arm where the endoscope OCT probe connects to
Summary
Head and neck cancer is primarily a mucosal disease of the upper aerodigestive tract with 90% of tumors arising as squamous carcinomas from epithelial membranes of the oral and nasal cavities, the pharynx and larynx. 28 Nov 2012 1 December 2012 / Vol 3, No 12 / BIOMEDICAL OPTICS EXPRESS 3347 most frequent malignant tumor of the upper aerodigestive tract in Europe. It is a preventable disease resulting from interplay of numerous etiological factors such as chronic consumption of tobacco and/or alcohol, environmental carcinogens, socioeconomic status, occupational hazards, dietary factors and genetic susceptibility. The introduction of new fiber-optic and rigid endoscopic techniques with stroboscopy has greatly enhanced the diagnostic and dynamic assessment of tumors of the upper aerodigestive tract, the larynx [1]. Miniaturized fiber-optic probes are a key component for emerging clinical applications of OCT and offer new possibilities to image diseased tissue deep within the body. Fiber imaging bundles have been incorporated into different OCT systems using a variety of optical configurations that eliminate mechanical scanning components required for endoscopic OCT applications [10,11,12]
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