Real-Time Optical Coherence Tomography for Minimally Invasive Imaging of Prostate Ablation

Abstract

Objective: Numerous ablation techniques have been developed to alleviate urethral obstruction and improve urodynamics in benign prostatic hyperplasia. Most techniques, however, rely on visual observation of surface changes for ablation end points. The feasibility of using real-time optical coherence tomography (OCT) for minimally invasive imaging to guide and monitor prostate resection is demonstrated with representative techniques of laser and radiofrequency ablation. Empiric comparisons of ablation dynamics are made, and the use of OCT as a high-resolution, subsurface modality for image guidance is evaluated.Materials and Methods: Optical coherence tomography is a high-resolution, high-speed near-infrared imaging technique analogous to ultrasound imaging, except that reflections of light are detected rather than sound. High-speed OCT is used to image the dynamic process of laser and radiofrequency ablation of in vitro human prostate tissue. OCT images of ablation sites are compared with corresponding histology.Results: Based on comparisons between OCT images and corresponding histology, OCT imaged transurethral prostate tissue morphology, including urethral sinuses and submucosal glands. Real-time OCT imaging provided rapid feedback and control of ablation dynamics. The compact and portable OCT technology is amenable to minimally invasive beam-delivery devices.Conclusions: Optical coherence tomography offers a minimally invasive means of assessing transurethral prostate morphology. Real-time OCT has the potential to provide image guidance of prostate resection for many of the existing surgical treatments directed at alleviating urethral obstruction associated with benign prostatic hyperplasia.