Abstract
A novel tri-modal microscope combining optical coherence tomography (OCT), spectrally encoded confocal microscopy (SECM) and fluorescence imaging is presented. This system aims at providing a tool for rapid identification of head and neck tissues during thyroid surgery. The development of a dual-wavelength polygon-based swept laser allows for synchronized, co-registered and simultaneous imaging with all three modalities. Further ameliorations towards miniaturization include a custom lens for optimal compromise between orthogonal imaging geometries as well as a double-clad fiber coupler for increased throughput. Image quality and co-registration is demonstrated on freshly excised swine head and neck tissue samples to illustrate the complementarity of the techniques for identifying signature cellular and structural features.
Highlights
Intraoperative tissue identification is standard practice in head and neck surgeries, especially during total or partial removal of the thyroid gland, a procedure called thyroidectomy
We demonstrate a tri-modal imaging system based on a dedicated wavelength-swept laser optimized for simultaneous optical coherence tomography (OCT), spectrally encoded confocal microscopy (SECM) and spectrally encoded fluorescence imaging (SEFI)
We present the benchtop tri-modal microscope, as a combination of three imaging sub-systems: OCT, SECM and SEFI
Summary
Intraoperative tissue identification is standard practice in head and neck surgeries, especially during total or partial removal of the thyroid gland, a procedure called thyroidectomy. Located in the neck below the thyroid cartilage, it is typically covered by a thin fibrous capsule, to which are often attached the small-sized (3-4 mm in diameter) parathyroid glands. These glands regulate calcium concentration in the body and are typically located at each corner of the thyroid gland, with left-right symmetry, their precise location and number (4 on average) varies from one individual to another [1]. Severe postoperative hypocalcemia translates into a prolonged hospitalization and heavier economic burden All these studies suggest careful dissection and examination of the thyroid capsule and gland in order to identify and preserve parathyroid glands during the operative procedure. A significant number of these could be prevented with a dedicated tool for examination of the thyroid capsule and surrounding tissues intra-operatively [6]
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