Optical Coherence Tomography using the Niris System in Otolaryngology

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Optical Coherence Tomography using the Niris
System in Otolaryngology

• Marc Rubinstein, MD, William B Armstrong, MD,
• Hamid R Djalilian, MD, Roger L Crumley, MD, MBA,
• Jason H Kim, MD, Quoc A Nguyen, MD, Allen I
  Foulad, BS,
• Pedram E Ghasri, BS, Brian JF Wong, MD, PhD.

University of California, Irvine
SPIE 2009 BiOS Biomedical Optics Symposium
January 24, 2009. San Jose, California.
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Objectives

• To determine the feasibility and efficacy of the
  Niris Optical Coherence Tomography system in
  imaging of the mucosal abnormalities of the head
  and neck
• To compare the use of this system to research OCT
  devices.

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Optical Coherence Tomography

• Non-invasive, high-resolution imaging modality
• Analogous to ultrasonography, but instead uses
  broadband near-infrared light
• Provides real time cross-sectional images

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Material

• Niris imaging system
• Is a commercially available time-domain OCT
  system, with a flexible probe
• Requires minimum setup
• It is friendly to use
• Easy to transport into the OR

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Material
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Material
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Methods

• Total of 150 patients
• OCT images of benign, premalignant and malignant
  lesions throughout the head and neck
• Imaging was performed in the outpatient setting
  and in the operating room

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Larynx
True Vocal Cord
1 mm
- Axial resolution 9µm - Lateral Resolution
20µm - Rate 1 sec/ frame, lat 1,200 pixel
- Axial Resolution 15µm - Lateral resolution
lt50µm - Rate 1.5 sec/frame, lat 200 pixel
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Larynx
Normal True Vocal Cord
True Vocal Cord with Scar band
True Vocal Cord SCCA
Squamous epithelium (SE), lamina propria (LP) and
basement membrane (BM), carcinoma (CA)
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Larynx
False Vocal Cord
1 mm
- Axial resolution 9µm - Lateral Resolution
20µm - Rate 1 sec/ frame, lat 1,200 pixel
- Axial Resolution 15µm - Lateral resolution
lt50µm - Rate 1.5 sec/frame, lat 200 pixel
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Larynx
Normal False Vocal Cord
Scar tissue of False Vocal Cord
Tumor in False Vocal Cord
Squamous epithelium (SE), lamina propria (LP) and
basement membrane (BM), blood vessels (BV),
transition zone (TZ), carcinoma (CA)
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Larynx
Normal Epiglottis
Arytenoid mucosa
Aryepiglottic Fold
Squamous epithelium (SE), lamina propria (LP) and
basement membrane (BM)
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Ear
Normal Middle Ear Mucosa
Middle Ear Keratin plug
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Ear
Normal Tympanic Membrane
Tympanic Membrane with tympanosclerosis
squamous layer (SL), fibrous layer (FL), cuboidal
epithelium (CE)
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Oral Cavity
Buccal Mucosa
Floor of the Mouth
Dorsal Tongue
Stratified squamous epithelium (SS), lamina
propria (LP) and basal membrane (BM), filiform
papilae
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Nasal Septum
- Axial Resolution 15µm - Lateral resolution
lt50µm - Rate 1.5 sec/frame, lat 200 pixel
PCE
LP
BM
- Axial resolution 9µm - Lateral Resolution
20µm - Rate 1 sec/ frame, lat 1,200 pixel
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OCT Systems
Niris
UCI OCT
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Current State of the Art OCT Systems
1Opt Express. 2008 Feb 1816(4)2547-54. 2Opt
Express. 2008 Sep 1516(19)15149-69. 3Opt
Express. 2008 Jan 2116(2)1096-103.
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High Speed 3D OCT Systems
Stratified squamous epithelium (sse), basement
membrane (bm), and superficial lamina propria
(slp)

• Opt.Lett., 2007, 32, 22, 3239-3241.

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Conclusions

• The Niris system
• Easily incorporated into the operating room and
  in the clinic.
• Very efficient and save device
• Setup and acquisition of the OCT images took
  approximately 5 minutes

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Conclusions

• Effective for identification of superficial
  tissue structures
• Epithelium
• Basement membrane
• Lamina propria
• Glands, ducts, blood vessels

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Conclusions

• Potential Medical Uses
• intra-operative decision-making, guiding surgical
  biopsies.
• Therapeutic options for different pathologies
  especially in premalignant disease.
• Monitoring disease state

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The Future of OCT?
CT 1975
CT 2000
?
OCT 2005
OCT 2015