Non-invasive imaging of subsurface paint layers with optical coherence tomography

Optical coherence tomography (OCT) systems are fast scanning infrared Michelson interferometers designed for the non-invasive examination of the interiors of the eye and subsurface structures of biological tissues. OCT has recently been applied to the non-invasive examinations of the stratigraphy of paintings and museum artefacts. So far this is the only technique capable of imaging non-invasively the subsurface structure of paintings and painted objects. Unlike the traditional method of paint cross-section examination where sampling is required, the non-invasive and non-contact nature of the technique enables the examination of the paint cross-section anywhere on a painting, as there is no longer an issue with conservation ethics regarding the taking of samples from historical artefacts. A range of applications of the technique including the imaging of stratigraphy of paintings and painted artefacts, the imaging of underdrawings to the analysis of the optical properties of paint and varnish layers is presented. Future projects on the application of OCT to art conservation are discussed

Optical interferometry- from astronomy to art

After more than a century, Michelson’s interferometer is still at the forefront of scientific investigation. While the first application was in astronomy, it is now used as a novel technique in a wide range of subjects, notably in the form of Optical Coherence Tomography used primarily for biomedical applications. This paper will introduce a new application of the interferometer for the examination of art for conservation purposes

Overlay of conventional angiographic and en-face OCT images enhances their interpretation

BACKGROUND: Combining characteristic morphological and functional information in one image increases pathophysiologic understanding as well as diagnostic accuracy in most clinical settings. En-face optical coherence tomography (OCT) provides a high resolution, transversal OCT image of the macular area combined with a confocal image of the same area (OCT C-scans). Creating an overlay image of a conventional angiographic image onto an OCT image, using the confocal part to facilitate transformation, combines structural and functional information of the retinal area of interest. This paper describes the construction of such overlay images and their aid in improving the interpretation of OCT C-scans. METHODS: In various patients, en-face OCT C-scans (made with a prototype OCT-Ophthalmoscope (OTI, Canada) in use at the Department of Ophthalmology (Academic Medical Centre, Amsterdam, The Netherlands)) and conventional fluorescein angiography (FA) were performed. ImagePro, with a custom made plug-in, was used to make an overlay-image. The confocal part of the OCT C-scan was used to spatially transform the FA image onto the OCT C-scan, using the vascular arcades as a reference. To facilitate visualization the transformed angiographic image and the OCT C-scan were combined in an RGB image. RESULTS: The confocal part of the OCT C-scan could easily be fused with angiographic images. Overlay showed a direct correspondence between retinal thickening and FA leakage in Birdshot retinochoroiditis, localized the subretinal neovascular membrane and correlated anatomic and vascular leakage features in myopia, and showed the extent of retinal and pigment epithelial detachment in retinal angiomatous proliferation as FA leakage was subject to blocked fluorescence. The overlay mode provided additional insight not readily available in either mode alone. CONCLUSION: Combining conventional angiographic images and en-face OCT C-scans assists in the interpretation of both imaging modalities. By combining the physiopathological information in the angiograms with the structural information in the OCT scan, zones of leakage can be correlated to structural changes in the retina or pigment epithelium. This strategy could be used in the evaluation and monitoring of patients with complex central macular pathology

Mathematical Modelling of Optical Coherence Tomography

In this chapter a general mathematical model of Optical Coherence Tomography (OCT) is presented on the basis of the electromagnetic theory. OCT produces high resolution images of the inner structure of biological tissues. Images are obtained by measuring the time delay and the intensity of the backscattered light from the sample considering also the coherence properties of light. The scattering problem is considered for a weakly scattering medium located far enough from the detector. The inverse problem is to reconstruct the susceptibility of the medium given the measurements for different positions of the mirror. Different approaches are addressed depending on the different assumptions made about the optical properties of the sample. This procedure is applied to a full field OCT system and an extension to standard (time and frequency domain) OCT is briefly presented.Comment: 28 pages, 5 figures, book chapte

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Imagistic Evaluation of the Orthodontics Interfaces.

In orthodontics, the scientific interest regarding adhesion is focused on optimizing adherents: metallic or aesthetic bracket base conditioning, creating aesthetic brackets with improved mechanical properties, enamel conditioning and artificial surface conditioning (aesthetic veneers and crowns). In order to investigate the interfaces between adherents there are several invasive (destructive) methods such as tensile bond strength tests, shear bond strength tests and microleakage tests

En-face optical coherence tomography - a novel application of non-invasive imaging to art conservation

Instrumental role in collaborative effort with another university and a leading art gallery in the first major reported application of OCT investigation to art objects – measurements of varnish layer thickness. Major contribution to the experimental apparatus (testing and calibration) and data collection and registration. (Impact Factor: 3.764

Ultrahigh-resolution combined coronal optical coherence tomography confocal scanning ophthalmoscope (OCT/SLO): A pilot study

Objective: To evaluate clinical images from a prototype ultrahigh resolution (UHR) combined coronal optical coherence tomography/confocal scanning ophthalmoscope (OCT/SLO) and to compare them to standard-resolution OCT/SLO images on the same patients. Design: Cross-sectional pilot-study. Participants: Sixty-six eyes of 42 patients with various macular pathologies, such as age-related macular degeneration, macular edema, macular hole, central serous retinopathy, epiretinal membrane and posterior vitreous traction syndrome. Methods: Each subject was first scanned with a standard-resolution OCT/SLO that has an axial resolution of ?10 micron. Immediately following, patients were scanned with the prototype UHR OCT/SLO device. The UHR system employs a compact super luminescent diode (SLD) with a 150 nm bandwidth centered at 890 nm, which allows imaging of the retina with an axial resolution of 3 microns. Both coronal and longitudinal OCT scans were acquired with each system, and compared side-by-side. Scan quality was assessed for the observer's ability to visualize the vitreo-retinal interface and retinal layers - in particular of the outer retina/RPE/choroidal interface, increased discrimination of pathological changes, and better signal intensity. Main outcome measures: Ultrahigh and standard-resolution coronal and longitudinal OCT/SLO images of macular pathologies. Results: In the side-by-side comparison with the commercial standard-resolution OCT/SLO images, the scans in the Ultrahigh resolution OCT/SLO images were superior in 85% of cases. Relatively poor quality images were attributed to lower signal-to-noise ratio, limited focusing, or media opacities. Several images that had a better signal intensity in the standard-resolution OCT/SLO system were found to show more retinal detail in the UHR system. In general, intraretinal layers in the UHR OCT/SLO images were better delineated in both coronal and longitudinal scans. Enhanced details were also seen in the outer retina/RPE/choroidal complex. The UHR OCT/SLO system produced better definition of morphological changes in several macular pathologies. Conclusions: Broadband SLD-based UHR OCT/SLO offers a compact, efficient, and economic enhancement to the currently available clinical OCT imaging systems. UHR OCT/SLO imaging enhanced the quality of the OCT C-scans, facilitated appreciation of vitreo-retinal pathologies, and improved sensitivity to small changes in the retina, and the outer retina/RPE/choroidal interface