Comparison of Tissue Architectural Changes between Radiofrequency Ablation and Cryospray Ablation in Barrett’s Esophagus Using Endoscopic Three-Dimensional Optical Coherence Tomography

Two main nonsurgical endoscopic approaches for ablating dysplastic and early cancer lesions in the esophagus have gained popularity, namely, radiofrequency ablation (RFA) and cryospray ablation (CSA). We report a uniquely suited endoscopic and near-microscopic imaging modality, three-dimensional (3D) optical coherence tomography (OCT), to assess and compare the esophagus immediately after RFA and CSA. The maximum depths of architectural changes were measured and compared between the two treatment groups. RFA was observed to induce 230~260  m depth of architectural changes after each set of ablations over a particular region, while CSA was observed to induce edema-like spongiform changes to ~640 μm depth within the ablated field. The ability to obtain micron-scale depth-resolved images of tissue structural changes following different ablation therapies makes 3D-OCT an ideal tool to assess treatment efficacy. Such information could be potentially used to provide real-time feedback for treatment dosing and to identify regions that need further retreatment.National Institutes of Health (U.S.) (Grant R01-CA75289-15)National Institutes of Health (U.S.) (Grant K99-EB010071-01A1)National Institutes of Health (U.S.) (Grant R44-CA101067-06)United States. Air Force Office of Scientific Research (Contract FA9550-10-1-0063)Medical Free Electron Laser Program (Contract FA9550-10-1-0551

Development of Coherence-Gated and Resolution-Multiplexed Optical Imaging Systems

<p>Optical interrogation techniques are particularly well-suited for imaging tissue morphology, biological dynamics, and disease pathogenesis by providing noninvasive access to subcellular-resolution diagnostic information. State-of-the-art spectral domain optical coherence tomography (SDOCT) systems provide real-time optical biopsies of in vivo tissue, and have demonstrated clinical potential, particularly for applications in ophthalmology. </p><p>Recent advances in microscopy and endoscopy have led to improved resolution and compact optical designs, beyond those of conventional imaging systems. Application of encoded and multiplexed illumination and detection schemes may allow for the development of optical tools that surpass classical imaging limitations. Furthermore, complementary technologies can be combined to create multimodal optical imaging tools with advantages over current-generation systems. </p><p>In this dissertation, the development of coherence-gated and resolution-multiplexed technologies, aimed towards applications in human vitreoretinal imaging is described. Technology development in coherence-gated systems included increasing the imaging range of SDOCT by removing the complex conjugate artifact, improving acquisition speed using a scanning spectrometer design and a two-dimensional detector array, and hardware and algorithmic implementations that facilitated imaging of Doppler flow. </p><p>Structured illumination microscopy techniques were applied for resolution enhancement, and a spectrally encoded ophthalmic imaging system was developed for en face confocal fundus imaging through a single-mode fiber. These devices were resolution-multiplexed extensions of existing ophthalmic imaging devices, such as scanning laser ophthalmoscopes (SLO), which demonstrated improved resolution and more compact optical designs as compared to their conventional counterparts.</p><p>Finally, several multimodal ophthalmic diagnostic tools were developed that combined the advantages of OCT with existing imaging devices. These included a combined SLO-OCT system and a vitreoretinal surgical microscope combined with OCT. These devices allowed for concurrent ophthalmic imaging using complementary modalities for improved visualization and clinical utility.</p>Dissertatio