1. Articles from Melissa J. Suter

    1-24 of 45 1 2 »
    1. Reply to: Endobronchial Optical Coherence Tomography: Shining New Light on Diagnosing UIP?

      Reply to: Endobronchial Optical Coherence Tomography: Shining New Light on Diagnosing UIP?

      From the Authors: We thank Kalverda and colleagues for their letter regarding our recently published paper [1], and appreciate the opportunity to provide additional clarity on the points that they raise about the work. Below we address the questions asked by Kalverda and colleagues: Enrollment criteria Our primary objective was to conduct a blinded, prospective study to evaluate the diagnostic accuracy of endobronchial OCT (EB-OCT) for microscopic ILD diagnosis as compared to concurrent surgical lung biopsy (SLB) and clinical follow-up diagnosis. Our inclusion criteria were: a) age >21 years, b) fibrotic ILD based on high-resolution computed tomography (HRCT) with unclear ...

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    2. Rapid non-destructive volumetric tumor yield assessment in fresh lung core needle biopsies using polarization sensitive optical coherence tomography

      Rapid non-destructive volumetric tumor yield assessment in fresh lung core needle biopsies using polarization sensitive optical coherence tomography

      Adequate tumor yield in core-needle biopsy (CNB) specimens is essential in lung cancer for accurate histological diagnosis, molecular testing for therapeutic decision-making, and tumor biobanking for research. Insufficient tumor sampling in CNB is common, primarily due to inadvertent sampling of tumor-associated fibrosis or atelectatic lung, leading to repeat procedures and delayed diagnosis. Currently, there is no method for rapid, non-destructive intraprocedural assessment of CNBs. Polarization-sensitive optical coherence tomography (PS-OCT) is a high-resolution, volumetric imaging technique that has the potential to meet this clinical need. PS-OCT detects endogenous tissue properties, including birefringence from collagen, and degree of polarization uniformity (DOPU) indicative ...

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    3. Diagnostic Accuracy of Endobronchial Optical Coherence Tomography for the Microscopic Diagnosis of Usual Interstitial Pneumonia

      Diagnostic Accuracy of Endobronchial Optical Coherence Tomography for the Microscopic Diagnosis of Usual Interstitial Pneumonia

      Rationale: Early, accurate diagnosis of interstitial lung disease (ILD) informs prognosis and therapy, especially in idiopathic pulmonary fibrosis (IPF). Current diagnostic methods are imperfect. HRCT resolution is limited while surgical lung biopsy (SLB) carries risks of morbidity/mortality. Endobronchial optical coherence tomography (EB-OCT) is a low-risk, bronchoscope-compatible modality that images large lung volumes in vivo with microscopic resolution, including subpleural lung, and has the potential to improve the diagnostic accuracy of bronchoscopy for ILD diagnosis. Objectives: We performed a prospective diagnostic accuracy study of EB-OCT in ILD patients with a low-confidence diagnosis undergoing SLB. Primary endpoints were EB-OCT sensitivity/specificity ...

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    4. In vivo assessment of changes to canine airway smooth muscle volume following bronchial thermoplasty with OR-OCT

      In vivo assessment of changes to canine airway smooth muscle volume following bronchial thermoplasty with OR-OCT

      The inability to assess and measure changes to the airway smooth muscle (ASM) in vivo is a major challenge to evaluating asthma and its clinical outcomes. Bronchial thermoplasty (BT) is a therapy for asthma that aims to reduce the severity of excessive bronchoconstriction by ablating ASM. While multiple long-term clinical studies of BT have produced encouraging results, the outcomes of BT treatment in practice have been variable, and questions remain regarding the selection of patients. Previously we have demonstrated an imaging platform called orientation-resolved optical coherence tomography that can assess ASM endoscopically using an imaging catheter compatible with bronchoscopy. In ...

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    5. Distinguishing Tumor from Associated Fibrosis to Increase Diagnostic Biopsy Yield with Polarization-Sensitive Optical Coherence Tomography

      Distinguishing Tumor from Associated Fibrosis to Increase Diagnostic Biopsy Yield with Polarization-Sensitive Optical Coherence Tomography

      Purpose: With recent advancements in personalized medicine, biopsies must contain sufficient tumor for histologic diagnosis and molecular testing. However, inadvertent biopsy of tumor-associated fibrosis compromises tumor yield, resulting in delayed diagnoses and/or repeat procedures when additional tumor is needed. The ability to differentiate tumor from fibrosis intraprocedurally during biopsy could significantly increase tumor yield. Polarization-sensitive optical coherence tomography (PS-OCT) is an imaging modality that is endoscope- and/or needle-compatible, and provides large volumetric views of tissue microstructure with high resolution (∼10 μm) while simultaneously measuring birefringence of organized tissues such as collagen. We aim to determine whether PS-OCT can ...

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    6. Processing-based approach for resolving the sample optic axis in endoscopic polarization-sensitive optical coherence tomography

      Processing-based approach for resolving the sample optic axis in endoscopic polarization-sensitive optical coherence tomography

      Fiber-based polarization-sensitive optical coherence tomography (PS-OCT) that utilizes a rotationally-scanning catheter has a variety of potential biomedical applications in luminal organ systems due to its ability to provide intrinsic contrast for birefringent tissue. Incorporating the optic axis (OA) of the tissue greatly enhances this potential by also permitting information about the orientation of the tissue to be extracted; however, measurement distortion that occurs has up to this point made it impossible to obtain accurate sample OA measurements. In this paper we present a straightforward calibration technique that allows the sample OA to be recovered. This technique requires no hardware modifications ...

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    7. Nano-optic endoscope for high-resolution optical coherence tomography in vivo

      Nano-optic endoscope for high-resolution optical coherence tomography in vivo

      Acquisition of high-resolution images from within internal organs using endoscopic optical imaging has numerous clinical applications. However, difficulties associated with optical aberrations and the trade-off between transverse resolution and depth of focus significantly limit the scope of applications. Here, we integrate a metalens, with the ability to modify the phase of incident light at subwavelength level, into the design of an endoscopic optical coherence tomography catheter (termed nano-optic endoscope) to achieve near diffraction-limited imaging through negating non-chromatic aberrations. Remarkably, the tailored chromatic dispersion of the metalens in the context of spectral interferometry is utilized to maintain high-resolution imaging beyond the ...

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    8. Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy

      Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy

      Background: Transbronchial needle aspiration (TBNA), often used to sample lymph nodes for lung cancer staging , is subject to sampling error even when performed with endobronchial ultrasound. Optical coherence tomography (OCT) is a high-resolution imaging modality that rapidly generates helical cross-sectional images. We aim to determine if needle-based OCT can provide microstructural information in lymph nodes that may be used to guide TBNA, and improve sampling error. Methods: We performed ex vivo needle-based OCT on thoracic lymph nodes from patients with and without known lung cancer. OCT imaging features were compared against matched histology. Results: OCT imaging was performed in 26 ...

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    9. Optical coherence tomography (OCT) imaging of dynamic airway behavior in an asthma model

      Optical coherence tomography (OCT) imaging of dynamic airway behavior in an asthma model

      To better understand bronchoconstriction in asthma, it is critical to dynamically visualize airway behavior in vivo. However, currently available imaging techniques do not have sufficient temporal and spatial resolution to investigate airway dynamics. We propose to use endobronchial Optical Coherence Tomography (OCT) to provide real-time cross-sectional images of airway dynamics with a high spatial resolution. Our aim was to study the structure and function of spatially distinct airways during tidal breathing (TB), breath-holds (BH) at end inspiration, and in a response to single deep inspiration (DI) and multiple DI (MDI) in a preclinical sheep asthma model. Anesthetized and mechanically ventilated ...

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    10. Automated segmentation and quantification of airway mucus with endobronchial optical coherence tomography

      Automated segmentation and quantification of airway mucus with endobronchial optical coherence tomography

      We propose a novel suite of algorithms for automatically segmenting the airway lumen and mucus in endobronchial optical coherence tomography (OCT) data sets, as well as a novel approach for quantifying the contents of the mucus. Mucus and lumen were segmented using a robust, multi-stage algorithm that requires only minimal input regarding sheath geometry. The algorithm performance was highly accurate in a wide range of airway and noise conditions. Mucus was classified using mean backscattering intensity and grey level co-occurrence matrix (GLCM) statistics. We evaluated our techniques in vivo in asthmatic and non-asthmatic volunteers.

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    11. Endoscopic optical coherence tomography: technologies and clinical applications [Invited]

      Endoscopic optical coherence tomography: technologies and clinical applications [Invited]

      In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic ...

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    12. Endoscopic biopsy apparatus, system and method

      Endoscopic biopsy apparatus, system and method

      Exemplary embodiments of apparatus, method and system for determining a position on or in a biological tissue can be provided. For example, using such exemplary embodiment, it is possible to control the focus of an optical imaging probe. In another exemplary embodiment, it is possible to implement a marking apparatus together with or into an optical imaging probe. According to one exemplary embodiment, it is possible (using one or more arrangements) to receive information associated with at least one image of at least one portion of the biological tissue obtained using an optical imaging technique. Further, it is possible to ...

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    13. Birefringence microscopy platform for assessing airway smooth muscle structure and function in vivo

      Birefringence microscopy platform for assessing airway smooth muscle structure and function in vivo

      The inability to visualize airway smooth muscle (ASM) cells in vivo is a major obstacle in understanding their role in normal physiology and diseases. At present, there is no imaging modality available to assess ASM in vivo. Confocal endomicroscopy lacks the penetration depth and field of view, and conventional optical coherence tomography (OCT) does not have sufficient contrast to differentiate ASM from surrounding tissues. We have developed a birefringence microscopy platform that leverages the micro-organization of tissue to add further dimension to traditional OCT. We have used this technology to validate ASM measurements in ex vivo swine and canine studies ...

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    14. Optimizing flushing parameters in intracoronary optical coherence tomography: an in vivo swine study

      Optimizing flushing parameters in intracoronary optical coherence tomography: an in vivo swine study

      Intracoronary optical frequency domain imaging (OFDI), requires the displacement of blood for clear visualization of the artery wall. Radiographic contrast agents are highly effective at displacing blood however, may increase the risk of contrast-induced nephropathy. Flushing media viscosity, flow rate, and flush duration influence the efficiency of blood displacement necessary for obtaining diagnostic quality OFDI images. The aim of this work was to determine the optimal flushing parameters necessary to reliably perform intracoronary OFDI while reducing the volume of administered radiographic contrast, and assess the influence of flushing media choice on vessel wall measurements. 144 OFDI pullbacks were acquired together ...

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    15. Diagnosing Lung Carcinomas with Optical Coherence Tomography

      Diagnosing Lung Carcinomas with Optical Coherence Tomography

      Rationale: Lung carcinoma diagnosis on tissue biopsy can be challenging due to insufficient tumor and lack of architectural information. Optical coherence tomography (OCT) is a high-resolution imaging modality that visualizes tissue microarchitecture in volumes orders of magnitude larger than biopsy. It has been proposed that OCT could potentially replace tissue biopsy. Objectives: We aim to determine if OCT could replace histology in diagnosing lung carcinomas . We develop and validate OCT interpretation criteria for common primary lung carcinomas : adenocarcinoma, squamous cell carcinoma (SCC), and poorly differentiated carcinoma . Methods: A total of 82 ex vivo tumor samples were included in a blinded ...

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    16. Esophageal-guided biopsy with volumetric laser endomicroscopy and laser cautery marking: a pilot clinical study

      Esophageal-guided biopsy with volumetric laser endomicroscopy and laser cautery marking: a pilot clinical study

      Background Biopsy surveillance protocols for the assessment of Barrett's esophagus can be subject to sampling errors, resulting in diagnostic uncertainty. Optical coherence tomography is a cross-sectional imaging technique that can be used to conduct volumetric laser endomicroscopy (VLE) of the entire distal esophagus. We have developed a biopsy guidance platform that places endoscopically visible marks at VLE-determined biopsy sites. Objective The objective of this study was to demonstrate in human participants the safety and feasibility of VLE-guided biopsy in vivo. Design A pilot feasibility study. Setting Massachusetts General Hospital. Patients A total of 22 participants were enrolled from January ...

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    17. Toward the Guidance of Transbronchial Biopsy Identifying Pulmonary Nodules With Optical Coherence Tomography

      Toward the Guidance of Transbronchial Biopsy Identifying Pulmonary Nodules With Optical Coherence Tomography

      Background Solitary pulmonary nodules (SPNs) frequently require transbronchial needle aspiration (TBNA) or biopsy to determine malignant potential, but have variable diagnostic yields. Confirming needle placement within SPNs during TBNA could significantly increase diagnostic yield. Optical coherence tomography (OCT) provides nondestructive, high-resolution, microstructural imaging with potential to distinguish SPN from parenchyma. We have developed needle-based OCT probes compatible with TBNA. Before OCT can play any significant role in guiding clinical TBNA, OCT interpretation criteria for differentiating SPN from lung parenchyma must be developed and validated. Methods OCT of SPN and parenchyma was performed on 111 ex vivo resection specimens. OCT criteria ...

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    18. Towards the guidance of transbronchial biopsy: Identifying pulmonary nodules with optical coherence tomography

      Towards the guidance of transbronchial biopsy: Identifying pulmonary nodules with optical coherence tomography

      Background: Solitary pulmonary nodules (SPN) frequently require transbronchial needle aspiration (TBNA) or biopsy to determine malignant potential, but have variable diagnostic yields. Confirming needle placement within SPNs during TBNA could significantly increase diagnostic yield. Optical coherence tomography (OCT) provides non-destructive, high-resolution, microstructural imaging with potential to distinguish SPN from parenchyma. We have previously developed needle-based OCT probes compatible with TBNA. Before OCT can play any significant role in guiding clinical TBNA, OCT interpretation criteria for differentiating SPN from lung parenchyma must be developed and validated. Methods: OCT of SPN and parenchyma was performed in 111 ex vivo resection specimens. OCT ...

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    19. Optical frequency domain imaging of ex vivo pulmonary resection specimens: obtaining one to one image to histopathology correlation

      Optical frequency domain imaging of ex vivo pulmonary resection specimens: obtaining one to one image to histopathology correlation

      Lung cancer is the leading cause of cancer-related deaths 1 . Squamous cell and small cell cancers typically arise in association with the conducting airways, whereas adenocarcinomas are typically more peripheral in location. Lung malignancy detection early in the disease process may be difficult due to several limitations: radiological resolution, bronchoscopic limitations in evaluating tissue underlying the airway mucosa and identifying early pathologic changes, and small sample size and/or incomplete sampling in histology biopsies. High resolution imaging modalities, such as optical frequency domain imaging (OFDI), provide non-destructive, large area 3-dimensional views of tissue microstructure to depths approaching 2 mm in ...

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    1-24 of 45 1 2 »
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