Polarization-Sensitive Optical Coherence Tomography Imaging of Benign and Malignant Laryngeal Lesions: An In Vivo Study
Polarization-Sensitive Optical Coherence Tomography Imaging of Benign and Malignant Laryngeal Lesions: An In Vivo Study
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DOI：
10.1177/0194599811403078
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发表时间：
2011-07-01
影响因子：
3.4
通讯作者：
Zeitels, Steven M.
中科院分区：
文献类型：
--
作者：
Burns, James A.;Kim, Ki Hean;Zeitels, Steven M.
Objective.光学相干断层扫描（OCT），一种成像技术，提供横截面的亚表面组织结构的图像，使用背散射光，是一种很有前途的非侵入性的成像方式，在体内评估声带分层微结构。偏振敏感OCT（PS-OCT）通过检测反射光的偏振状态的变化来增强常规OCT。本研究对全麻下接受直接喉镜检查的患者的各种良性和恶性喉部病变进行成像，以确定PS-OCT是否能提供有关声带显微结构和声门表面病理学的有用信息。前瞻性临床试验。设置。三级护理中心。主题和方法。23例患者在全麻下接受显微喉镜检查，分别治疗良性（n = 18）和恶性（n = 5）声门疾病，采用OCT和PS-OCT进行双侧成像（n = 46声带）。术中显微摄影指导成像探头的放置。如果存在，还对外观正常的声门组织进行成像。当有临床指征时，活检或完全切除病变建立组织学确诊。PS-OCT提供了高达1.2 mm深的高质量垂直横截面图像，补充了显微喉镜检查和传统OCT用于声带病变。通过PS-OCT可视化瘢痕组织，其特征在于双折射模式比正常声门组织的双折射模式更强烈。肿瘤的典型表现是分层结构和双折射的破坏或缺失。在人类声带成像过程中将PS-OCT与OCT相结合，可提供表征声带病变（特别是瘢痕组织）的有用信息。
Objective. Optical coherence tomography (OCT), an imaging technology that provides cross-sectional subsurface tissue structure images using back-scattered light, is a promising noninvasive imaging modality for in vivo assessment of vocal fold layered microstructure. Polarization-sensitive OCT (PS-OCT) augments conventional OCT by detecting changes in the polarization state of reflected light. This study imaged various benign and malignant laryngeal pathologies in patients undergoing direct laryngoscopy under general anesthesia to determine whether PS-OCT would provide useful additional information about vocal fold microstructure and glottic surface pathology.Study Design. Prospective clinical trial.Setting. Tertiary care center.Subjects and Methods. Twenty-three patients who were undergoing microlaryngoscopy under general anesthesia for benign (n = 18) and malignant (n = 5) glottic disease were imaged bilaterally with OCT and PS-OCT (n = 46 vocal folds). Intraoperative microphotography guided placement of the imaging probe. Normal-appearing glottic tissue was also imaged if present. When clinically indicated, biopsy or complete removal of the lesion established histologic confirmation.Results. PS-OCT provided high-quality, vertical, cross-sectional images up to 1.2-mm deep that complemented microlaryngoscopy and conventional OCT for vocal fold pathologies. Scar tissue was visualized by PS-OCT, characterized by a birefringence pattern more intense than that of normal glottic tissue. Cancer typically showed disruption or absence of both layered structure and birefringence.Conclusion. Combining PS-OCT with OCT during human vocal cord imaging provides useful information in characterizing vocal cord lesions, particularly scar tissue.