Optical coherence tomography, optical topographical imaging and fluorescence guided surgical laser ablation

生物光子学技术和成像模式正在基于目标规格、成像参数和实验协议而用于临床应用中。这些技术在临床领域的相关和重要转化可以实现，并应用于有意义的医疗实践。本申请中提出的研究目标是开发术中光学相干断层扫描和荧光图像引导的手术激光消融。短期目标包括在手术过程中建立深度控制激光消融，改善消融结果的实时评估，改进现有的光学地形成像手术导航技术，以实现准确的术中靶向，以及设计和开发组合光学相干断层扫描和荧光成像平台，用于在手术环境中进行高分辨率实时结构和功能成像。该研究项目的长期目标是在手术环境中利用激光消融、光学地形成像、光学相干断层扫描和荧光成像来改进现有的手术方案。目标临床受益将包括神经外科和耳鼻喉科领域。医用激光消融是一种用于在外科手术过程中去除组织的成熟技术。Yang博士和他的实验室研究了在硬组织中使用超短脉冲激光消融，并使用线内相干成像（ICI，光学相干断层扫描的衍生物）作为非接触式实时反馈方法，以去除局部目标体积内的材料。在深度控制的手术中使用激光消融具有很大的潜力，特别是对于需要额外小心提高精度的神经外科手术。非电离辐射，例如手术暴露区域的光学地形成像（OTI），可以与具有实时反馈的3D数据相结合，用于手术导航。OTI可以与医疗激光消融结合使用，以提高系统响应速度，并在反馈回路中使用可见光谱光实现更快的完整地形图像采集和配准周期，以控制激光消融的横向定位。速度的提高将补充OTI为激光消融提供的精度。光学相干断层扫描（OCT）和荧光成像是两种现有的成像模式，用于研究实验室和临床疾病检测，分析和诊断。两种成像模式的组合使用具有很大的潜力，可直接获得手术受益，如跟踪/导航和组织消融。OCT是一种使用近红外光（800 ~ 1550 nm）干涉测量的成像技术，可提供近组织学分辨率（范围从亚微米到几微米），用于无创或微创成像。荧光成像是一种成像模式，其涉及通过目标样本的荧光团吸收和发射光以形成荧光显微镜检测到的信号的图像。用于手术引导的OCT和荧光成像的开发和实施只会使手术室中的光学跟踪和激光消融更加准确。OCT和荧光引导可应用于医疗领域，并成为神经外科医生在激光消融手术期间的标准手术室技术。

Biophotonics technology and imaging modalities are being used in clinical applications based on the target specifications, imaging parameters, and experimental protocols. Relevant and significant translation of these technologies into the clinical world can be achieved and applied in meaningful medical practices. The goal of the research proposed in this application is to develop intraoperative optical coherence tomography and fluorescence image guided surgical laser ablation. Short term goals include establishing depth controlled laser ablation in the context of surgical procedures and improve real-time assessment of ablation results, improving on existing optical topographical imaging surgical navigation technique for accurate intraoperative targeting, and designing and developing a combined optical coherence tomography and fluorescence imaging platform for high-resolution real-time structural and functional imaging in the surgical setting. The long-term goal for this research project will be to utilize laser ablation, optical topographical imaging, optical coherence tomography, and fluorescence imaging in a surgical setting to improve the existing surgical protocols. The targeted clinical benefits will include the fields of neurosurgery and otolaryngology. Medical laser ablation is an established technique for the removal of tissue during surgical procedures. Dr. Yang and his laboratory have investigated using ultra-short pulsed laser ablation in hard tissues with inline coherent imaging (ICI, a derivative of optical coherence tomography) as a non-contact real-time feedback method to remove material within a localized target volume. There is great potential to utilize laser ablation in surgery with depth control, especially for neurosurgeries that require increased precision with extra care. Non-ionizing radiation, such as optical topographical imaging (OTI) of a surgically exposed area, can be combined with 3D data with real-time feedback for surgical navigation. OTI can be combined with medical laser ablation to increase the system response speed and achieve faster complete topographical image acquisition and registration cycles with robust performance using visible spectrum light, in a feedback loop to control laser ablation’s lateral positioning. The speed improvement will complement the accuracy that OTI will provide for laser ablation. Optical coherence tomography (OCT) and fluorescence imaging are two existing imaging modalities used in the research laboratory and in the clinic for disease detection, analysis and diagnosis. There is great potential for the combined usage of both imaging modalities for direct surgical benefits such as tracking/navigation and tissue ablation. OCT is an imaging technology that uses near infrared light (800 ~ 1550 nm) interferometry and offers near-histological resolution (ranging from submicron to a few microns) for non-invasive or minimally invasive imaging. Fluorescence imaging is an imaging modality that involves the absorption and emission of light by fluorophores of a target specimen to form an image of the detected signal by a fluorescence microscope. The development and implementation of OCT and fluorescence imaging for surgical guidance will only enable greater accuracy in optical tracking and laser ablation in the surgical suite. OCT and fluorescence guidance can be applied in the medical field and become standard operating room technology for neurosurgeons during laser ablation surgeries.