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

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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.