WO1998038907A1 - Instrument d'analyse a balayage optique de tissu vivant - Google Patents

Instrument d'analyse a balayage optique de tissu vivant Download PDF

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Publication number
WO1998038907A1
WO1998038907A1 PCT/US1998/004364 US9804364W WO9838907A1 WO 1998038907 A1 WO1998038907 A1 WO 1998038907A1 US 9804364 W US9804364 W US 9804364W WO 9838907 A1 WO9838907 A1 WO 9838907A1
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WIPO (PCT)
Prior art keywords
fiber
lens
optical
housing
imaging
Prior art date
Application number
PCT/US1998/004364
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English (en)
Other versions
WO1998038907B1 (fr
Inventor
Stephen A. Boppart
Gary J. Tearney
Brett E. Bouma
Mark E. Brezinski
James G. Fujimoto
Eric A. Swanson
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Massachusetts Institute Of Technology
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Application filed by Massachusetts Institute Of Technology filed Critical Massachusetts Institute Of Technology
Priority to EP98915128A priority Critical patent/EP0971626A1/fr
Priority to JP53882698A priority patent/JP2001515382A/ja
Publication of WO1998038907A1 publication Critical patent/WO1998038907A1/fr
Publication of WO1998038907B1 publication Critical patent/WO1998038907B1/fr

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    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
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    • A61B1/00188Optical arrangements with focusing or zooming features
    • AHUMAN NECESSITIES
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    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00096Optical elements
    • AHUMAN NECESSITIES
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    • A61B1/07Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
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    • A61B5/6846Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
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    • G01B9/02001Interferometers characterised by controlling or generating intrinsic radiation properties
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    • G01B9/02062Active error reduction, i.e. varying with time
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    • AHUMAN NECESSITIES
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    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/043Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances for fluorescence imaging
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Definitions

  • This invention relates generally to the field of optical imaging and more specifically to the field of optical image guided procedures.
  • adeno carcinoma or in locating voids in multi-layer polymer packages.
  • improved visualization enables new image guided procedures such as guiding an atherectomy catheter to
  • optical imaging offers certain advantages over other approaches because it is non-ionizing, non-contact, and can achieve high resolution.
  • optical imaging techniques including optical coherence tomography (OCT) and
  • OCT optical coherence tomography
  • OCT achieves depth resolution via a combination of the focal properties of the imaging optics used and the coherence properties of the optical' source used.
  • OCT and other interferometric imaging modalities has three fundamental advantages over standard direct detection optical imaging techniques: 1) the ability to achieve nearly shot-
  • 5,321,501 describe several OCT imaging embodiments and their application in ophthalmology.
  • the present forward directing imaging system includes forward directed optical coherence tomography (OCT) in a probe including a scanning mechanism .
  • OCT optical coherence tomography
  • the system uses non-retroreflected OCT and includes a light source, a sample illuminator, a reference arm, a beam splitter, a sample light collector, a detector to
  • a beam combiner positioned to direct light from a sample light collector and a reference arm to a detector where output from the detector is
  • the scanning mechanism includes a motor and a cam
  • the motor causes rotation of the cam moving the lens and optical fiber to orthogonally to the longitudinal axis of the probe housing to scan a sample.
  • a piezoelectric transducer or by a wire around a pivot, pnenumatic devices, or by an
  • the scanning mechanism includes
  • the forward scaning OCT imaging system may be applied in a hand-held probe, or surgical tools such as probes, scalpels, scissors, forceps and biopsy instruments.
  • surgical tools such as probes, scalpels, scissors, forceps and biopsy instruments.
  • Embodiments of these devices include the application of surgical laser fibers.
  • the optical probe is an endoscope used to examine natural
  • the invention contemplates a surgical grinding endoscope which uses a cutting element in the forward or side direction combined with
  • the OCT imaging system is used with a laparoscope to perform diagnostics and surgical procedures within body cavities.
  • laparoscope embodiment also contemplates the use of forward scanning lasers.
  • the imaging system is applied to a surgical microsope for procedures requiring an en face as well as a cross sectional view into the tissue.
  • the imaging system is also applied to a high numerical aperture microscope in yet another
  • Another important embodiment of the invention is for therapeutics such as atherectomy,
  • this invention are implantable to allow for continuous or periodic extraction of information from the tissue site where implanted.
  • FIG. 1 is a block diagram of an embodiment of an OCT imaging system.
  • FIG. 2 is a block diagram of an embodiment of a Non-Retroreflected OCT configuration.
  • FIG. 3 is a block diagram of the modular system configuration.
  • FIG. 4a-i are crossectional views of embodiments of a catheter with forward scanning capabilities.
  • FIG. 5 a and 5b are longitudinal sectional views of embodiments of devices which permit forward
  • FIG. 6 a-f are longitudinal sectional views of embodiments of a catheter that utilizes a fixed lens and movable fiber for forward scanning.
  • FIG. 7 a-f are longitudinal sectional views of embodiments of a catheter that utilizes a fixed fiber and movable lens for forward scanning.
  • FIG. 8a-d are crossectional views of general methods for deflecting imaging beam in a forward direction.
  • FIG. 9a-c are longitudinal sectional views of embodiments of imaging beam characteristics.
  • FIG. 10 is a longitudinal sectional view of an embodiment of a forward-scanning hand-held probe.
  • FIG. 11 is a longitudinal sectional view of an embodiment of a forward-scanning hand-held probe
  • FIG. 12 is a longitudinal sectional view of an embodiment of the integration of a hand-held probe
  • FIG. 13 is a longitudinal sectional view of an embodiment of a forward-scanning hand-held
  • FIG. 14 is a longitudinal sectional view of an embodiment of a forward-scanning laparoscope with
  • FIG. 15 is a longitudinal sectional view of an embodiment of a forward-scanning laser surgical
  • FIG. 16a-c is a longitudinal sectional view of an embodiment of a surgical/dissecting microscope with multiple scan methods.
  • FIG. 17a-b is a longitudinal sectional view of an embodiment of a high numerical 'aperture OCT microscope.
  • FIG. 18a-b is a longitudinal sectional view of an embodiment of a flexible forward-directed optical guidewire/scanning endoscope.
  • FIG. 19 is a longitudinal sectional view and a cross-sectional view of an embodiment of the integration of forward-imaging devices with endoscope accessory ports.
  • FIG. 20 is a longitudinal sectional view of an embodiment of a close-pack fiber bundle with cross- talk reduction.
  • FIG. 21a-c is a longitudinal sectional view of an embodiment of an imaging surgical grinding catheter.
  • FIG. 22 is a longitudinal sectional view of an embodiment of the distal end of a device with an integrated microchip for image acquisition.
  • FIG. 23a-b is a longitudinal sectional top and side view of an embodiment of optical phased array
  • FIG. 24 is a frontal view of anatomical sites for implantable probes.
  • FIG. 25a-d are longitudinal sectional views of embodiments of surgical tools and probes.
  • FIG. 26a-c is a longitudinal sectional view of an embodiment of laparoscopic and endoscopic
  • FIG. 27 is a longitudinal sectional view of an embodiment of a surgical biopsy punch tool.
  • FIG. 28a-c is a longitudinal and cross-sectional view of embodiments of devices for cervical imaging.
  • the imaging engine can be of a variety of embodiments including optical coherence tomography or other interferometric imaging systems, fluorescence and other spectroscopic imaging systems, Raman imaging, diffuse wave optical imaging, two photon imaging systems or combinations thereof.
  • the imaging engine includes the associated imaging system sub-systems
  • light from an optical source 10 is directed to a given position on a
  • the interferometric imaging technique is often of an embodiment where the optical beam directed onto the specimen
  • the delivery system can be from a
  • the detected light is processed in a receiver processor 38 to extract
  • optical properties as a function of depth or other spatial metrics (e.g. location of incident beam on the sample). For instance, a reflectivity profile, or plot of the
  • the probe module may include methods for performing scanning of the radiation pattern. Thus, by performing repeated
  • image information can be obtained.
  • images can be acquired in parallel.
  • Three basic types of OCT imaging engines are known in the art and include: reference-arm scanning, frequency tunable optical source, and optical spectral analysis imaging. In each of these
  • the interferometer 19 and associated optics are used to couple light from the optical source onto the sample and optical reference.
  • the interferometer 19 also couples light after being altered by the sample and optical reference (either delayed, transmitted, reflected, or scattered)
  • the interferometer may contain free-space optics and/or optical fibers. In one embodiment the fibers are single-mode fibers.
  • the interferometer may be of a variety of embodiments including Michelson or Mach-Zehnder configurations. Within the interferometer frequency or phase
  • modulation elements enable en face imaging or enhanced signal processing; dispersion balancing
  • Transverse (including lateral, axial, or radial) scans are acquired using the actuator to scan
  • probe unit For OCT imaging engines, depth (or longitudinal) scans are acquired using one of the three methods mentioned above and described below. The computer controls the interaction
  • the OCT optical coherence tomography
  • images represent information on the microstructural optical properties of a sample. These include index-of-refraction discontinuities, scattering, absorption, birefringence, dispersion, and spectra-
  • the properties can be spatially resolved using a variety of scanning techniques. Such techniques include performing sequential depth scans interlaced with transverse scans or vise versa or the images can be acquired in parallel. Because rapid images can be obtained, the extensions beyond 1, 2, or 3-D imaging are possible with this invention. In particular, by visualizing images over time, functional imaging is possible. For example, the visualization of a beating embryo heart in response to various stimulants can be achieved.
  • a mode-locked, superluminescent or other suitably broad-bandwidth optical source is used and coupled to the interferometer.
  • reflectivity profiles of the sample can be
  • the receiver processing unit 38 can consist of a single
  • a frequency tunable optical source is coupled to the interferometer.
  • the receiver processing unit 38 includes photo-detectors which receive signals
  • the source is again a broad bandwidth source coupled to an interferometer. Reflections from the sample/specimen and
  • reference reflection(s) will optically interfere at the receiver, which is an optical spectrum analyzer.
  • the optical spectrum will consist of fringe profiles, the contrast of which is proportional
  • processing algorithms such as Fourier analysis the reflectivity or other interferometric profile of the optical properties of the sample can be obtained.
  • processing algorithms such as Fourier analysis the reflectivity or other interferometric profile of the optical properties of the sample can be obtained.
  • spectral analysis including single or multiple gratings or prisms combined with
  • the source is a Raman pumped master-oscillator power amplifier (MOP A) source.
  • MOP A Raman amplifiers are commonly used in Wavelength Division Multiplexing (WDM) optical
  • pulsed pump laser one can create a broadband optical power amplifier at the Stokes shift away from the pump laser (- 13 THz). If this amplifier is seeded with a lower power semiconductor,
  • Raman pumps are spaced by approximately the
  • Raman gain bandwidth then the bandwidth of the amplifier will be broadened, approximately, by a factor of two. Additional pumps can be used to further broadened the amplifier bandwidth and the gain spectra associated with the individual pumps can be tailored to shape the gain spectra by tailoring their respective pump powers.
  • the master oscillator can be tailored to be very broadband by using in-fiber Bragg or long
  • the pump laser can be derived from a cladding pumped Yb or Nd fiber or other rare earth doped fibers pumped from broad area or other semiconductor lasers as is known in the art. These lasers lase at -1.1 ⁇ m and they can be used to pump Er:Yb fiber to create a Raman pump laser at a wavelength
  • optical source 10 used
  • This aiming laser can be directly visualized by a human operator using a hand-held probe or surgical microscope or other
  • a special imaging camera capable of detecting radiation unseen by the human eye, can be used to visualize the optical source radiation.
  • the visible aiming laser or the imaging from the special camera can be used to feed the
  • the optical source 10 is coupled to a 2:2 fiber optic splitter 14 containing paths to a reference mirror 18 (corner cube) and to a probe unit 22 that illuminates
  • the beam waist of the illumination port 26 of the probe unit 22 is offset from the beam
  • the receiver processor 38 whose output is analyzed by a computer 42.
  • embodiments often a large surface reflection, at, for example, an air/skin interface, can mask all
  • This non-retroreflection embodiment may be
  • optical imaging engines can be used with the scanning and probe modules described in this invention. These include: transillumination techniques, diffuse-wave
  • Diffuse-wave imaging is a fairly new optical imaging technology that uses
  • Diffuse-wave imaging has
  • An interferometer is not required for diffuse-wave imaging.
  • the source is often a
  • the receiver is a direct detection receiver that measures
  • Images of the specimens' optical properties can be obtained by plotting the phase or magnitude of the detected optical intensity as a function of scan location. As with the OCT imaging engine, the images are displayed and used for diagnosis or in guiding therapeutic procedures.
  • Laser induced fluorescence imaging is another attractive imaging engine technology
  • Fluorescence imaging is based on using short wavelength visible light to excite native fluorescence (or fluorescence from selectively bound exogenous chromophores) in tissues. Differences in the biochemical constituents of the tissue will produce differences in fluorescence
  • the optically accessible tissue surface or as an image of the tissue surface Differences in fluorescence are then interpreted with an algorithm in order to differentiate the pathology of the tissue.
  • the desired endpoint is to assess the presence of dysplasia or cancer.
  • An interferometer is not required for this engine technology nor are single-mode optical fibers.
  • optical spectrum analysis of one or more regions tuned to the fluorescence wavelength As the incident excitation radiation and collected fluorescence radiation is scanned, optical images of the
  • probe-module scanning designs can be use as
  • fluorescence imaging engine could be used simultaneously over the same single-mode probe
  • the OCT source and the short wavelength excitation laser could be combined using a fiber optic wavelength division multiplexer (WDM) coupler and the collected OCT light
  • the probe module could contain two
  • one single-mode fiber for OCT imaging and one single or multi-mode fiber for fluorescence imaging could be used to direct the respective radiation patterns.
  • Common or separate scanning elements could be used to direct the respective radiation patterns.
  • Scanning is performed using a
  • image data and all associated imaging sub-systems including optics, electronics, motors,
  • controllers and computers to control the incident light, detect the image signal, process the
  • the Beam Delivery/Scanning Module 12 which includes the general forward-scanning (or other types of
  • scanning e.g. radial, lateral, or axial
  • Various methods are used to scan or translate the optical beam in order for the system to collect data and form an image.
  • These general forward-scanning methods include any number of beam delivery or
  • probe modules including, but not limited to hand-held probes, laparoscopes, surgical microscopes, high numerical aperture or standard microscopes, forward-scanning flexible catheters, fiber
  • the forward-scanning method may:
  • catheter function as a phased array; or function as an attachment which inherently adds to the functionality of the research or clinical instrument or tool as in the hand-held probe attached to
  • An OCT Scanning Engine Module 11 includes a light source, axial (depth or range)
  • the three engines described above permit axial ranging to be performed within the optical system and components.
  • the reference-arm scanning, source frequency scanning, and spectral analysis OCT all permit axial ranging, but perform this by distinctly different methods.
  • Each of the three methods may be used in conjunction with any of the beam scanning methods.
  • optical scanning engines including other interferometric imaging
  • fluorescence and other spectroscopic imaging systems fluorescence and other spectroscopic imaging systems, Raman imaging, diffuse wave optical imaging, two photon imaging systems or combinations thereof.
  • the OCT Scanning Engine Module 11 and the Beam Delivery/Scanning Module 12 are controlled by a Control Computer Module 13 typically including a central computer which is responsible for synchronization, generating drive waveforms, generating necessary trigger pulses,
  • control computer may also function as part of the last module, the Nisualization Module, although this may be a
  • the Nisualization Module 15 receives the image data from the Control Computer Module
  • Nisualization may be performed with an OCT image monitor and/or a standard video monitor
  • a screen containing all the system parameters and settings to control the operation of the system 2) a screen containing all the system parameters and settings to control the operation of the system.
  • the video image is the en face surface view
  • the OCT image is a cross-sectional profile, en face, or
  • the video technology can permit integration with heads-up display allowing the user to view these
  • Heads-up display concepts can be integrated within the eyepieces of the microscopes allowing the user to visualize the OCT image and the cross-sectional, sub-surface morphology of the specimen without having to remove his/her eyes from the microscope and
  • Video technology may also permit such images to be overlaid thereby
  • the visible aiming laser described previously 1 can also be displayed in the Visualization Module 15. This visible aiming beam can be displayed on the screen containing the video image to allow registration of the OCT and video images by the user.
  • the Therapeutic Engine Module 17 is associated with medical, scientific, and industrial
  • This module 17 uses the information output from the Visualization Module 15 to guide therapeutic procedures. This guidance can be through a human feedback aided by the Visualization Module 15 or autonomous via computer or
  • Module 17 itself.
  • Example applications where this imaging guide therapy would be beneficial include guidance of mechanical or laser-based atherectomy catheters, placing stents, inflating balloons using percutaneous angioplasty catheters, operating microsurgical tools during laparoscopy procedures, etc.
  • Forward-directed optical scanning can be performed via a number of methods. These methods are then incorporated into various instruments. In the most general description, the optical device will involveone or more optical fibers to deliver the light to the sample, focusing
  • optics to focus the beam to the desired spot with a predetermined spot size and confocal parameter, and a means of translation to enable the acquisition of adjacent axial scans for the
  • Scanning methods can be generally, categorized as one of five general principles: 1) methods which move the fiber/lens as a single
  • the forward- scanning optics and mechanicals are contained within, but not limited to, a cylindrical enclosure 50 that is small in diameter (-1-10 mm) such as a catheter, endoscope
  • This enclosure 50 may be rigid or flexible and readily integrated into the instruments discussed in later sections.
  • the distal end of the enclosure 50 consists of anoptional transparent window 54 that permits the optical beam to be transmitted with little attenuation while protecting the optics and mechanics from fluids and contaminants. Such an enclosure allows easy
  • the optical imaging plane Distal to the tip of the enclosure lies the optical imaging plane.
  • this image plane may be the plane where the optical beam is focused to a minimum spot size. This plane should fall within the region of interest for
  • Figure 4a describes an apparatus for mechanical translation of the fiber/lens unit.
  • single-mode fiber 58 is fixed to a GRIN lens 62 or a small diameter lens such as a ball lens at a given separation. This separation specifies the working distance to the focal plane, the spot size,
  • the lens can be fabricated directly into the fiber forming a single focusing unit.
  • the fiber/lens unit lies within a track (not shown) which permits
  • a spring-apparatus (not shown) returns the fiber/lens unit back to its original location when not displaced by the elliptical knob 70 .
  • the motor unit 61 may also be located at the proximal end of the device with
  • Figure 4b translates the fiber/lens unit with a piezoelectric cantilever 74.
  • a piezoelectric cantilever 74 Such a cantilever
  • the cantilever 78 does not have to be made of piezoelectric material. Rather, piezoelectric stacks may be used in conjunction with a metal or flexible material cantilever .
  • the cantilever 78 would be flat to prevent twisting and thin in the axis of flexure to
  • Displacements can be increased by progressively locating the piezoelectric stack closer to the cantilever site of attachment.
  • the cantilevers piezoelectric or otherwise
  • they may be oriented
  • one or more movable wires or guides 90 are used to mechanically displace in a push/pull manner the fiber/lens unit in an arc about a pivot point 94.
  • the movable wire 90 is housed within the cylindrical enclosure along with the single-mode optical fiber 58.
  • the translation of the fiber/lens unit 63 is dependent on the point of attachment of the wire 90
  • Figure 4d utilizes pneumatic principles to displace the fiber/lens unit 63 within the enclosure.
  • two or more air/fluid-filled bags 96, 96' are used in a complementary fashion to
  • a rigid tube 100 can house the fiber 58 and lens
  • a translation track 104 is located near the distal end of
  • This track is offset at an angle with respect to the axis of the cylindrical enclosure 50.
  • fiber/lens unit 63 to be translated at an angle, as well as in the transverse direction. Such a scan
  • Figure 4f illustrates how electrostatic/magnetic principles can be applied to laterally translating the fiber/lens unit.
  • the lens 63 is coated with a metalized material which can be
  • electrostatically charged plates 108 can be used to translate the fiber/lens unit 63.
  • the metalized lens 63 will be attracted to this region and hence, be displaced in the lateral direction.
  • the metalized fiber/lens 63 unit is attached to a flexural pivot (not shown). Very high lateral velocities can be achieved by rapidly alternating the charges on the
  • a secondary imaging fiber bundle 120 an optical imaging processing mechanism at distal end 124
  • the sensing mechanism shown in Figure 5b is a position sensing rolling mechanism 125 analogous to the computer
  • the device is physically placed on the specimen or sample to be imaged and translated
  • a flat or angle- cleaved optical fiber 58 is located on the translation mechanism.
  • the fiber 58 is then translated on one side (in the image plane) of the lens 62.
  • the focal region will not lie in a single image plane, but will sweep out an arc.
  • the focal spot size will change.
  • a lens system can be manufactured which reduces the aberrations which
  • Figure 8a utilizes a rotating cable 128 within the cylindrical enclosure 50.
  • the optical fiber 58 is contained within and is protected by the cable
  • an offset GRIN lens 62 (or other type of lens) is metered with respect to
  • the optical fiber 58 Because the lens axis is offset with respect to the optical fiber 58, the emitted
  • the beam is not focused on axis with the fiber. Instead, the focus occurs at an angle which is
  • Drive unit 60 may be implemented in a number of ways including mechanical linkage from a motor to a rotating
  • This forward-directed scanning method has the advantage that the device can be incorporated into flexible instruments or catheters.
  • the lens can be mounted on-axis
  • a second method, illustrated in Figure 8b, describes a technique for arbitrary scan patterns
  • This method also utilizes an internal cable 128 and an additional internal
  • the sheath 132 which rotate in counter-directions with respect to one another.
  • the outer cylindrical enclosure 50 remains fixed.
  • the most inner element is a metal cable 128 which houses and protects an optical fiber 58 within its core.
  • the distal end of this includes a circular prism 136 (trapezoidal in cross section).
  • External to this cable/fiber/prism 128, 58, 136 is a counter-rotating
  • arbitrary scan patterns can be produced.
  • the emitted beam is focused by a lens 152 prior to exiting the cylindrical enclosure 50.
  • an alternate embodiment (not shown) is to have one drive
  • variable cone angle can be rigidly mounted to the fiber prior to
  • Figure 8c illustrates the use of a beam-deflector element 148 placed between a pair of lenses 153, 153'.
  • the proximal lens 153 directs the light from the fiber 58 through the beam-
  • the deflector element 148 After passing through the beam-deflector 148, a second lens 153' is used to focus the light into the image plane.
  • the beam-deflecting element can consist of, but is not limited to, liquid-crystal, electro-optic, or acousto-optic modulators. Note that alternative
  • embodiments can use different lens arrangements depending on the aperture size and type of beam-deflector used.
  • the design illustrated in Figure 6d utilizes a two-dimensional miniaturized deflector 146 such as an electrostatic deflector that can be microfabricated on semiconductor or other substrates
  • the imaging beam exiting the fiber is reflected by a prism/mirror 150 on to
  • This design has the potential for arbitrary scan patterns generated at high speeds.
  • Other types of deflectors such as electromagnetic, piezoelectric, etc., can be use as well in this configuration.
  • beam deflection can be accomplished by translating or displacing a mirror in front
  • Side-directed radial scanning can be performed by using a fold mirror and rotating the
  • the inner cylindrical unit may be rotated about the central axis while the outer cylindrical unit is held stationary. This permits linear scanning at arbitrary angles in order for the user to choose which angle is most suitable for a particular application.
  • the acquired linear scans would form a spoke-like pattern about a center point.
  • three-dimensional data sets can be acquired.
  • the first is called FOCUS POSITIONING (Fig 9 A) which is the axial displacement/adjustment of the beam focus without changing any of the beam
  • FIG. 9b VARYING (FIG. 9b) which implies changes in spot size, depth of focus, and working distance, and finally, FOCUS TRACKING (FIG. 9c) which refers more specifically to the OCT imaging
  • the beam spot size could be increased or decreased (hence the transverse resolution
  • One method involves translating the entire apparatus in the z (depth) direction either toward or away from the specimen. This repositions the focus
  • Translation can be performed manually with a micrometer adjustment or via a
  • the two lenses 156, 156' can be varied without affecting the beam characteristics.
  • telescopic arrangement is important for several implementations including endoscopes where it is
  • Both focus positioning and focus varying are likely to be used in combination.
  • large regions of a specimen or sample may be scanned at lower resolutions and with a
  • Focus varying can be implemented to reduce the spot size (increase resolution) and hence, reduce the depth-of-field. At this point, focus positioning would be
  • Focus varying is illustrated in FIG. 9b.
  • lens 156 is translated and changes spot size, depth field, and working distances.
  • zoom lens configurations Several alternative embodiments are possible such as zoom lens configurations.
  • a high numerical aperture objective or lens and a small beam spot diameter are required to achieve sufficient lateral resolution.
  • This small spot diameter has a correspondingly small depth-of-field or depth-of-focus as is known in the art.
  • focus tracking must also be
  • Figure 9C illustrates an example of focus tracking.
  • ⁇ L is the displacement of the focusing
  • ⁇ F is the displacement of the focusing spot within the specimen 164
  • ⁇ R is the
  • ⁇ R can be a complicated non-linear equation depending on the index of refraction profile
  • the index profile of the sample is approximately uniform and given by n sam pi e , and small angle approximations to the focused light
  • the liquid volume will adjust to maintain a constant focal
  • mirror 160 can remain stationary.
  • Another approach for focus tracking that can easily accommodate more complex sample index profiles is to perform transverse priority scanning and adjust the reference mirror location to
  • the adjustment can be manual in response to a human operator visualizing the real-time OCT image or it can be automated by maximizing the detected
  • imaging thick specimens e.g. histological
  • one algorithm is to block the
  • the reference optical signal uses the OCT system in a direct detection confocal microscope.
  • a highly reflecting substrate e.g. a mirror
  • the specimen is then scanned manually or in an automated way to profile the back scattered signal power in search for the weaker reflection off of the more distant mirror.
  • the OCT system is
  • the focusing lens is then placed at the back surface (mirror) reflection and the OCT reference reflection optical path length is again
  • the lens location is stepped and the reference arm is swept and this
  • a hand-held probe has applications in, but is not confined to, the medical field, materials
  • a forward-directed imaging probe offers the advantage that no portion of the
  • the instrument has to come in contact with the tissue prior to obtaining imaging data. This is in contrast to devices that image in the radial or transverse direction.
  • the catheter or device
  • the hand-held probe can be used to access any external region of the human body, or any external orifice, without have the
  • the fiber path lengths between the sample and reference arms must be matched or otherwise compensated for dispersion
  • the OCT imaging engine, to which is connected the hand-held probe can be of any reasonable
  • a hand-held probe can be used to image any external region of the human body while the patient stands, sits, or lies in a bed.
  • the use of micro-optics the
  • distal portion of the device can be made very small and able to be inserted short distances into
  • FIG. 10 One implementation of a forward-scanning hand-held probe is shown in Figure 10. This design utilizes a piezoelectric cantilever 74 to displace the fiber/lens unit 63 in an arc, however,
  • the design is not limited to the use of cantilevers and may incorporate any of the general methods described herein.
  • the overall dimensions of this device are no larger than a standard ink pen,
  • the cylindrical enclosure 50 is made of a protective and insulating plastic that shields the cantilever 74, fiber 58, and lens 62 from
  • the piezoelectric bimorph material is centered within the cylindrical enclosure 50 probe
  • the proximal end 79 of the cantilever 74 is fixed to a micrometer 168 to vary the location of the imaging beam focus with respect to the
  • the tube also protects the small lens 62 and single-mode fiber 58.
  • the lens 62 used in this design is a GRIN (GRadient INdex) lens which allows effective focusing of the light emitted from the fiber while maintaining a small outer diameter.
  • the small cylindrical GRIN lens 62 easily fits within the cylindrical tube 172. To reduce the degree of -optical back-
  • the fiber can be
  • angle-cleaved and the GRIN can be angle-polished.
  • the fiber is attached to the GRIN lens using ultraviolet cured optical cement at a pre-determined distance. This distance determines the
  • focusing properties of the emitted light such as working distance, spot size, and confocal parameter.
  • Alternate lens embodiments include using fiber up-tapers with an integrated polished
  • lens or other lenses that are known in the art.
  • the distal end of the cylindrical enclosure has a clear plastic cap 176 that is removable after contact with biological tissue.
  • This cap serves four major purposes: 1) to allow the probe to be placed in contact with the tissue specimen or material sample thereby fixing the image plane
  • the probe can move with the tissue or sample, 3) the clear plastic permits the user to visualize where
  • the replaceable cap maintains cleanliness and avoids transmission of bacteria or viruses between
  • arm 172 increases the displacement to 2 mm. Larger displacements can be achieved by increasing the applied voltage (while remaining below the damage threshold of the material) and increasing the length of the extension arm.
  • FIG. 11 A second hand-held probe design is illustrated in Figure 11. This design utilizes similar cantilever-displacement principles, but offers an interchangeable lens 180 to vary the magnification of the device. Instead of affixing a GRIN lens to the fiber, the fiber 58 alone is
  • fiber 184 is collimated by lens 152 and directed toward a second, more distal lens 180 where it is focused at a forward imaging plane, within the sample to be imaged.
  • the pair of lenses 152, 180 are collimated by lens 152 and directed toward a second, more distal lens 180 where it is focused at a forward imaging plane, within the sample to be imaged.
  • the pair of lenses 152, 180 are collimated by lens 152 and directed toward a second, more distal lens 180 where it is focused at a forward imaging plane, within the sample to be imaged.
  • magnification is determined by the ratio of the focal lengths
  • magnification Other imaging systems may also be used.
  • the distal cap 176 and lens 180 are interchangeable by replacing unit 190 or 176 thereby permitting various imaging systems
  • the interchangeable cap 176 and lens 180 are disposable and serves to protect the remainder of the probe from liquids and contaminants. This
  • micrometer 168 represented in Figure 11 is
  • directed imaging probe 164 is comparable in size to a surgical scalpel 186, the two can be
  • Two-dimensional imaging can be integrated or multiple image planes can be imaged simultaneously by interweaving the scan
  • Images obtained with the imaging probe will permit the surgeon to view the substructure and avoid sensitive structures such as nerves or vessels or assist in determining locations of tumors and identifying tumor margins prior to resection.
  • OCT may be configured to perform laser Doppler velocimetry of the tissue prior to incision. Images can be generated
  • the scalpel 186 and probe 164 could angle the beam more closely to the tip of the scalpel 186. Also the scalpel blade could be rotated 90° with respect to the axis of imaging, and the
  • probe could be located below the scalpel so that the cutting axis is imaged prior to incision.
  • one or more optical fibers can be positioned within the scalpel blade itself (for example in
  • a blade made of optically translucent material or in a more conventional metal blade with appropriate imaging ports (not shown) with the tip of the fiber located at the tip or along the edge of the scalpel blade.
  • imaging can be performed whereas with lower numbers of fibers, isolated depth information can be acquired.
  • Single axial scans can be
  • the lenses If the fibers are in near contact with the specimen or sample, the lenses to focus the
  • Such fibers may be located within a blunt- tipped probe (see Figure 25a) which is commonly used during surgical procedures to move tissue
  • the blunt probe is typically held in the opposite hand as the scalpel and frequently used to point to and identify tissue.
  • an entire micro-scanning device can be incorporated onto the end of the scalpel which scans the beam in an angular pattern along the incision plane.
  • an entire micro-scanning device can be incorporated onto the end of the scalpel which scans the beam in an angular pattern along the incision plane.
  • high power continuous wave lasers or high energy pulsed lasers can be integrated with the OCT imaging system to replace the surgeons scalpel.
  • High power or high energy laser light can effectively disrupt biological tissues.
  • High power or high energy laser light can effectively disrupt
  • Figure 13 illustrates the concept of
  • Each fiber 58, 59 could be translated with a piezoelectric
  • each of the fibers 58, 59 could be attached to the same piezoelectric cantilever 74, 74' or the surgical laser fiber 59 could
  • Both the OCT imaging beam and the high power/energy laser radiation may be propagated down the same optical fiber permitting precise registration between OCT image and location of laser surgical procedures. This design will enable a single, integrated hand-held device
  • This configuration also permits the acquisition of images prior to, during, and immediately following the delivery of the laser
  • the high power laser could be delivered using the same single mode fiber used for OCT, then wavelength selective beam splitters/couplers (not shown) or fast optical switches (not shown) could be used to
  • a small pair of orthogonal galvanometers (not shown) can also be incorporated at the proximal end of the hand-held probe
  • the internal scanning mechanism can be configured to
  • the design of the forward- scanning hand-held probe represents a general method of transverse displacement that is modular in design. Using the probe to transversely displace a
  • a laparoscope is an optical device that is used typically in medical applications to visualize tissue surfaces with magnification at a remote internal site.
  • the concept of laparoscopic surgery has contributed to minimally invasive surgery; the idea that surgical procedures can be
  • the laparoscope 192 consists of a rigid cylindrical enclosure 50 1-2 cm in diameter and 10-50 cm in length.
  • the proximal end 200 contains optics
  • a CCD camera 194 can be mounted at the proximal end 200 with the en face image of the tissue
  • white-light fiber-optic bundles (198) that run parallel to the imaging optics which provide illumination of the tissue surface.
  • Typical surgical procedures using laparoscopes involve inflating the human abdominal cavity with a gas to provide space to visualize internal organs and
  • Sub-surface imaging can significantly complement the en face imaging that is currently performed
  • the en face imaging significantly complements the sub-surface OCT imaging by allowing the user to simultaneously visualize the
  • Figure 14 illustrates the optical design of a forward-
  • proximal end 200 At the proximal end 200 are optics which permit the simultaneous en face viewing and OCT imaging utilizing the same optics along the length of the laparoscope.
  • transverse scanning mechanism (not shown) is employed based on either those described in Figures 4-8, galvanometer scanners, or the modular concept of the forward scanning probe.
  • proximally located scanning elements can be extended to two dimensions and permit arbitrary scan patterns at the distal end 204 of the laparoscope. This arbitrary pattern can be
  • the CCD imaging camera 194 can display the scan location, pattern, and
  • a transversely scanned beam is focused by a lens 152 and fully reflected by a beam splitter 14 which transmits visible wavelengths, but reflects near
  • the OCT imaging beam is focused at the image plane of the laparoscope relay optics 202.
  • the relay optics 202 consists of either a series of GRIN or relay lenses or a
  • translations of the OCT beam focus in the image plane are relayed as translations in the object plane where the tissue sample is located.
  • an alternative to transverse scanning is to locate a angular scanning device(s) in a pupil plan at the distal end of the laparoscope.
  • Rod lenses are
  • An integral pitch length rod lens will relay a non-inverted image from one face to the other. In this case, a beam which is focused into the proximal end of
  • the rod lens will be focused at the distal end as if the rod was of zero length.
  • the image at the opposite rod face will be
  • these non-integral pitch length rod lenses are used
  • lenses can be small standard lenses, ball lens, or additional GRIN lenses which can be attached directly to the rod lens.
  • the magnification of the lens/rod lens of the laparoscope sets the resolution and depth-of-
  • Focus positioning can be performed by
  • an eyepiece Referring again to FIG. 14 for simultaneous visualization of the scan location, an eyepiece
  • lens 151 is used to image the image plane, through the beam splitter 14, on to either the human eye or a CCD 194 camera.
  • White-light illumination is delivered through multi-mode fibers 198
  • imaging beam e.g. 1300 nm
  • visible wavelengths « 650 nm
  • relay optics 202 results in non-coincident image/object planes. This, however, can be compensated for by adjusting the location of the eyepiece 151 and focusing lens 152 located at
  • the object planes for the two wavelengths are made to coincide.
  • the proximal end there will be two image planes,
  • each wavelength can effectively be relayed down the laparoscope 192 to a single coplanar
  • a chromatic optical element(s) can be used in the common path to maintain a common image plane.
  • one modification includes the addition of a second beamsplitter 14' to allow the high-energy/power light to enter the relay optics 202 and be
  • focal lengths of the eyepiece 151 and image beam focusing lens 152 are lengthened.
  • yet another embodiment has the surgical laser integrated into the OCT imaging port.
  • the surgical laser can be integrated via a WDM coupler (or other means) to deliver the surgical light to the
  • This integrated laparoscope design will combine the ability to visualize intra-abdominal contents or other internal body structures via minimally invasive surgical procedures with sub ⁇
  • Forward-directed scanning can be integrated with existing surgical or dissecting microscopes to permit imaging of an arbitrarily oriented sub-surface tomographic plane to be
  • NA numerical aperture
  • microscope is not only limited to medical applications, but is useful when acquiring
  • infrared imaging beam can be captured and stored on either video tape or digitized and stored on
  • Figure 16a The concept of the forward-scanning surgical microscope 210 is illustrated in Figure 16. Three scan methods are shown. In Figure 16a, the optical fiber 57 from the sample arm of the
  • OCT imaging engine is inserted into a collimator 67.
  • the collimated beam is directed through a
  • scanners enable the forward-directed imaging beam to be scanned in arbitrary patterns on the specimen or sample. This arbitrary pattern also enables the acquisition of multiple cross-sectional
  • a beamsplitter 14 mounted at 45° redirects the near infrared imaging beam and the visible aiming beam downward
  • the beam splitter 14 is coated to reflect the imaging and aiming beam wavelengths while allowing other visible wavelengths to transmit.
  • the focusing lens 152 will focus the imaging and aiming beams at two different locations. Since the visible aiming beam is only used to trace the location of the imaging beam, its focal position is relatively insignificant.
  • FIG. 16b A second method for forward-scanning is shown in Figure 16b. This concept reiterates the modularity of the forward-scanning instruments. The methods previously can be used to perform forward-directing scanning beneath a surgical/dissecting microscope.
  • the cylindrical enclosure 50 or probe 164 can be attached to the scope 210 to place the forward imaging plane
  • the probe 164 can be positioned at an angle with respect to the imaging axis of the microscope 210.
  • the probe 164 can be placed within 10-20° of the microscope axis if the dimensions
  • a fold mirror (not shown), similar to the beamsplitter in Figure 16a can be used to allow a freely held probe to be positioned horizontally
  • Linear scans at arbitrary angles can be obtained by rotating the forward-directed imaging probe 164 about its axis. If the scanning
  • stage 217 and/or and imaging probe 164 can be rotated about a fixed point on the specimen to
  • two-dimensional scanning can be performed by incorporating multi-axis cantilevers or other two-dimensional displacement mechanisms.
  • the confocal parameter of this device is large, focus varying and focus positioning can be incorporated to improve the flexibility of the device and its ease-of-use when integrated with the microscope 210.
  • a visible aiming laser could be included in the probe unit 164 to easily facilitate
  • the microscope can be designed with a small monitor 167 to allow the OCT image to be seen directly through the eyepiece 218 so a surgeon/operator may remove the probe 164 and freely move it
  • the hand-held probe 164 may contain a therapeutic device such as discussed with respect to figures 12 and 13.
  • FIG. 16c the same axis of the microscope 210 is shown in Figure 16c.
  • This design utilizes the piezoelectric cantilever 74 described in earlier sections.
  • the cantilever 74 is attached to a translation stage 214
  • a fiber/GRIN lens unit 63 is attached at the end of the cantilever 74 so the
  • optical imaging beam is directed downward toward specimen.
  • This unit can be positioned
  • a second stage (not shown)can be used to
  • the translation stage 214 can be used to acquire multiple arcs and construct a 3-D data set. Positioning this design beneath a
  • stereo-microscope does limit the view of the sample or specimen to be imaged.
  • the stereo-microscope does limit the view of the sample or specimen to be imaged.
  • the profile of the cantilever 74 and GRIN lens 63 can be made very thin and if placed far enough away from the focus of the microscope imaging optics, then the cantilever 74 will not be distracting to the user.
  • cross- sectional image obtained with the OCT or other type of imaging engine can be overlaid or otherwise combined so that a human user can simultaneously view both images through the eye
  • NA numerical aperture
  • microscopes are higher than in the surgical/dissecting microscopes, typically between 50-400X.
  • the numerical apertures for these objectives is higher ranging from 0.1 to 0.5 and higher.
  • high NA microscope is to allow the precise positioning of the imaging beam on the specimen or
  • Focus tracking permits the coherence envelope of the OCT source to be continuously aligned with the focal region of the microscope objective and hence, collect image information only within 'the confocal
  • the focus depth in the specimen is not simply related to any
  • custom generated waveforms will be generated to focus track inside a specimen.
  • a high speed dynamic feedback system can be used to compensate as imaging is performed.
  • Figure 17 illustrates the integration of forward-directed imaging with a high NA
  • microscope 222 Commercial microscopes have been designed to provide several access ports
  • Typical ports include the camera port
  • the port 226' designed for direct
  • galvanometer scanning mechanism 206 to scan the imaging beam through the direct illumination
  • FIG. 17b a galvanometer-based scanning mechanism 206' in an objective mount
  • the sample to be imaged is placed on the stage 214 of the microscope 222.
  • the stage 214 is raised or lowered to position the focus of the imaging beam within the sample as well as to focus the image for visualization through the eyepieces 218.
  • a monitor could also be added analogous to 167 in FIG. 16.
  • the optical fiber 57 from the sample arm of the OCT imaging engine is attached to a connectorized fiber collimator 238 which collimates the imaging beam before being
  • the orthogonal galvanometers 206 allow arbitrary scan patterns at the object plane of the microscope 222 as well as for acquiring
  • the collimated beam passes through the
  • the collimated imaging beam is focused by an infinity-corrected
  • microscope objective 234 which is anti-reflection coated for the wavelength of the imaging beam.
  • the advantage of this implementation is the inconspicuous location of the forward-scanning
  • the second implementation shown in Figure 17 utilizes micro-galvanometer scanners
  • a beam splitter 14' designed to reflect the imaging and the aiming beams. If the
  • a negative lens 158 can be placed within the optical path of the microscope to correct for the
  • the advantage of this implementation is the ease of access for a wide variety of microscopes and the rapid installation prior to use. In both implementations, because the imaging wavelength is out of the visible spectrum, specially coated optics and objective lenses are required. These, however,
  • scanning is performed with depth priority. That is, the beam is positioned at one location via a two-dimensional scanning mechanism while the OCT engine varies the effective path length between the sample and reference arms of the interferometer in order to collect data in depth (z direction). The scanning mechanism then repositions the beam and another axial depth
  • Imaging can also be performed with transverse priority by keeping the axial position fixed during a single transverse scan and then stepping in depth as subsequent transverse
  • Rapid transverse scanning can readily be performed with galvanometers and mirrors.
  • the OCT imaging embodiment can be extended to include non- retroreflected imaging embodiments as described with respect to Figure 2.
  • the illumination could be scanned from above the sample and the detection light could be scanned as
  • the illumination pattern could be stationary and only the detection
  • a flexible endoscope (a type of laparoscope) can be use to image in non-vascular tissue and a flexible catheter or guidewire can be used for intravascular imaging.
  • the concept of forward-scanning can be extended to devices such as these designed to access remote sites that
  • catheter, or guidewire sheath are two imaging techniques which are used to provide both an en
  • sheath is designed for en face imaging and is performed through a sealed transparent tip 254 located at the distal end 254 of the device.
  • a fiber bundle and lens combination 258 is used both
  • this fiber bundle 258 is used to visualize where OCT imaging is being performed by observing where the visible scanning beam is located.
  • the second imaging technique contained within the sheath is designed for OCT or other
  • second sheath 262 Contained within an inner, second sheath 262 is a
  • a metal pin 270 is located at the distal end of the cable and is displaced from the center of the cable axis. This metal pin 270 inserts into a groove 274 at the base of a pivoting GRIN, ball, or small lens housing 280.
  • the GRIN lens 62 is located at the distal end of the housing 280, over the site where the housing pivots. In one embodiment a
  • single-mode fiber 58 runs parallel to the sheath 262 and cable 266 and inserts into the GRIN lens housing 280 where it is fixed to the GRIN lens 62 at a given distance.
  • the fiber 58 may run inside the speedometer cable with appropriate sheathing to protect it (not shown). The fiber/lens separation and the lens characteristics determine the beam focusing properties of the
  • endoscope, catheter, or guidewire can be varied as in focus varying techniques.
  • the endoscope, catheter, or guidewire can be varied as in focus varying techniques.
  • GRIN lens housing 280 is free to pivot about an axis located at the GRIN lens 62. As the cable 266 is rotated at the proximal end 256 of the endoscope 250, catheter, or guidewire, the rotation is translated to the distal end to drive the GRIN lens housing 280. The displaced, rotating pin 270
  • GRIN lens housing 280 to pivot back and forth.
  • the appropriately shaped elliptical grove will achieve a linear sweep of the
  • forward- scanning light Alternative groove designs may be circular and implement sinusoidal forward scanning of the emitted light from the endoscope.
  • the linear (transverse) scanning of the forward-directed light is preferred since the dwell time (and hence signal-to-noise) on each
  • transverse pixel is constant.
  • One method to achieve this is to have the cable 266 rotated at the proximal end 256 at a constant angular velocity.
  • the off-axis metal pin 270 from the perspective of the GRIN lens housing 280, is translated in one plane in a sinusoidal manner. To convert this
  • Multidimensional data sets can be acquired by rotating the entire endoscope 250, catheter, or guidewire within the lumen or cavity and collecting multiple pie-shaped cross-sections about a single central axis.
  • Forward-directed optical image data can be acquired without transverse displacement by
  • optical fiber 58 is located within the core of a metal guidewire or guidewire 284 made of other material.
  • the distal end of the fiber 58 has some means of focusing the light into the specimen either by a molded, integrated, fiber lens or an attached micro-GRIN lens (not shown).
  • Guidewires are used in nearly every catheter-based procedure to define the path of the catheter through the lumen. Often, the procedure is performed without visualizing via ultrasound
  • the single axial ranging data can provide information regarding the tissue type and structural morphology distal to the end of the guidewire and reduce the likelihood of forcing the guidewire through sensitive areas. Note that in addition to this design housing only one single-mode fiber, multiple
  • fibers bundled packed in a line or in two dimensions could be utilized to provide some imaging in
  • Each fiber could be connected to a separate imaging engine or scanned sequentially (using an optical switch or angular scanning optics) at the distal end.
  • outer diameters range from 1-3 mm for the flexible forward-scanning endoscope, catheter,
  • Forward-directed imaging using a flexible fiber bundle 288 is another embodiment of this invention and is shown in Figure 20.
  • the flexible bundle 288 is composed of a large number of
  • proximal 292 and distal 294 ends of the bundle are maintained which implies that a scan pattern at the proximal end 292 is accurately represented at the distal end 294 of the bundle.
  • a previous attempt to perform forward-directed imaging through a fiber bundle using low-coherence interferometry resulted in moderate to significant inter-fiber mode coupling which increased the
  • each individual fiber can be coated during the fiber manufacturing process.
  • forward-directed scanning can be performed in arbitrary
  • aperture lens 296 is used to focus the OCT imaging beam on to the proximal face 292 and to individually and sequentially address in time each fiber 58.
  • the propagating light is focused at the object plane, distal to the end of the bundle, by an integrated fiber lens (not shown). Fiber lenses integrated into each fiber eliminate the need for additional, larger focusing lenses at the distal end and eliminate the aberrations induced with this type of optical setup.
  • proximal end 292 accomplished at the proximal end 292 by placing either the microscope objective of the proximal end 292 of the bundle on a translation stage (not shown) that has sufficient resolution and precision to address each individual fiber 58 or by using a combination of angle scanning devices and lenses. Alternatively, a direct parallel detection of the image can be utilized.
  • the flexible-endoscope can be integrated to guide or autonomously control laser and other surgical devices.
  • a single or multi-mode optical fiber could be integrated into the center of the imaging bundle.
  • forward-directed imaging methods can be integrated with forward and radial-directed rotating blade/grinding
  • Figure 21ai shows the distal end 304 of a radial-directed rotating blade catheter 300 with additional imaging optics.
  • the catheter 300 used for this procedure is flexible and of small diameter ( ⁇ 3 mm).
  • the distal end 304 has a region of the outer sheath 308 removed to expose
  • axis of the catheter is a rotating shaft 316 which is used to rotate the blade 312 at the distal end 304.
  • the curved, rotating blades 312 also provide a mirror-like surface off of which the OCT imaging beam is reflected.
  • the area of the blade 312 where the imaging beam is incident can be physically isolated from the grinding region in applications where the
  • One or a pair of single-mode optical fibers 58 run along the length of the catheter
  • Each is attached to a focusing element 320 which focuses the beam at the object plane located outside of the catheter sheath 308 in the region to be removed by the rotating blades
  • the blades are machined at a precise
  • the imaging plane may not necessarily be
  • helical blades used simply for performing lateral imaging.
  • an imaging port 324 could be located within the rotating shaft 316.
  • the optical fiber 58 could run along or within the axis of the rotating shaft 316 and a
  • small beam director 328 e.g. GRIN lens attached to a small prism
  • the essential design feature is that the rotation used to drive the cutting blade is
  • the optical imaging port could be designed so as to allow automated or manual adjustment of the location of the beam director element along the axis
  • FIG. 21b A forward-directed rotating blade with forward-directed imaging is shown in Figure 21b.
  • the concepts are similar to those described above except here the distal face 304 of the catheter
  • Imaging is performed through the rotating blades 312 with the imaging plane located distal to the end 304 of the catheter 300. If the pitch of the rotating blades 312 is small, the duty cycle for imaging will be large. There will only be brief periods when imaging cannot be
  • the second method in Figure 21b. ii uses a single focusing element 320 and relies on the curvature or pitch of the blades 312 to reflect the imaging
  • this type of deflecting technique can be used solely for diagnostics.
  • an imaging port 324 could be located within the distal portion of the rotation shaft 316. As described in reference to Figure 8 and other
  • a small spinning beam director 328 can be used to sweep out a conical section in
  • Figure 2 lei shows another embodiment of a forward grinding catheter/endoscope 300.
  • an optically clear block 332 with an integral grinding surface is rotated.
  • OCT or other laser imaging system is used to image through the grinding element 332 and into
  • the grinder 332 is open to interface with the tissue. Alternate designs can convert the circular motion of the rotating shaft 316 to a gearing mechanism that rotates the clear grinding block 332
  • an optical beam director element could be
  • an internal or external optical imaging port can be extended to include a transverse grinder as well.
  • One of the central concepts of this aspect of the invention is the use of the mechanical motion of rotational or reciprocal cutting tools to also drive the optical imaging port which can be coupled physically with the cutting tool so that motion of the cutting tool is used to simultaneously perform scanning thereby maintaining registration of the cutting tool surface and
  • the catheter sheath or cylindrical enclosure consists of a distal
  • the connections between the integrated microchip 344 and the remaining instrumentation consists of only a few electrical wires 174 for control, input, and output of data. Located on the microchip 344 are the necessary micro-fabricated components for the light
  • Input to the microchip 344 include power, control for source output,
  • Output from the chip includes any feedback signals for control and the data
  • imaging can be implemented on a microchip, future reductions in micro-fabricated components will only lead to additional implementation in existing optical instruments or as autonomous imaging robots.
  • Phased arrays have the advantage that they contain no moving parts and thus can be scanned quickly. They rely on the precise relative optical phase of the emitted light from each array element which either constructively or destructively
  • This OEIC 352 contains one or a series of beam dividers (not shown) which
  • the OEIC 352 may be made of silica on silicon (Si ⁇ 2/Si), LiNbO3, InGaAsP, or other elements commonly used for creating optical waveguides and/or phase shifting elements.
  • Each of the N channels contains an electro-optic or thermo-optic phase
  • This phase shifter 356 may be on the same optical substrate as the beam divider
  • phase shifters 356 varying linear phase shift is implemented in between elements, the beam will be scanned off-axis as shown.
  • phased array Another embodiment (not shown) for the phased array is to utilize multiple (e.g. 100)
  • beam conditioning optics may be necessary to optimize
  • the performance of the array and to reduce the focal region of the array.
  • the focal region of the array For operation, the
  • proximal end of the device must include piezoelectric or mechanical fiber stretchers which vary
  • each fiber and/or rotate each fiber (and hence change the phase of the light) by several hundred microns, or enough to sufficiently vary the phase by 360°.
  • the imaging engine must perform all of these operations in parallel. We note that this approach to control the phase in individual fibers despite catheter bending and fiber stretching must be done precisely.
  • One embodiment of this invention is the concept of implantable or embeddable probes (or other devices) in living biological tissues or other structures/specimens such as a structural
  • the implanted fibers may consist of a single fiber or fiber bundles and they
  • transmitters may work in retro-reflection mode, transillumination mode, or any relative location of transmitters
  • the number of transmission fibers may be different from the number of receiver fibers.
  • the receiver processing unit can have a mechanical
  • multiple receivers may be used or the fibers may be wavelength or time division multiplexed.
  • Multiple fibers can have any orientation with respect to one another around the tissue of interest so as to optimize the detection of salient features necessary for diagnosis of disease state, structural
  • the interface between the OCT system and implanted probes may
  • the body for instance a small distance below the surface of the skin such that transcutaneous illumination is possible
  • outside the body for instance a small fiber optic
  • the implanted device can be used to monitor the effect of radiation
  • oriented around and/or within the tissue of interest can be used to detect structural and/or metabolic changes indicative of response or toxicity of the agent of interest.
  • the implanted device may be used to assess neural activity. Fiber(s) may be placed in
  • Neural activity may be monitored by either changes in nerve size, spectral properties
  • Solute In one embodiment, chemical concentrations (such as solute, gas, or metabolite concentrations) may be measured in organ parenchyma (such as the myocardium), lumen
  • support structures such as fascia
  • free space such as air
  • the implanted device may be used to assess regional or whole body vascular function.
  • Probes for example, may be placed in both external cerebral and lower extremity
  • the implantable device may be implanted within and/or in the general vicinity of the bone marrow for the purpose of monitoring the production of both normal and abnormal blood cells.
  • the implanted device may be placed in the organ of interest for the
  • phenotypic changes such as cell size, cell number, muscle strain/contraction, nuclear concentration, or cell surface maker concentration.
  • the device will be placed within or in the
  • Forward directed imaging can be performed with the source fiber or fibers proximal to the
  • tissue of interest and the receiving fiber/detector distal to the tissue of interest.
  • This is a special case of the concepts previously described with respect to Figure 2.
  • the procedure would be of particular use for assessing or surgically manipulating vessels, nerves, and lymph nodes.
  • the illumination beam and/or receiver aperture can be scanned with any of the previously described methods.
  • the receiving element can consist of a single fiber or detector (aperture scanned or not)
  • Forward, axial, or cross-sectional directed imaging can be performed during transurethral prostatectomy procedures such as: transurethral resection of the prostate (TURP), suprapubic
  • one or more fibers can be placed within, adjacent, or on the struts of
  • Fibers will extend to sites from the distal to proximal end of the blade.
  • a flush port may be included on the guide
  • Open Field Surgical Tools Forward directed backscattering or transillumination imaging can be used with instruments used in the surgical field including scissors, forceps, hemostats, and snares. Uses will include
  • the probes could be used for one-dimensional ranging and thus do not require scanning or could be of any of the scanning embodiments described previously.
  • Figure 25 shows some examples.
  • Figure 25a shows a simple hand held surgical probe 340
  • a fiber 57 runs down the center of the surgical probe 340 and contains the imaging and scanning optics 346 as a simple lens such as GRIN lens 62 (or no lens) at the distal end 344.
  • Figure 25b shows an
  • optical imaging and scanning module 346 is mounted near the hinge 352 and aligned so as to illuminate the region
  • Figure 25d shows an example where the optical imaging and scanning module 346 is used to illuminate the region near the end of a snare
  • the integration with the OCT or other optical imaging engine can include single or multiple
  • Forward-directed backscattering or transillumination imaging also can be used with
  • instruments used in laparoscopy/endoscopy including scissors, forceps, snares, or dissecting
  • the imaging and scanning optics be located within the long smooth body of the tool as
  • the devices can have a simple single
  • fiber 57 for performing longitudinal ranging and 1-D imaging can contain a fiber bundle (not
  • the integration with the OCT system can include single or multiple fibers.
  • punch biopsy tools typically consist of small (1-5 mm diameter) cylindrical blades 372 at the distal
  • fibers and beam focusing optics can be located within the cylindrical blade or, in the case of
  • excisional grippers pinchers (not shown), can be located at the pivot-point of the instrument
  • Tissue extraction or disruption (performed with rotating spurs, blades, or similar devices,
  • compression, heat, Shockwave, RF, toxin, or laser illumination can be guided with forward,
  • Single fibers or fiber bundles may be used to perform ranging or imaging as required. Tissue extraction or disruption may be performed in an antegrade or retrograde direction.
  • extraction or disruption can be performed in a cross-sectional direction or parallel to the
  • Tissue extraction or disruption may be guided with feedback from the OCT system, thereby changing, for example, regional blade speed or pressure or in the event
  • the devices can be individually controlled by separate OCT imaging engines.
  • Figure 25 a in side and end view provides an
  • imaging is accomplished using a fiber bundle 288 that is arranged in a series of one
  • each fiber can be coupled (not shown) to a small lens, an integral fiber up-taper, or a single lens group.
  • a small lens an integral fiber up-taper, or a single lens group.
  • fibers 57 can be scanned sequentially using a free space beam steering mirror and lenses, coupled
  • FIG. 28b Shown in Figure 28b is a radial/circular scanning embodiment similar to that previously described with respect to Figure 18c.
  • the output of fiber 57 is collinated using lens 152 and reflected off mirror 154 and adjustable fold mirror 158.
  • the radial distance or angle of fold mirror 158 can be

Abstract

L'invention concerne un système d'imagerie comprenant une tomographie à cohérence optique (OCT) dirigée vers l'avant, et une OCT par balayage vers l'avant non rétroréfléchissant. On peut également utiliser des techniques de télémétrie et d'image interférométriques et une image fluorescente, à effet Raman, à deux photons, et à ondes diffuses. Les mécanismes de balayage vers l'avant comprennent une came fixée à un moteur, des dispositifs pneumatiques, un dispositif pivotant, des transducteurs piézoélectriques, et des lames électrostatiques permettant un balayage essentiellement transversal; des prismes contrarotatifs et des lentilles décalées permettent un balayage arbitraire. Le système d'image de l'invention s'applique à des sondes manuelles y compris des sondes intégrées à des sondes chirurgicales, des scalpels, des ciseaux, des pinces et des instruments de biopsie. Les sondes manuelles comprennent des lasers à balayage vers l'avant. Le système d'image s'applique également à des laparoscopes et des endoscopes destinés à des interventions diagnostiques et thérapeutiques dans des orifices du corps, des canaux, des tubes, des conduits, des vaisseaux, et des cavités du corps.
PCT/US1998/004364 1997-03-06 1998-03-06 Instrument d'analyse a balayage optique de tissu vivant WO1998038907A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP98915128A EP0971626A1 (fr) 1997-03-06 1998-03-06 Instrument d'analyse a balayage optique de tissu vivant
JP53882698A JP2001515382A (ja) 1997-03-06 1998-03-06 生体組織の光学走査用機器

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US3804797P 1997-03-06 1997-03-06
US60/038,047 1997-03-06
US5416397P 1997-07-29 1997-07-29
US60/054,163 1997-07-29

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