Histopathologic analysis of biopsy specimens obtained via white light endoscopy (WLE) is the gold standard for the diagnosis of several mucosal diseases in the upper gastrointestinal (GI) tract. However, this standard of care entails a series of critical shortcomings such as missing depth information, high costs, time inefficiency, low-resolution imaging in vivo, high sampling variability, missing intrinsic tissue-specific contrast, and anesthesia related risk. In the quest for a diagnostic technology to replace the current standard of care, in vivo optical endomicroscopy has emerged as a promising alternative. This paper tells the story of a cluster of optical microscopy-based modalities invented, further developed, or first-validated in the laboratory of Dr. Guillermo J. Tearney (Tearney Lab) at the Wellman Center for Photomedicine of Massachusetts General Hospital over the past two decades, that combined lead to a novel method for diagnosis of eosinophilic esophagitis (EoE). Rather than being a comprehensive literature review, this paper aims to describe the translational journey towards a disease specific diagnostic and research tool for this increasingly recognized yet poorly understood immune-mediated disorder of the esophagus.

/pdf/in-vivo-optical-endomicroscopy-two-decades-of-translational-3c0m4422nf.pdf

In vivo optical endomicroscopy: two decades of translational research towards next generation diagnosis of eosinophilic esophagitis

In the imaging of airway tissue, optical coherence tomography (OCT) provides cross-sectional images of tissue structures, shows cilia movement and mucus secretion, but does not provide sufficient contrast to differentiate individual cells. By using fast sequences of microscopic resolution OCT (mOCT) images, OCT can use small signal fluctuations to overcome lack in contrast and speckle noise. In this way, OCT visualizes airway morphology on a cellular level and allows the tracking of the dynamic behavior of immune cells, as well as mucus transport and secretion. Here, we demonstrate that mOCT, by using temporal tissue fluctuation as contrast (dynamic mOCT), provides the possibility to study physiological and pathological tissue processes in vivo.

Dynamic microscopic optical coherence tomography to visualize the morphological and functional micro-anatomy of the airways.

Tu2047 – A Transnasal Imaging Tube for Unsedated Oct Imaging of the Upper Gastrointestinal Tract

Micro-optical coherence tomography ({micro}OCT) improves the spatial resolution of in vivo OCT imaging by utilizing sophisticated focusing schemes and broadband illumination. This study explores the safety of coronary and trachea tissue exposure to {micro}OCT illumination. (C) 2021 The Authors

https://biorxiv.org/content/10.1101/2021.08.12.455289v1.full.pdf

Safety Assessment of Broadband Laser Exposure in μOCT

Lum015, a translatable molecular imaging agent, enables oct-nirf imaging of inflammatory protease activity in preclinical and human atherosclerosis

We report the use of our multimodal near-infrared fluorescence (NIRF) and OCT imaging system and catheter to perform the first imaging of LUM015 inflammatory activity in rabbit models of atherosclerosis in vivo. Using co-injection and multi-channel intravascular NIRF-OCT, we compared LUM015 (6.2 mg/kg) and preclinical ProSense (VM110, 3.5 mg/kg) fluorescence in the same subject. We found that co-registered fluorescence carpet maps were remarkably similar with a PCC of 0.51 and a Mander’s overlap coefficient of 0.79. Results suggest that LUM015 will be a viable clinical option for intracoronary imaging of plaque inflammatory activity in patients. 

Intravascular dual-modality optical coherence tomography and multichannel near-infrared fluorescence inflammation imaging with the cathepsin-activatable LUM015 imaging agent

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Tu2047 – A Transnasal Imaging Tube for Unsedated Oct Imaging of the Upper Gastrointestinal Tract

Safety Assessment of Broadband Laser Exposure in μOCT

Lum015, a translatable molecular imaging agent, enables oct-nirf imaging of inflammatory protease activity in preclinical and human atherosclerosis

Intravascular dual-modality optical coherence tomography and multichannel near-infrared fluorescence inflammation imaging with the cathepsin-activatable LUM015 imaging agent