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BIOS 2008 CONFERENCE : ADVANCED BIOMEDICAL AND CLINICAL DIAGNOSTIC SYSTEMS IV D. VU, M. MUJAT, T. USTUN, D. HAMMER, D. FERGUSON,  and N. IFTIMIA PHYSICAL SCIENCES, INC., ANDOVER, MA B. GOLDBERG, P. JILLELLA, and G. TEARNEY MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA Spectral-domain low coherence interferometry system for fine/core needle biopsy guidance
Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
About  F ine/Core  N eedle  A spiration  B iopsy ,[object Object],[object Object],[object Object]
Motivation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction to LCI Coherent Source Low-Coherence Source Mirror Displacement Detectod Singla Mirror Displacement Detector l c ~1/  Image courtesy of - J. De Boer, Wellman Center for Photomedicine  / 2
SDLCI Principle and its application in FNAB
Instrumentation Optical probes SD-LCI  integrated into FNAB probe SD-OCT probe
Instr u mentation Opto-electronic System ,[object Object],[object Object],[object Object],[object Object],[object Object],System Specs :  Light Source : 1300 nm Depth Resolution:  15 microns Imaging Range:  3 mm Camera Line Rate:  2k lines/sec
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],In Vitro Clinical Study
Data Processing Algorithm Intensity (a.u.) Depth (pixels)
Clustering of tissue types
Criteria for tissue differentiation
Results Intensity Map Tissue Differentiation Map Adipose Tissue A = 87%, F = 11.3%, T = 1.7% Full depth scale ~ 1mm
Results Intensity Map Tissue Differentiation Map Adipose Tissue A = 7.7%, F = 0%, T = 92.3% Full depth scale ~ 1mm
Results Intensity Map Tissue Differentiation Map Adipose Tissue A = 67.1%, F = 32.9%, T = 0% Full depth scale ~ 1mm
Animal study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Next steps ,[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]
Acknowledgement ,[object Object],[object Object]

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2008 SPIE Photonics West

  • 1. BIOS 2008 CONFERENCE : ADVANCED BIOMEDICAL AND CLINICAL DIAGNOSTIC SYSTEMS IV D. VU, M. MUJAT, T. USTUN, D. HAMMER, D. FERGUSON, and N. IFTIMIA PHYSICAL SCIENCES, INC., ANDOVER, MA B. GOLDBERG, P. JILLELLA, and G. TEARNEY MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA Spectral-domain low coherence interferometry system for fine/core needle biopsy guidance
  • 2.
  • 3.
  • 4.
  • 5. Introduction to LCI Coherent Source Low-Coherence Source Mirror Displacement Detectod Singla Mirror Displacement Detector l c ~1/  Image courtesy of - J. De Boer, Wellman Center for Photomedicine  / 2
  • 6. SDLCI Principle and its application in FNAB
  • 7. Instrumentation Optical probes SD-LCI integrated into FNAB probe SD-OCT probe
  • 8.
  • 9.
  • 10. Data Processing Algorithm Intensity (a.u.) Depth (pixels)
  • 12. Criteria for tissue differentiation
  • 13. Results Intensity Map Tissue Differentiation Map Adipose Tissue A = 87%, F = 11.3%, T = 1.7% Full depth scale ~ 1mm
  • 14. Results Intensity Map Tissue Differentiation Map Adipose Tissue A = 7.7%, F = 0%, T = 92.3% Full depth scale ~ 1mm
  • 15. Results Intensity Map Tissue Differentiation Map Adipose Tissue A = 67.1%, F = 32.9%, T = 0% Full depth scale ~ 1mm
  • 16.
  • 17.
  • 18.
  • 19.

Editor's Notes

  1. Hi, I am here today to talk to you about an optical technique that we believe has a potential to improve the outcome of needle biopsy in breast cancer diagnosis.
  2. And here is the outline of my talk. I will quickly go over the background, motivation, and how we applied LCI to breast tumor needle biopsy. I will briefly introduce our instrumentation and present some preliminary data from the first few clinical studies using our tissue differentiation algorithm.
  3. First let’s talk about how Needle Biopsy is done. As you can see in the photo, a needle is inserted into the breast where a lump is felt. The pathologist then tries to collect a sample from this lump by aspiration. This sample is then spread onto a slide for examination. This procedure is fast, cheap, and less traumatic for the patient. But (click)
  4. as you can imagine, it takes skills and practice in order to collect sample from the correct site to avoid false negative diagnosis. The lump can move around the needle because of the nature of the surrounding tissues in the beast. They’re mostly fat. Because of this the rate of false negative varies a lot from one pathologist to another. It also gets harder when the tumor is smaller. Therefore Ultra sound and CT scan are then brought in to help the pathologist see where he is going with the needle. But this addition equipment is time consuming, expensive, and requires additional trained staff. This is where we believe LCI implementation can be cheaper, less time consuming alternative. It can be integrated directly onto an existing biopsy probe. Not a lot of training will be needed since the instrument will come with a software to report exactly what type of tissue the biopsy probe is in contact with in real time.
  5. LCI is widely used in the medical optics community. It is interferometry method that allows us to collect depth-resolved data at high resolution. It is based on the concept Michelson interferometer where the light source is split into 2 paths by the beam splitter – one to the reference arm and the other to the sample arm, then the reflected light from the 2 paths are then joined and measured at the detector. When the 2 optical paths are equal, interference occurs. What is shown here are signal detected with 2 different types of light sources. A coherent light source will produce an interference signal over a large range of mirror displacements; whereas a low coherent source only produces a signal when the optical path lengths of the 2 arms match within the coherent length of the source - we are talking about microns in resolution. By scanning the mirror to different location, we are able collect signal at different depth of the sample and construct a depth reflectivity profile. With the advancement of fiber base optics, we are able to have the same apparatus that is more compact and portable. This allows us to bring the optical fiber at the sample arm into a needle as I will show you later. Over the year, the method of LCI has been greatly improved such as the implementation of Fourier Domain LCI including spectral domain and swept source. In these new processes, the moving part is removed to improve the speed of the system as well as noise. Our application uses Spectral Domain. (click)
  6. It is the same set up with the difference in a few parts. The scanning reference mirror is replaced by an adjustable mirror to coarsely match the reference and sample optical paths with each other. At the detection end, instead of a point detector as in the case of Time Domain shown previously, we have a spectrometer which spreads the signal into a spectrum. The Fourier transform of this 1 shot will give us the same reflective profile as in Time domain. As you can imagine, this method would greatly improve our data collection rate as well as noise. In order to construct a 2-D profiles which shows the reflectivity cross-section of a sample, we scan the sample arm across the sample. We call this our OCT probe. At the bottom of the slide are a few examples of the different relfectivity profiles of different tissue types – adipose, fibrous, and tumor. The inherent difference allows us to train our software to distinguish between them.
  7. Here’s what our instrument looks like. As I mentioned earlier, that our instrument can be directly integrated into an existing biopsy probe. A fiber is inserted into the needle, then adapters can be made to mate this needle into the syringe of the biopsy probe. With the tip of the fiber being at the very tip of the needle, we are able to detect exactly what the needle is touching. On the right, we have the OCT probe, which has optics and mechanical parts to scan a mirror across the sample so that depth reflectivity profiles can be collected at different location in the sample
  8. As you can see, the system is very compact. (click) There’s the 15” monitor, computer, and opto-electronics system. (click) The reference arm length can be adjusted from the front and optical fiber connection to the sample arm is also accessible from the front in order to switch back and forth between the FNA and OCT probes. (click) Here’s the inside of the Opto-electronics box. We built our own spectrometer as well as the optical delay line (reference) so they are in the end cheaper and capable of acquiring data at a faster rate than a commercial off the shelf. As you can see, the system is very compact. (click) There’s the 15” monitor, computer, and opto-electronics system. (click) The reference arm length can be adjusted from the front and optical fiber connection to the sample arm is also accessible from the front in order to switch back and forth between the FNA and OCT probes. (click) Here’s the inside of the Opto-electronics box. We built our own spectrometer as well as the optical delay line (reference) so they are in the end cheaper and capable of acquiring data at a faster rate than a commercial off the shelf.
  9. The purpose of our clinical study is to develop a library of different tissue types in order to develop an algorithm to distinguish them from each other. This algorithm training set so far included over 70 samples – normal and cancerous – from 7 patients. The algorithm is then validated by another set of samples. The data collection process is as follows. We use our LCI single profile probe to collect signal at a single point which gives us this reflectivity profile. Then we marked the same spot with ink. We take a few OCT scans over the same location to confirm where we were looking at because a 2-D image is easier to visualize than just a reflectivity profile. We then send the marked sample to a pathologist for a histology at the same location.
  10. Onto the data processing procedure. The purpose of this algorithm is to collect as much information as possible about these individual depth reflectivity profiles in order to differentiate the different tissue types.
  11. 1300nm to avoid the absorption of blood.
  12. 1. How does your optical design improve aberration and MTF (what is MTF?)? The optics is specially designed for our use- reduce cromatic and spherical aberations. The resolution and performance of an optical objective can be characterized by a quantity known as the modulation transfer function (MTF), which is a measurement of the microscope's ability to transfer contrast from the specimen to the intermediate image plane at a specific resolution. Computation of the modulation transfer function is a mechanism that is often utilized by optical manufacturers to incorporate resolution and contrast data into a single specification.       2. I should mention briefly about how the system is also cabaple of acquiring OCT data and include a photo of the probe? In your PPT, you did present the OCT data.         Yes- show a picture of the probe and mention that we did both OCT and point measurements with the needle probe to train and test our algorithm         3. So the advantage of the custom camera is the 1500 A-lines speed (you mean A-lines/sec, right?). There’s no off the shelf commercial camera out there that can acquire images that fast? or there is but too expensive? Besides the speed, is there any other advantages?        There are off the shelf cameras- but they are expensive (>20K), big, and therefore not suitable for a portable instrument. Also, ours includes galvo sincronization for frame sync.       4. In slide #14, what is the 3 rd plot?        Is the PS. However, those slides are orientative only. You will use the ones from Mircea.        5. Why do we always start off explaining the method of TD-LCI even though we don’t use TD anymore but SD. Is it because TD is easier to visualize with the moving ref mirror? And then you jump in to saying SD is now used because... and then you list the advantages (no moving part etc), but how exactly are we able to extract the depth profile from the spectrum using FFT? Should I go into detail of explaining the science behind it (like in the TD case): “Because of the idea of LCI, any signal that is not within the coherence length of the light source is rejected, and because different wavelength of the source travel in tissue at different speed (diffraction) --> constructive interference at each wavelength only occurs at a particular depth location in the tissue. From knowing the specs of our light source (the coherence length), we can calibrate the tissue depth resolution/size to pixel size in the detected spectrum.” Is that right?           People in audience might not be familiar with OCT. A short introduction will not hurt. Not much explanation.. there You will show latter the data processing algorithm.