Special ReviewClinical Imaging with Optical Coherence Tomography☆
Section snippets
System Design
The most common interferometer design used in OCT is a Michelson interferometer, which uses a single partially reflective beam splitter to illuminate both the reference arm and the sample. Light reflected from each arm is recombined in this same element, allowing very simple alignment. In terms of the reflectivity of the beam splitter, r, the maximum percentage of power transmitted from the source to the sample and back to the detector is r(1 − r). For a standard Michelson interferometer (r =
Intracoronary Imaging
Myocardial infarction is the major cause of death in industrialized countries. Rupture of vulnerable atherosclerotic plaques is currently recognized as an important mechanism for acute myocardial infarction, which often results in sudden death. Recent advances in cardiovascular research have identified anatomic, biomechanical, and molecular features of atherosclerotic plaques that predispose them to rupture. In most vulnerable plaques, these features include (a) activated macrophages at the
Upper Gastrointestinal Tract
Barrett esophagus is a benign metaplastic condition that is clinically important primarily because it is a precursor of adenocarcinoma of the esophagus and the esophagogastric junction. Approximately 80% of esophageal adenocarcinomas and 40% of esophagogastric junctional carcinomas are associated with Barrett esophagus (52, 53). The longitudinal extent of metaplastic epithelium is not relevant to the diagnosis of Barrett esophagus. In fact, it is well documented that patients with short
Biliary Tract
Endoscopic retrograde cholangiopancreatography with tissue sampling is the diagnostic test of choice in patients suspected of having malignant biliary obstruction. The reported sensitivity of biliary brush cytology, however, is highly variable, and there are only limited data on the accuracy of endoluminal forceps biopsy. The difficulty in obtaining sufficient tissue for diagnosis is a major limitation of both techniques. Evaluating strictures caused by cholangiocarcinoma can be especially
Conclusion
OCT has evolved from its conception in 1991 into an imaging modality with the potential to address a variety of clinical diagnostic problems. The advent of miniature, application-specific endoscopic or catheter imaging probes and high-speed imaging has allowed pilot studies to be performed in living patients. Results of the studies performed to date are encouraging, but the medical community awaits large-scale clinical trials to determine the efficacy of this technique in the diagnosis of
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Supported by the National Science Foundation, the National Institutes of Health, the Whitaker Foundation, CIMIT, and the Air Force Office of Scientific Research.