NonInvasive Optical Imaging of Vocal Cord Microstructure

声带微观结构的非侵入性光学成像

• 批准号: 6794966
• 负责人: Brian WONG
• 金额: $ 14.94万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6794966
• 关键词: basement membrane; bioimaging /biomedical imaging; biomedical equipment development; biopsy; clinical research; early diagnosis; histology; human subject; image guided surgery /therapy; laryngoscopy; larynx disorder; larynx neoplasms; noninvasive diagnosis; optical tomography; patient oriented research; respiratory disorder diagnosis; respiratory imaging /visualization; three dimensional imaging /topography; vocal cords

DESCRIPTION (provided by applicant): The diagnosis and management of many true vocal cord (TVC) lesions requires biopsy or excision which exposes the patient to the risks of general anesthesia, TVC injury, and potential iatrogenic glottic speech impairment. Unfortunately, many TVC lesions cannot be diagnosed without a biopsy, and this is particularly true with early TVC cancer, where chronic laryngitis is often clinically indistinguishable from malignancy. This application addresses this problem by developing a non-contact imaging device to provide high-resolution cross-sectional images of the TVC using Optical Coherence Tomography (OCT). OCT is an emerging imaging modality that uses low-coherence light to construct high-resolution (10-20 microns), cross-sectional images of tissue to depths of up to 3 mm. The specific aims of this study include: 1) design a high speed OCT instrument coupled to a surgical microscope; 2) obtain in vivo morphometric measurement of human TVC microstructure (e.g.; thickness of epithelium, Reinke's space, etc.); and 3) correlate in vivo OCT images with histology obtained from biopsies. This study will enroll approximately 125 adult patients undergoing laryngeal microendoscopy at UC Irvine Medical Center over two years. In over 60%, a tissue biopsy specimen will be available to allow correlation with conventional histology. Since many of these patients will have a biopsy to diagnose cancer, this study will also provide pilot information on the efficacy of OCT in diagnosing early TVC cancer, where the cardinal feature is invasion of the basement membrane. In addition to structural information on TVC microanatomy, the OCT device will provide functional images of specific tissue properties, including birefringence (collagen organization), using polarization-sensitive OCT, and microscopic blood flow, using Optical Doppler Tomography. We expect our instrument to: 1) image vocal cord microstructure including basement membrane integrity; 2) delineate the superficial and deep extent of both benign and malignant TVC neoplasms; and 3) facilitate real-time image guided microsurgery of the TVC, allowing more accurate tissue biopsies or surgery. Further, OCT imaging will provide a means of documenting the evolution of TVC pathology with 3-D images, thus complementing conventional endoscopy and stroboscopy. Application of OCT to microlaryngeal surgery may reduce iatrogenic phonatory disability by reducing trauma to delicate structures that accompanies conventional techniques.

描述（由申请人提供）：许多真实声带（TVC）病变的诊断和管理需要活检或切除，这使患者面临全身麻醉，TVC损伤和潜在的医生性造型性语音障碍的风险。不幸的是，在没有活检的情况下，无法诊断出许多TVC病变，而早期TVC癌症尤其如此，在早期的TVC癌症中，慢性喉炎通常在临床上与恶性肿瘤无法区分。该应用程序通过开发非接触式成像设备来解决此问题，以使用光学相干断层扫描（OCT）提供TVC的高分辨率横截面图像。 OCT是一种新兴的成像方式，使用低旋光灯来构建组织的高分辨率（10-20微米），组织的横截面图像至最大3毫米的深度。这项研究的具体目的包括：1）设计一种与手术显微镜相连的高速OCT仪器； 2）获得人类TVC微结构的体内形态测量（例如；上皮的厚度，Reinke的空间等）； 3）将体内OCT图像与从活检中获得的组织学相关。这项研究将在UC Irvine医疗中心进行喉部微观镜检查约125名成年患者。在60％以上，将可以使用组织活检标本以允许与常规组织学相关。由于这些患者中的许多患者将进行活检以诊断癌症，因此该研究还将提供有关OCT在诊断早期TVC癌症的疗效的试验信息，其中基本特征是对地下室膜的入侵。除了有关TVC微型解剖学的结构信息外，OCT设备还将使用对偏振敏感的OCT和微观血流提供特定组织特性的功能图像，包括双折射（胶原蛋白组织）。我们希望我们的仪器能够：1）图像声带微观结构，包括基底膜完整性； 2）描述良性和恶性TVC肿瘤的肤浅和深度； 3）促进了TVC的实时图像引导的显微外科手术，从而可以更准确的组织活检或手术。此外，OCT成像将提供一种用3-D图像记录TVC病理演变的方法，从而补充常规内窥镜检查和频镜检查。将OCT应用于微咽外科手术可以通过将创伤减少到伴随传统技术的精致结构来减少医源性语音障碍。