This PDF file contains the front matter associated with SPIE Proceedings Volume 11214, including the Title Page, Copyright information, Table of Contents, Author and Conference Committee lists.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive form of interstitial lung disease (ILD). High-resolution CT (HRCT) is currently used to identify macroscopic IPF features. However, for 50% of patients, ultimate diagnosis relies on microscopic features from invasive, high-risk surgical biopsies (SLBX). We conducted a pilot study to assess endobronchial OCT (EB-OCT) for in vivo diagnosis of IPF, enrolling ILD patients with nondiagnostic HRCT undergoing SLBX. EB-OCT visualized salient IPF features, including microscopic features not visible on HRCT, and accurately diagnosed IPF and non-IPF ILD as compared with SLBX. EB-OCT has the potential for in vivo microscopic diagnosis of IPF.

The goal of bronchial thermoplasty (BT) is to reduce the symptoms associated with asthma by ablating the hyper-responsive airway smooth (ASM), but results have been mixed. In this work we present the results of a study in which we imaged canines before and after BT using polarization-sensitive optical coherence tomography (PS-OCT) in order to assess the potential of PS-OCT for use in conjunction with the BT procedure. By employing a novel processing technique we demonstrate PS-OCT results obtained at full system resolution, allowing us to accurately measure even vanishingly thin ASM distributions following the BT procedure.

We present a motorized distal scanning endoscope with an outer diameter of 1.35 mm and 52 fps rotation speed for in vivo imaging in the peripheral airways of lungs. Three lung segments of an asthma patient pre and post bronchial thermoplasty (BT) treatment were imaged. Optical coherence tomography (OCT) intensity images, attenuation coefficient (AC) images and polarization sensitive OCT (PS-OCT) images showing both birefringence, optic axis uniformity (OAxU) and optic axis (OA) orientation were extracted from the acquired data. PS-OCT endoscopy visualized airway smooth muscle layer thickness and location pre and post BT treatment as means to predict its effectiveness.

Despite the emerging market in energy-based devices to treat Genitourinary Syndrome of Menopause (GSM) in menopausal women, the exact effect of the laser on vaginal tissue remains poorly understood. We developed a point-of-care intravaginal endoscope that can obtain simultaneous information on structural and vascular information during the vaginal laser procedure. We evaluated the capability of assessing the treatment outcome by investigating patients receiving the CO2 fractional laser treatment. Our study supports the hypothesis that the treatment effect highly depends on the initial tissue parameters such as epithelium thickness and vascular density.

In this study, we demonstrate a 12x36 mm motorized capsule for OCT imaging of the esophagus. The capsule produces unobstructed images by using a distal reflector design, thus avoiding shadow caused by the motor wires. The motor synchronous control enables three working modes: circumferential imaging, angular sector imaging and accurate beam positioning. Distortion artifacts shown in the sector imaging were found to be induced by velocity changes of the motor. We specifically characterized the motor speed and found a symmetric and repeatable behavior during sector scanning. Resampling of the sector images A-lines was carried out to achieve uniform angular spacing according to the measured speed profile. Also, distortion between consecutive sector frames was corrected using image registration to achieve stable imaging.

Polarization-sensitive optical coherence tomography (PS-OCT) provides cross-sectional images of different polarization states, which can be utilized to obtain additional properties of biological tissue, such as birefringence. It has been demonstrated that collagen secreted by smooth muscle cells (SMC) is highly associated with the stability of atherosclerotic plaques; since both collagen and SMC are birefringent, endoscopic PS-OCT may provide a means to quantitatively analyze the risks and stability of atherosclerotic plaques. Here, we developed a compact spun-fiber-based PS-OCT to achieve robust imaging. In this work, the phase retardation map and OCT images of an ex vivo cadaver coronary artery are presented, and the birefringence of the collagen and SMC is identified.

Cervical cancer continues to be among the most frequently diagnosed and fatal cancers among women, ranking fourth in both categories globally in 2018. Detecting and treating early signs of cervical cancer drastically improves patient survivability. We will present images of the inner endocervical canal and the ectocervix taken by a fiber-based imaging system capable of co-registered Optical Coherence Tomography (OCT) and Autofluorescence Imaging (AFI). The rotary-pullback double clad fiber (DCF) imaging catheter captures 3D volumetric OCT scans and 2D AFI surface maps from within the endocervix. Images are obtained from patients undergoing colposcopy-guided biopsies or Loop Electrosurgical Excision Procedure (LEEP).

Polarization sensitive imaging can reveal the arrangement of tissue constituents without the need for resolving power necessary to directly visualize them. Several clinical applications for diseases in the pulmonary tract and the coronary artery can benefit from such capability. Unfortunately, robust and reliable endoscopic polarimetry is plagued by the unpredictability of the polarization state of light delivered to and collected from tissue through fiber optic catheters. We propose a nano-optic endoscope that uses polarization-sensitive metalenses to deliver and collection light of known polarization states to and from tissue, enabling measurement of tissue retardation and optic axis unambiguously.

A miniature endomicroscope is presented that combines a large field-of-view (up to 1.7 mm) for OCT-imaging and a high-resolution mode with 360 μm field-of-view (NA = 0.5) for multi-photon fluorescence or OCT imaging. The 4.7x magnification variation is achieved by the axial positioning of an inner micro-optical lens group using an integrated electro-magnetic z-actuator. A reverse fiber-optic piezotube-scanner with minimized length is employed for the image acquisition by resonant spiral scanning. With the probe diameter of 2.7 mm and a rigid length of about 60 mm, the approach may pave the way to clinical applications of these two modalities in a single probe.

Multimodal multiphoton microscopy (MPM) can provide fast, label-free, non-invasive examination of cells, extracellular matrix, and lipids. Two-photon microscopy (2PM) can detect second harmonic generation (SHG) from fibrillar collagen and striated muscle myosin, whereas two-photon excitation fluorescence (2PEF) can detect intrinsic fluorophores such as NADH from cells. Meanwhile, three-photon microscopy (3PM) can detect third harmonic generation (THG) from lipids and tissue interfaces. We have developed a miniaturized multimodal multiphoton system which can perform label-free two-photon and three-photon imaging. An Er-doped fiber laser delivers fundamental pulses at 1580 nm and 80 fs for exciting THG. SHG and 2PEF are excited at 790 nm via the frequency doubling of 1580 nm pulses. For clinical applications, a compact probe is being developed with single-mode fiber for delivering the femtosecond excitation pulses and multi-mode fiber for collecting the MPM signals. A MEMS mirror performs lateral scanning at up to 4 frames/s. For objective lenses, a miniature aspherical lens (NA=0.64) is compared with a gradient index microobjective (NA=0.8). Shape memory alloy actuator used in smartphone cameras is evaluated for shifting the focal plane to acquire Z-stacks for 3D tissue imaging. High-resolution SHG, 2PEF, and THG images are acquired from biological tissues and show that multimodal MPM endomicroscopy has great potential for clinical applications as an alternative to histology.

Esophageal cancer is less predictive than other diseases, and patients are usually diagnosed at an advanced stage, so effective treatment is usually too late. Therefore, this experiment proves that AI detects esophageal cancer. The diagnostic ability of the number of phases is expected to assist doctors in using endoscopy plus artificial intelligence to increase the accuracy of diagnosis of esophageal cancer.

This study provided 936 images of esophageal cancer endoscopy as a training image, including 498 white light endoscopes (WLI) and 438 narrow-band imaging endoscopes (NBI) images. According to the esophageal cancerization process, it is divided into four types: metaplasia (Dysplasia), metaplasia and esophageal cancer (Dysplasia-ECA), and esophageal cancer (ECA). A Single Shot Multibox Detector (SSD) was constructed by Convolutional Neural Network (CNN), and 264 test images were prepared to evaluate the accuracy of the model diagnosis.

We developed a system called DNN-CAD to identify neoplastic or hyperplastic colorectal polyps less than 5 mm. The system classified polyps with a PPV of 89.6%, and a NPV of 91.5%, and in a shorter time than endoscopists. This deep-learning model has potential for not only endoscopic image recognition but for other forms of medical image analysis, including sonography, computed tomography, and magnetic resonance images.

The construction of an SSD system for detecting esophageal cancer can analyze stored endoscopic images with high sensitivity in a short time, but more training can improve the accuracy of diagnosis. The system can facilitate early detection in practice and thus have a better diagnosis in the future.