University of Surrey

Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic people

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Optical coherence tomography angiography (OCTA) is a non-invasive, high-resolution imaging modality with growing application in dermatology and microvascular assessment. Accepted reference values for OCTA-derived microvascular parameters in skin do not yet exist but need to be established to drive OCTA into the clinic. In this pilot study, we assess a range of OCTA microvascular metrics at rest and after post-occlusive reactive hyperaemia (PORH) in the hands and feet of 52 healthy people and 11 people with well-controlled type 2 diabetes mellitus (T2DM). We calculate each metric, measure test–retest repeatability, and evaluate correlation with demographic risk factors. Our study delivers extremity-specific, age-dependent reference values and coefficients of repeatability of nine microvascular metrics at baseline and at the maximum of PORH. Significant differences are not seen for age-dependent microvascular metrics in hand, but they are present for several metrics in the foot. Signi...

Pilot study of optical coherence tomography angiography-derived microvascular metrics in hands and feet of healthy and diabetic peopl

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Optical coherence tomography angiography (OCTA) is a non-invasive, high-resolution imaging modality with growing application in dermatology and microvascular assessment. Accepted reference values for OCTA-derived microvascular parameters in skin do not yet exist but need to be established to drive OCTA into the clinic. In this pilot study, we assess a range of OCTA microvascular metrics at rest and after post-occlusive reactive hyperaemia (PORH) in the hands and feet of 52 healthy people and 11 people with well-controlled type 2 diabetes mellitus (T2DM). We calculate each metric, measure test–retest repeatability, and evaluate correlation with demographic risk factors. Our study delivers extremity-specific, age-dependent reference values and coefficients of repeatability of nine microvascular metrics at baseline and at the maximum of PORH. Significant differences are not seen for age-dependent microvascular metrics in hand, but they are present for several metrics in the foot. Signi...

How to improve microendoscopes? New probe design brings promises to improve biomedical imaging

Microendoscopes are the cornerstone of modern medical diagnostics—they allow us to see what we could not even describe two decades ago. The technology is constantly improving, with ICTER scientists contributing to the development of the probes. Microendoscopes using fiber optics are becoming increasingly important imaging tools, but they have physical limitations. They are essential for applications that require a long working distance, high resolution, and a minimum probe diameter. A new research paper by Dr. Karol Karnowski of ICTER, Dr. Gavrielle Untracht of the Technical University of Denmark (DTU), Dr. Michael Hackmann of the University of Western Australia (UWA), Onur Cetinkaya of ICTER and Prof. David Sampson of the University of Surrey, sheds new light on modern microendoscopes. The research work started while the authors worked in the same research group at UWA. ( Read Full Article )

Superior Imaging Performance of All-Fiber, Two-Focusing-Element Microendoscopes

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All-fiber-optic imaging microendoscopes are emerging as an important tool in bioimaging studies, including those conducted with optical coherence tomography, but physical limitations constrain the achievable beam characteristics of designs using a single focusing element. These constraints are especially relevant for applications that require a long working distance, high resolution, and/or minimal probe diameter. Through detailed analysis based on ABCD matrix modelling, we show that side-viewing probes combining a graded-index (GRIN) fiber with a ball lens – GRIN-ball-lens probes (GBLPs) – offer superior performance over a range of numerical apertures and pave the way for a broader range of imaging applications. The performance of side-viewing GBLPs designed for 1300-nm optical coherence tomography imaging is compared against commonly used single-focusing-element all-fiber side-viewing probe designs, namely, ball-lens probes (BLPs) and GRIN-fiber probes (GFPs). All poss...

Cocoa flavanol consumption improves lower extremity endothelial function in healthy individuals and people with type 2 diabetes

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Background : diabetes and age are major risk factors for the development of lower extremity peripheral artery disease (PAD). Cocoa flavanol (CF) consumption is associated with lower risk for PAD and improves brachial artery (BA) endothelial function. Objectives : to assess if femoral artery (FA) endothelial function and dermal microcirculation are impaired in individuals with type 2 diabetes mellitus (T2DM) and evaluate the acute effect of CF consumption on FA endothelial function. Methods : in a randomised, controlled, double-blind, cross-over study, 22 individuals ( n = 11 healthy, n = 11 T2DM) without cardiovascular disease were recruited. Participants received either 1350 mg CF or placebo capsules on 2 separate days in random order. Endothelial function was measured as flow-mediated dilation (FMD) using ultrasound of the common FA and the BA before and 2 hours after interventions. The cutaneous microvasculature was assessed using optical coherence tomography angiography. Results...

Team uses open-source toolbox for harmonized analysis of clinical angiography images

Dr. Danuta Sampson, a visiting senior researcher at the University of Surrey, with her colleagues, has embraced open research principles to support the discovery of novel biomarkers aimed at reducing the mortality of vascular disease, the leading cause of death worldwide. Accurate assessment of the microvasculature (the smallest vessels in the human body) could identify biomarkers that lead to a decline in vascular disease mortality. Optical coherence tomography angiography (OCTA) is a non-invasive modality capable of imaging microvasculature in the human retina and in the skin. OCTA studies have been performed using many different lab-based and commercial clinical instruments, imaging protocols, data analysis methods, and metrics, often applied inconsistently and only partially reported, resulting in a confusing picture that represents a major barrier to progress in OCTA biomarker discovery. ( Read Full Article )

Correcting magnification error in foveal avascular zone area measurements of optical coherence tomography angiography images with estimated axial length

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Background: To generate and validate a method to estimate axial length estimated (AL est ) from spherical equivalent (SE) and corneal curvature [keratometry (K)], and to determine if this AL est can replace actual axial length (AL act ) for correcting transverse magnification error in optical coherence tomography angiography (OCTA) images using the Littmann-Bennett formula. Methods: Data from 1301 participants of the Raine Study Gen2-20 year follow-up were divided into two datasets to generate (n = 650) and validate (n = 651) a relationship between AL, SE, and K. The developed formula was then applied to a separate dataset of 46 participants with AL, SE, and K measurements and OCTA images to estimate and compare the performance of AL est against AL act in correcting transverse magnification error in OCTA images when measuring the foveal avascular zone area (FAZA). Results: The formula for AL est yielded the equation: AL est = 2.102K - 0.4125SE + 7.268, R 2 = 0.794. There was good ag...

Towards standardizing retinal optical coherence tomography angiography: a review

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The visualization and assessment of retinal microvasculature are important in the study, diagnosis, monitoring, and guidance of treatment of ocular and systemic diseases. With the introduction of optical coherence tomography angiography (OCTA), it has become possible to visualize the retinal microvasculature volumetrically and without a contrast agent. Many lab-based and commercial clinical instruments, imaging protocols and data analysis methods and metrics, have been applied, often inconsistently, resulting in a confusing picture that represents a major barrier to progress in applying OCTA to reduce the burden of disease. Open data and software sharing, and cross-comparison and pooling of data from different studies are rare. These inabilities have impeded building the large databases of annotated OCTA images of healthy and diseased retinas that are necessary to study and define characteristics of specific conditions. This paper addresses the steps needed to standardize OCTA imagi...

OCTAVA: An open-source toolbox for quantitative analysis of optical coherence tomography angiography images

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Optical coherence tomography angiography (OCTA) performs non-invasive visualization and characterization of microvasculature in research and clinical applications mainly in ophthalmology and dermatology. A wide variety of instruments, imaging protocols, processing methods and metrics have been used to describe the microvasculature, such that comparing different study outcomes is currently not feasible. With the goal of contributing to standardization of OCTA data analysis, we report a user-friendly, open-source toolbox, OCTAVA (OCTA Vascular Analyzer), to automate the pre-processing, segmentation, and quantitative analysis of en face OCTA maximum intensity projection images in a standardized workflow. We present each analysis step, including optimization of filtering and choice of segmentation algorithm, and definition of metrics. We perform quantitative analysis of OCTA images from different commercial and non-commercial instruments and samples and show OCTAVA can accurately and re...

Imaging the small with the small: Prospects for photonics in micro-endomicroscopy for minimally invasive cellular-resolution bioimaging

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Many bioimaging studies, including those in engineered tissue constructs, intravital microscopy in animal models, and medical imaging in humans, require cellular-resolution imaging of structures deep within a sample. Yet, many of the current approaches are limited in terms of resolution, but also in invasiveness, repeatable imaging of the same location, and accessible imaging depth. We coin the term micro-endomicroscope to describe the emerging class of small, cellular-resolution endoscopic imaging systems designed to image cells in situ while minimizing perturbation of the sample. In this Perspective, we motivate the need for further development of micro-endomicroscopes, highlighting applications that would greatly benefit, reviewing progress, and considering how photonics might contribute. We identify areas ripe for technological development, such as micro-scanners and small lens systems, that would advance micro-endomicroscope performance. With the right developments in photonics...

Detection of localized pulsatile motion in cutaneous microcirculation by speckle decorrelation optical coherence tomography angiography

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Significance: Pulsatility is a vital characteristic of the cardiovascular system. Characterization of the pulsatility pattern locally in the peripheral microvasculature is currently not readily available and would provide an additional source of information, which may prove important in understanding the pathophysiology of arterial stiffening, vascular ageing, and their linkage with cardiovascular disease development. Aim: We aim to confirm the suitability of speckle decorrelation optical coherence tomography angiography (OCTA) under various noncontact/contact scanning protocols for the visualization of pulsatility patterns in vessel-free tissue and in the microvasculature of peripheral human skin. Results: Results from five healthy subjects show distinct pulsatile patterns both in vessel-free tissue with either noncontact or contact imaging and in individual microvessels with contact imaging. Respectively, these patterns are likely caused by the pulsatile pressure and pulsatile blo...

Influence of tissue fixation on depth-resolved birefringence of oral cavity tissue samples

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Significance: To advance our understanding of the contrast observed when imaging with polarization-sensitive optical coherence tomography (PS-OCT) and its correlation with oral cancerous pathologies, a detailed comparison with histology provided via ex vivo fixed tissue is required. The effects of tissue fixation, however, on such polarization-based contrast have not yet been investigated. Aim: A study was performed to assess the impact of tissue fixation on depth-resolved (i.e., local) birefringence measured with PS-OCT. Approach: A PS-OCT system based on depth-encoded polarization multiplexing and polarization-diverse detection was used to measure the Jones matrix of a sample. A wide variety of ex vivo samples were measured freshly after excision and 24 h after fixation, consistent with standard pathology. Some samples were also measured 48 h after fixation. Results: The tissue fixation does not diminish the birefringence contrast. Statistically significant changes were observed i...

In vivo imaging of the depth-resolved optic axis of birefringence in human skin

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Recent progress has enabled the reconstruction of the local (i.e., depth-resolved) optic axis (OAx) of biological tissue from measurements made with polarization-sensitive optical coherence tomography (PS-OCT). Here we demonstrate local OAx imaging in healthy human skin in vivo . The images reveal dense, weaving patterns that are imperceptible in OCT intensity tomograms or conventional PS-OCT metrics and that suggest a mesh-like tissue organization, consistent with the morphology of dermal collagen. Using co-registered polarization-sensitive optical coherence microscopy, we furthermore investigated the impact of spatial resolution on the recovered OAx patterns and confirmed their consistency. OAx orientation as a contrast mechanism merits further exploration for applications in dermatology. ( Read Full Article )

Comparison of plaque distribution and wire-free functional assessment in patients with stable angina and non-ST elevation myocardial infarction: an optical coherence tomography and quantitative flow ratio study

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Background Data comparing plaque characteristics and wire-free physiological assessment in the target vessel in patients with stable angina versus acute coronary syndrome are sparse. Therefore, we investigated the difference in plaque distribution between stable angina and non-ST-elevation myocardial infarction (NSTEMI) and explored the relationship between target vessel vulnerability by optical coherence tomography (OCT) and wire-free functional assessment with quantitative flow ratio (QFR). Methods Patients with stable angina ( n  = 25) and NSTEMI ( n  = 24) were in the final prospective study cohort from the DECODE study (ClinicalTrials.gov, NCT02335086). All 5480 OCT frames in the region of interest were analyzed to study plaque morphology in the target vessel. QFR was analyzed from baseline coronary angiography before percutaneous coronary intervention. Vulnerable vessel score (VVS) was calculated from each plaque, and vessel QFR was then compared. R...

Change in Leadership at OBEL, The University of Western Australia

Even before I left the University of Kent in 1993, I had noticed how cool optical coherence tomography (OCT) was – and how similar it was to some of my own work on coherence multiplexing for communications. Kent was where I did my PhD, obtained my first faculty appointment, and hired my dear friend Adrian Podoleanu to work on telecoms – not OCT! Back in Australia in 1995, I arranged for Eric Swanson to speak at our national meeting – Australian Conference on Optical Fibre Technology – things were moving fast in OCT, but I was working…. still in telecoms. It wasn’t until starting my own group back at the University of Western Australia, that I could shift fields to biomedical optics and begin to pursue OCT. For the first few years, I had an office, then an office and a lab, then four honours students, then a PhD. Piece by piece, we all created a lab. I count the official start date as the arrival of my first postdoc, Andrei Zvyagin, in May 1998 &n...

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