NonInvasive Optical Imaging of Vocal Cord Microstructure

Summary

Principal Investigator: BRIAN contact WONG
Affiliation: University of California
Country: USA
Abstract: 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.
Funding Period: 2003-09-01 - 2006-08-31
more information: NIH RePORT

Top Publications

  1. ncbi Low-voltage polymer-based scanning cantilever for in vivo optical coherence tomography
    Yuli Wang
    Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, California 92697, USA
    Opt Lett 30:53-5. 2005
  2. ncbi Laryngeal epithelial thickness: a comparison between optical coherence tomography and histology
    M L Kaiser
    Department of Surgery, University of California Irvine, Orange, CA 92612, USA
    Clin Otolaryngol 34:460-6. 2009
  3. ncbi Gradient-index lens rod based probe for office-based optical coherence tomography of the human larynx
    Shuguang Guo
    University of California, Irvine, Department of Biomedical Engineering, Irvine, California 92697, USA
    J Biomed Opt 14:014017. 2009
  4. ncbi Optical coherence tomography-enhanced microlaryngoscopy: preliminary report of a noncontact optical coherence tomography system integrated with a surgical microscope
    David E Vokes
    Department of Otolaryngology Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California, USA
    Ann Otol Rhinol Laryngol 117:538-47. 2008
  5. ncbi Optical coherence tomography of the newborn airway
    James M Ridgway
    Department of Otolaryngology Head and Neck Surgery, University of California Irvine, Irvine, California, USA
    Ann Otol Rhinol Laryngol 117:327-34. 2008
  6. ncbi Optical coherence tomography of the cochlea in the porcine model
    Ali Sepehr
    Beckman Laser Institute and Medical Clinic, University of California Irvine, USA
    Laryngoscope 118:1449-51. 2008
  7. ncbi Optical coherence tomography of the larynx in the awake patient
    Ali Sepehr
    Department of Otolaryngology Head and Neck Surgery, University of California, Irvine, CA, USA
    Otolaryngol Head Neck Surg 138:425-9. 2008
  8. ncbi In vivo optical coherence tomography of the human oral cavity and oropharynx
    James M Ridgway
    Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, USA
    Arch Otolaryngol Head Neck Surg 132:1074-81. 2006
  9. ncbi Optical coherence tomography of laryngeal cancer
    William B Armstrong
    Department of Otolaryngology Head and Neck Surgery, University of California Irvine, Orange, California 92868, USA
    Laryngoscope 116:1107-13. 2006
  10. ncbi Office-based optical coherence tomographic imaging of human vocal cords
    Shuguang Guo
    University of California, Irvine, Department of Biomedical Engineering and Beckman Laser Institute, 92697, USA
    J Biomed Opt 11:30501. 2006

Scientific Experts

  • William B Armstrong
  • BRIAN contact WONG
  • Lingfeng Yu
  • Shuguang Guo
  • Zhongping Chen
  • Ali Sepehr
  • James M Ridgway
  • Jianping Su
  • Jorge Perez
  • Usama Mahmood
  • M L Kaiser
  • David E Vokes
  • Ryan Jackson
  • Ryan P Jackson
  • Behrooz A Torkian
  • Terry Shibuya
  • Yuli Wang
  • D E Vokes
  • M Gu
  • Z Chen
  • S Guo
  • David Vokes
  • J M Ridgway
  • M Rubinstein
  • R L Crumley
  • Ryan Wright
  • Janice E Chang
  • Jack H Sills
  • David C Kim
  • Zhonping Chen
  • Jorge A Perez
  • Hamid R Djalilian
  • Gurpreet Ahuja
  • Roberto Barretto
  • Elizabeth Orwin
  • James Ridgway
  • Richard Haskell
  • Roger L Crumley
  • Anu Kohli
  • Roger Crumley
  • Lih-Huei L Liaw
  • River Hutchison
  • Tristan Sharp
  • Alexander W Jahng
  • Mai Gu
  • Guann-Pyng Li
  • Mark Bachman

Detail Information

Publications14

  1. ncbi Low-voltage polymer-based scanning cantilever for in vivo optical coherence tomography
    Yuli Wang
    Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, California 92697, USA
    Opt Lett 30:53-5. 2005
    ..Low driving voltage ensures safety. Two different optical designs achieve both forward and sidewise scanning and make it possible to image everywhere within the human oral cavity. In vivo OCT imaging of the human tongue is demonstrated...
  2. ncbi Laryngeal epithelial thickness: a comparison between optical coherence tomography and histology
    M L Kaiser
    Department of Surgery, University of California Irvine, Orange, CA 92612, USA
    Clin Otolaryngol 34:460-6. 2009
    ..The purpose of our study is to measure normal laryngeal epithelial thickness by in vivo optical coherence tomography, and compare these values to those obtained from fixed ex-vivo laryngectomy specimens...
  3. ncbi Gradient-index lens rod based probe for office-based optical coherence tomography of the human larynx
    Shuguang Guo
    University of California, Irvine, Department of Biomedical Engineering, Irvine, California 92697, USA
    J Biomed Opt 14:014017. 2009
    ..In-vivo OCT imaging of the human larynx is demonstrated. Office-based OCT is a promising imaging modality for early laryngeal cancer diagnosis...
  4. ncbi Optical coherence tomography-enhanced microlaryngoscopy: preliminary report of a noncontact optical coherence tomography system integrated with a surgical microscope
    David E Vokes
    Department of Otolaryngology Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California, USA
    Ann Otol Rhinol Laryngol 117:538-47. 2008
    ..This aim of this study was to develop and evaluate a novel OCT system integrated with a surgical microscope to allow hands-free OCT imaging of the VFs, which could be performed simultaneously with microscopic visualization...
  5. ncbi Optical coherence tomography of the newborn airway
    James M Ridgway
    Department of Otolaryngology Head and Neck Surgery, University of California Irvine, Irvine, California, USA
    Ann Otol Rhinol Laryngol 117:327-34. 2008
    ..We examined the ability of this noninvasive technique to characterize the newborn airway in a prospective clinical trial...
  6. ncbi Optical coherence tomography of the cochlea in the porcine model
    Ali Sepehr
    Beckman Laser Institute and Medical Clinic, University of California Irvine, USA
    Laryngoscope 118:1449-51. 2008
    ..To demonstrate the feasibility of optical coherence tomography in microstructural imaging of the porcine cochlea...
  7. ncbi Optical coherence tomography of the larynx in the awake patient
    Ali Sepehr
    Department of Otolaryngology Head and Neck Surgery, University of California, Irvine, CA, USA
    Otolaryngol Head Neck Surg 138:425-9. 2008
    ..To demonstrate the feasibility of performing optical coherence tomography of the human larynx on the awake patient with a novel flexible fiberoptic delivery system...
  8. ncbi In vivo optical coherence tomography of the human oral cavity and oropharynx
    James M Ridgway
    Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, USA
    Arch Otolaryngol Head Neck Surg 132:1074-81. 2006
    ..This study provides a composite series of in vivo OCT images of the oral cavity and oropharynx in a variety of normal regions and pathologic states as well as outline future applications of OCT technology...
  9. ncbi Optical coherence tomography of laryngeal cancer
    William B Armstrong
    Department of Otolaryngology Head and Neck Surgery, University of California Irvine, Orange, California 92868, USA
    Laryngoscope 116:1107-13. 2006
    ..This prospective study evaluated the ability of OCT to identify the characteristics of laryngeal cancer and measure changes in the basement membrane, tissue microstructure, and the transition zone at the edge of tumors...
  10. ncbi Office-based optical coherence tomographic imaging of human vocal cords
    Shuguang Guo
    University of California, Irvine, Department of Biomedical Engineering and Beckman Laser Institute, 92697, USA
    J Biomed Opt 11:30501. 2006
    ..Office-based OCT has the potential to guide surgical biopsies, direct therapy, and monitor disease. This is a promising imaging modality to study the larynx...
  11. ncbi In vivo optical coherence tomography of the nasal mucosa
    Usama Mahmood
    Department of Biomedical Engineering and Otolaryngology-Head and Neck Surgery, Beckman Laser Institute, University of California at Irvine, Irvine, California 92612, USA
    Am J Rhinol 20:155-9. 2006
    ..As an in vivo tissue microstructural imaging modality, OCT may be valuable in studying the impact of allergic and infectious disease on the nasal mucosa and monitoring its response to pharmacologic therapy...
  12. ncbi Noninvasive measurement of ablation crater size and thermal injury after CO2 laser in the vocal cord with optical coherence tomography
    Behrooz A Torkian
    Department of Otolaryngology-Head and Neck Surgery, Beckman Laser Institute, University of California-Irvine, 1002 Health Sciences Road, Irvine, CA 92612, USA
    Otolaryngol Head Neck Surg 134:86-91. 2006
    ..OCT may be a useful diagnostic and monitoring tool in an otolaryngology practice...
  13. ncbi In vivo optical coherence tomography of the human larynx: normative and benign pathology in 82 patients
    Brian J F Wong
    Department of Otolaryngology Head and Neck Surgery, University of California Irvine, Orange, California, USA
    Laryngoscope 115:1904-11. 2005
    ..Patients undergoing surgical head and neck endoscopy were examined using a fiberoptic OCT imaging probe to study and characterize microstructural anatomy and features of the larynx and benign laryngeal pathology in vivo...
  14. ncbi Office-based dynamic imaging of vocal cords in awake patients with swept-source optical coherence tomography
    Lingfeng Yu
    University of California, Irvine, Department of Biomedical Engineering, Irvine, California 92697, USA
    J Biomed Opt 14:064020. 2009
    ..Office-based OCT is a promising imaging modality to study the larynx for physicians in otolaryngology...