Microvascular networks of human basal cell carcinomas (BCC) and surrounding skin were assessed with optical coherence angiography (OCA) in conjunction with photodynamic therapy (PDT). OCA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3–12 months post-treatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success.

Photodynamic therapy (PDT) is emerging as a common and efficacious method for basal cell carcinoma (BCC) treatment, and new non-invasive imaging technologies can further enhance it. Optical coherence angiography (OCA) was employed in this study. OCA is a non-invasive, label-free, real-time bioimaging method that has proven to be a helpful tool for visualizing normal and pathological vasculature, including vascular damage evaluation after using a vasculature-targeted therapy for predicting its success. In experimental study, it was shown that both the tumor and peri-tumorous vessels stasis (disappearance in OCA images) in 24 hours post treatment play significant roles in PDT success. On controllable mouse ear tumor model the following practical and robust OCA-based criterion of PDT success was formulated: there should be no visibly perfused vessels on OCA images inside the tumor borders, whereas in the 2 mm near-tumor proximity regions the vascular density should not exceed 1% from OCA image area in 24 hours post PDT. The criterion obtained on the experimental model was translated to clinical study. OCA monitoring of basal cell carcinoma reaction to PDT has shown that dramatic decrease in the vascular density in the tumor in 24 hours post PDT can predict tumor non-recurrence with high diagnostic accuracy for 12 months follow-up. The strong reaction of peri-tumorous vessels in 24 hours post PDT is associated with hypertrophic scar formation in 3-6 months, but the weak reaction of peri-tumorous vascular reaction leads to normotrophic scar formation.

Prediction of tumour treatment response may play a crucial role in therapy selection and optimization of its delivery parameters. Here we use optical coherence angiography (OCA) as a minimally-invasive, label-free, real-time bioimaging method to visualize normal and pathological perfused vessels and monitor treatment response following vascular-targeted photodynamic therapy (PDT). Preclinical results are reported in a convenient experimental model (CT-26 colon tumour inoculated in murine ear), enabling controlled PDT and post-treatment OCA monitoring. To accurately predict long-term treatment outcome, a robust and simple microvascular metric is proposed. It is based on perfused vessels density (PVD) at t = 24 hours post PDT, calculated for both tumour and peri-tumour regions. Histological validation in the examined experimental cohort (n = 31 animals) enabled further insight into the excellent predictive power of the derived early-response OCA microvascular metric. The results underscore the key role of peri-tumour microvasculature in determining the long-term PDT response.

The main purpose of this work is to evaluate the possibility to distinguish in vivo benign papilloma, severe dysplasia and squamous cell carcinoma by establishing quantitative image characteristics of multiphoton tomography (MPT) and multimodal optical coherence tomography images (MM OCT). Specific features of papillomatous outgrowths at different stages were revealed using 7,12-dimethylbenz[a]anthracen (DMBA)-induced hamster oral carcinoma. Analysis of MPT images included assessment of nuclear-cytoplasmic (NC) ratio, nuclear density and heterogeneity parameter F. Cross-polarization OCT images were quantified via the integral depolarization factor (IDF). Analysis of OCT microvascular maps enabled differential analysis based on the number of smallest-diameter blood vessels present in a particular pathology. Both MPT and MM OCT metrics showed some difference between benign papilloma, dysplastic papilloma, and squamous cell carcinoma tissue states. The results suggested that combined use of MPT and MM OCT have great potential for in vivo differentiation between benign and malignant papillomas.

Photodynamic therapy (PDT) is a promising modern approach for cancer therapy with low normal tissue toxicity. This study was focused on a vascular-targeting Chlorine E6 mediated PDT. A new angiographic imaging approach known as M-mode-like optical coherence angiography (MML-OCA) was able to sensitively detect PDT-induced microvascular alterations in the mouse ear tumour model CT26. Histological analysis showed that the main mechanisms of vascular PDT was thrombosis of blood vessels and hemorrhage, which agrees with angiographic imaging by MML-OCA. Relationship between MML-OCA-detected early microvascular damage post PDT (within 24 hours) and tumour regression/regrowth was confirmed by histology. The advantages of MML-OCA such as direct image acquisition, fast processing, robust and affordable system opto-electronics, and label-free high contrast 3D visualization of the microvasculature suggest attractive possibilities of this method in practical clinical monitoring of cancer therapies with microvascular involvement.

A novel machine‐learning method to distinguish between tumor and normal tissue in optical coherence tomography (OCT) has been developed. Pre‐clinical murine ear model implanted with mouse colon carcinoma CT‐26 was used. Structural‐image‐based feature sets were defined for each pixel and machine learning classifiers were trained using “ground truth” OCT images manually segmented by comparison with histology. The accuracy of the OCT tumor segmentation method was then quantified by comparing with fluorescence imaging of tumors expressing genetically encoded fluorescent protein KillerRed that clearly delineates tumor borders. Because the resultant 3D tumor/normal structural maps are inherently co‐registered with OCT derived maps of tissue microvasculature, the latter can be color coded as belonging to either tumor or normal tissue. Applications to radiomics‐based multimodal OCT analysis are envisioned.

Mucositis is the limiting toxicity of radio(chemo)therapy of head and neck cancer. Diagnostics, prophylaxis and correction of this condition demand new accurate and objective approaches. Here we report on an in vivo longitudinal monitoring of the oral mucosa dynamics in 25 patients during the course of radiotherapy of oropharyngeal and nasopharyngeal cancer using multifunctional optical coherence tomography (OCT). A spectral domain OCT system with a specially-designed oral imaging probe was used. Microvasculature visualization was based on temporal speckle variations of the full complex signal evaluated by high-pass filtering of 3D data along the slow scan axis. Angiographic image quantification demonstrated an increase of the vascular density and total length of capillary-like-vessels before visual signs or clinical symptoms of mucositis occur. Especially significant microvascular changes compared to their initial levels occurred when grade two and three mucositis developed. Further, microvascular reaction was seen to be dose-level dependent. OCT monitoring in radiotherapy offers a non-invasive, convenient, label-free quantifiable structural and functional volumetric imaging method suitable for longitudinal human patient studies, furnishing fundamental radiobiological insights and potentially providing useful feedback data to enable adaptive radiotherapy (ART).

In this study we demonstrate the capability of cross-polarization optical coherence tomography (CP OCT) to assess collagen and elastin fibers condition in atherosclerotic plaques basing on ratio of the OCT signal levels in cross- and со- polarizations. We consider the depolarization factor (DF) and the effective birefringence (Δn) as quantitative characteristics of CP OCT images. We revealed that calculation of both DF and Δn in the region of interest (fibrous cap) yields a statistically significant difference between stable and unstable plaques (0.46±0.21 vs 0.09±0.04 for IDF; (4.7±1.0)•10–4 vs (2.5±0.7)•10–4 for Δn; p<0.05). In parallel with CP OCT we used the nonlinear microscopy for analysis of thin cross-section of atherosclerotic plaque, revealing the different average isotropy index of collagen and elastin fibers for stable and unstable plaques (0.30 ± 0.10 vs 0.70 ± 0.08; р<0.001). The proposed approach for quantitative assessment of CP OCT images allows cross-scattering and birefringence characterization of stable and unstable atherosclerotic plaques.

The aim of this study was to use microchannels drilled by an Er:YAG laser into a human tooth through the enamel into the dentin for direct injection of hydrogen peroxide (HP) to produce a minimally invasive, rapid, tooth bleaching effect. The experiments were conducted in vitro. Five microchannels with a diameter of similar to 200 mu m and a depth of similar to 2 mm were drilled through the palatal side of a human tooth crown using the microbeam of an Er:YAG-laser with a wavelength of 2.94 mu m. After injection of an aqueous solution of 31%-HP through the microchannels, the tooth color was evaluated using a VITA shade guide and International Commission on Illumination L * ab color parameters. A tooth model used for the evaluation of the distribution of HP concentration was created and the amount of HP which can be injected into tooth dentin to bleach it safely was estimated. Injection of 1.5 +/- 0.1 mm(3) of 31%-HP into the tooth led to noticeable bleaching within 3 h and significant improvement of tooth color within 24 h. (C) 2016 Society of Photo-Optical Instrumentation Engineers (SPIE)

For skin defect treatment and rejuvenation the ablative laser skin resurfacing with a CO2 laser is widely applied in cosmetology and dermatology. However this treatment can result in the risk of undesirable side effects and requires a long-term recovery after the procedure. When non-ablative laser skin rejuvenation is used as an alternative, the level of safety is increased, however the efficacy of the procedure is considerably reduced.The use of fractional laser photothermolysis is a particularly important step in the development of laser technology for cosmetology and dermatology. Due to the creation of only microscopic areas of thermal damage under the laser exposure, this method results in safe, quick healing and complete recovery of the skin without any undesirable side effects. The review presented here illustrate the high efficacy of the application of both ablative and non-ablative fractional laser photothermolysis for wrinkles reduction, for general improvement of the skin appearance, for the abnormal pigmentation treatment, and the removal or appearance improvement of atrophic scars from acne as well as in areas of skin stretching (striae).

A combination of approaches to the image analysis in cross-polarization optical coherence tomography (CP OCT) and high-resolution imaging by nonlinear microscopy and atomic force microscopy (AFM) at the different stages of atherosclerotic plaque development is studied. This combination allowed us to qualitatively and quantitatively assess the disorganization of collagen in the atherosclerotic arterial tissue (reduction and increase of CP backscatter), at the fiber (change of the geometric distribution of fibers in the second-harmonic generation microscopy images) and fibrillar (violation of packing and different nature of a basket-weave network of fibrils in the AFM images) organization levels. The calculated CP channel-related parameters are shown to have a statistically significant difference between stable and unstable (also called vulnerable) plaques, and hence, CP OCT could be a potentially powerful, minimally invasive method for vulnerable plaques detection.

We combined cross-polarization optical coherence tomography (CP OCT) and non-linear microscopy based on second harmonic generation (SHG) and two-photon-excited fluorescence (2PEF) to assess collagen and elastin fibers in the development of the atherosclerotic plaque (AP). The study shows potential of CP OCT for the assessment of collagen and elastin fibers condition in atherosclerotic arteries. Specifically, the additional information afforded by CP OCT, related to birefringence and cross-scattering properties of arterial tissues, may improve the robustness and accuracy of assessment about the microstructure and composition of the plaque for different stages of atherosclerosis.

We combined cross-polarization optical coherence tomography (CP OCT) and non-linear microscopy based on second harmonic generation (SHG) and two-photon-excited fluorescence (2PEF) to assess collagen and elastin fibers and other vascular structures in the development of atherosclerosis, including identification of vulnerable plaques, which remains an important clinical problem and imaging application. CP OCT's ability to visualize tissue birefringence and cross-scattering adds new information about the microstructure and composition of the plaque. However its interpretation can be ambiguous, because backscattering contrast may have a similar appearance to the birefringence related fringes. Our results represent a step towards minimally invasive characterization and monitoring of different stages of atherosclerosis, including vulnerable plaques. CP OCT image of intimal thickening in the human coronary artery. The dark stripe in the cross-polarization channel (arrow) is a polarization fringe related to the phase retardation between two eigen polarization states. It is histologically located in the area of the lipid pool, however this stripe is a polarization artifact, rather than direct visualization of the lipid pool.

The aim of the investigation was to develop an approach to quantitative evaluation of polarization properties (birefringence and cross-scattering) basing on cross-polarization OCT images (CP OCT) in order to characterize the development stages of atherosclerotic plaques and to reveal unstable ones.Materials and Methods. We report on quantitative analysis of CP OCT images of the seven development stages of atherosclerotic plaques ex vivo. Integral depolarization factor (ID F) and effective birefringence coefficient (Delta n) were proposed as parameters for quantitative characterization of the CP OCT images.Results. Calculation of the ID F and Delta n in the local region of interest (intima/fibrous cap) showed a statistically relevant difference between stable (stage IV) and unstable (stage Va) plaques (0.46 +/- 0.21 against 0.09 +/- 0.04 for ID F and (0.47 +/- 0.10)center dot 10(-3) against (0.25 +/- 0.07)center dot 10(-3) for Delta n; p<0.05). It was found that Delta n value in the range (0.22-0.29)center dot 10(-3) (within the limits of two standard deviations) indicates the presence of only a small amount of highly organized collagen in the fibrous cap of an unstable plaque which can indicate its tendency to rupture. We believe that these changes are connected with the prevalence of disorganized fibers during the inflammatory process in the fibrous cap of an unstable plaque, and to the presence of clusters of foam cells and inflammatory cells between them.Conclusion. The proposed approach to the quantitative evaluation of CP OCT images (calculation of ID F and building Delta n maps) allows to assess both cross-scattering and birefringence of atherosclerotic plaques at various development stages and more reliably reveal their vulnerability.

Quantitative image analysis and parameter extraction using a specific implementation of polarization-sensitive optical coherence tomography (OCT) provides differential diagnosis of mucosal pathologies in in-vivo human bladders. We introduce a cross-polarization (CP) OCT image metric called Integral Depolarization Factor (IDF) to enable automatic diagnosis of bladder conditions (assessment the functional state of collagen fibers). IDF-based diagnostic accuracy of identification of the severe fibrosis of normal bladder mucosa is 79%; recurrence of carcinoma on the post-operative scar is 97%; and differentiation between neoplasia and acute inflammation is 75%. The promising potential of CP OCT combined with image analysis in human urology is thus demonstrated in vivo.

Background and ObjectivesUncovering implants with lasers, while bloodless, has been associated with a risk of implant and bone overheating. The present study evaluated the effect of using a new generation of high-power diode lasers on the temperature of a dental implant and the surrounding tissues using an in vitro model.Study Design/Materials and MethodsThe implant temperature was measured at three locations using micro thermocouples. Collateral thermal damage of uncovered soft tissues was evaluated using NTBC stain. Implant temperature rise during and collateral thermal soft-tissue damage following implant uncovering with and without tissue air-cooling was studied using both the classic operational mode and the new thermo-optically powered (TOP) technology.ResultsFor the classic surgical mode using a cork-initiated tip and constant laser power set at 3.4W, the maximum temperature rise in the coronal and apical parts of the implant was 23.24.1 degrees C and 9.5 +/- 1.8 degrees C, respectively, while 1.5 +/- 0.5mm of collateral thermal damage of the soft tissue surrounding the implant model occurred. Using the TOP surgical tip with constant laser power reduced implant overheating by 30%; collateral thermal soft-tissue damage was 0.8 +/- 0.2mm. Using the TOP surgical mode with a tip temperature setting of 800 degrees C and air-cooling reduced the implant temperature rise by more than 300%, and only 0.2 +/- 0.1mm of collateral thermal soft-tissue damage occurred, typical for optimized CO2 laser surgery. Furthermore, use of the new generation diode technology (TOP surgical mode) appeared to reduce the time required for implant uncovering by a factor of two, compared to the standard surgical mode.ConclusionsUse of the new generation diode technology (TOP surgical mode) may significantly reduce overheating of dental implants during uncovering and seems to be safer for the adjacent soft and hard tissues. Use of such diode lasers with air-cooling can radically reduce the rise in implant temperatures (by more than three times), potentially making this technology safe and effective for implant uncovering. Lasers Surg. Med. 47:411-420, 2015. (c) 2015 Wiley Periodicals, Inc.

In this study a minimally invasive microsurgical approach was used for laser patterned microcoagulation (LPM) to initiate gingival and oral mucosal tissue regeneration. We performed a feasibility assessment and histological examination of laser damage and regeneration in the gingiva and oral mucosa using an animal model. The study animals comprised 18 healthy rabbits which were treated in vivo with single pulses from a diode laser at a wavelength of 980 nm and a power of up to 20 W applied to the gingival and oral mucosa at multiple time points. Biopsies were stained with hematoxylin and eosin, nitroblue tetrazolium chloride and picrosirius red, and evaluated by two pathologists blinded to the parameters and date of laser exposure. Histological analysis revealed that the continuity of the epithelial basal cell layer had been reestablished by 1-2 days after LPM, and complete epithelial regeneration had occurred by 7-12 days. A pronounced reactive inflammation developed in the column area 1 day after treatment. High activity of fibroblasts producing new collagen participated in the formation of a network of new thin-wall blood vessel. By the 28th day the tissue structure was almost completely restored with a similar increase of vascularity, and there were no signs of scarring. By the 90th day, tissue structure was completely restored, indicating complete healing. A single LPM treatment induces a wound healing response in the oral mucosa, showing the potential of LPM for the initiation of oral mucosa and gingival regeneration. Complete healing observed in 3 months after treatment with no keratinization change or scar tissue formation.

The goal of the research was analysis of the effect of collagen condition in formation of cross‐polarized CP OCT images. We used of the CP OCT technique for studying collagen condition on an example of oral mucosa. Special histologic picrosirius red (PSR) staining of cheek mucosa specimens was used with subsequent assessing of the result of collagen staining in polarized light. High correlation ( r = 0.692, p = 0.0001) between OCT signal standard deviation (SD) in cross‐polarized images and brightness of PSR stained collagen fibers in cheek mucosa specimens was demonstrated in patients with inflammatory intestine and oral mucosa diseases. We have found that the OCT signal SD in cross‐polarized images reflects two boundary conditions of collagen disorganization, namely, loss of fiber properties at active inflammation which attenuates the signal and fibrosis that occurs due to synthesis of a new remodeled collagen which amplifies the OCT signal. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

In recent years there has been demonstrated the ability of Erbium (Er) laser to cause effective ablation of bone tissue with minimum collateral damage. Non-surgical treatment of periodontitis using Er laser improves probing depth and clinical attachment level. However, periodontal anti-inflammatory therapy should not be limited to these parameters, but also should initiate tissue regeneration including bone tissue damaged by the disease.The aim of the investigation was to evaluate feasibility and characterize the process of laser microablative tunnel formation in gingiva and alveolar bone using a pulse-periodic, single mode Er laser, and determine laser parameters providing appropriate size of the tunnel and coagulation zone needed to initiate healing and regeneration of the alveolar bone.Materials and Methods. Ex vivo pig jaw was used as a model for the study. To create a through-gingiva microperformation of the alveolar bone, we used a laboratory prototype of Er laser and delivery system AltaPE-AT (Dental Photonics, Inc.).Results. We performed a microperforation of a 1 mm thick gingiva and created a microcrater (tunnel) in the underlying bone using a single pulse with energy 5, 10 and 30 mJ. The laser tunnel characteristics in the gingiva, bone and dentine were characterized as a function of laser irradiation parameters. Optical microscopy and histology examination did not reveal carbonization or significant collateral damage of the bone tissue.Conclusion. Using a laboratory prototype of Alta PE-AT Er laser we demonstrated feasibility of through gingiva laser microperforation of alveolar bone that can serve as the first step towards further study of healing and initiation of the alveolar bone regeneration.