Maria Angela Franceschini
Insertable, Implantable and Wearable Micro-optical Devices for the Early Detection of Cancer
Stanford University, United States
Monday, 25 April, 09:45 - 10:30
Abstract: Current technologies for the detection of cancer lack the sensitivity for early detection at times when therapy would be most effective, and cannot detect minimal residual disease that persists after conventional therapies. Therefore, it will be necessary to develop image-guided approaches for multiplexed molecular characterization of cancer and methods to visualize small numbers of cancer initiating cells. Imaging and sensing will need to move from detection limits of 1 cm to 1 mm, or even 100 µm diameter masses, and new technologies with this sensitivity need to be developed. Optical imaging has the sensitivity for this level of detection and there are a number of recent advances that will enable the use of optics in the clinic for cancer detection. New instruments based on micro-optical designs can be used to reach in the body to reveal microanatomic and molecular detail that are indicators of early cancers. We are advancing the technologies that enable miniaturization of 3-D scanning confocal microscopes and Raman endoscopes to examine tissue in situ for early anatomic and molecular indicators of disease, in real time, and at cellular resolution. These new devices will lead to a shift from the current diagnostic paradigm of biopsy followed by histopathology and recommended therapy, to one of non-invasive point-of-care diagnosis with the possibility of treatment in the same session. By creating the tools for point-of-care pathology we are reducing the time and distance between the patient and the diagnostic event, and changing the practice of medicine. The emerging combinations of instruments and molecular probe strategies will reveal disease states in finer detail and provide greater information to clinicians for more informed, and directed therapies. Personalized medicine is really molecular medicine and the new imaging and diagnostic tools that characterize molecular basis of disease are driving personalized care and early intervention.
Advances in Measuring Cerebral Oxygen Delivery and Consumption in the Clinic with Near Infrared Spectroscopy
Maria Angela Franceschini
Massachusetts General Hospital, United States
Tuesday, 26 April, 08:00 - 08:45
Abstract: With the foundation of our seminal frequency-domain near infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS) efforts with neonates established, we are now developing novel devices and approaches to better quantify cerebral blood flow and oxygen metabolism in the clinical setting. I will present the first fully integrated FD-NIRS/DCS commercial system. I will show results of this technology in measuring infants affected by hydrocephalus in Africa, and measuring pediatric and adult patients in intensive care settings in Boston. In parallel to the clinical translation of the established FD-NIRS/DCS technology, we have also advanced the field and developed totally new approaches which have the potential to be rapidly translated into a clinically viable, non-invasive, comprehensive cerebral hemodynamic monitoring method with significant advantages over existing methods. In particular, time-domain diffuse correlation spectroscopy (TD-DCS) is a novel technology which enables us for the first time to employ time-gating strategies used in TD-NIRS to DCS cerebral blood flow measurements and realize improvements which are not possible when the two techniques are performed independently. The development of DCS devices with fast acquisition rates allow us to acquire cerebral blood flow variations due to the cardiac cycle. We are the first to explore the possibility of using the pulsatile blood flow to assess intracranial pressure continuously and non-invasively.
Optical Coherence Tomography: From Research to Clinical Practice
Massachusetts Institute of Technology, United States
Wednesday, 27 April, 08:00 - 08:40
Abstract: Optical coherence tomography (OCT) uses echoes of light to generate micron resolution, cross-sectional and three-dimensional images of microstructure in materials and biological systems. Since it development 25 years ago, OCT has been applied in multiple clinical specialties as well as in fundamental science, with an extensive international research community. In ophthalmology, OCT has become a standard of care for the diagnosis and monitoring of retinal disease and played a major role in the development of new pharmaceutical therapies. Tens of millions of imaging procedures are performed worldwide every year. Functional methods such as Doppler or OCT angiography enable measurement of blood flow and 3D visualization of microvasculature. In conjunction with fiber optic catheters and novel imaging devices, OCT can perform internal body imaging and is an emerging modality for intravascular and endoscopic imaging. Next generation swept source OCT enables high speeds with gigavoxel data sets as well as meter ranges with micron level precision. The development of OCT required multidisciplinary teams spanning science, engineering, clinical medicine and business. This presentation will review the history OCT as an example of translation from research to clinical practices, as well as comment on current advances and future prospects.
From Brownsville to Blantyre: How Optical Technologies Can Improve Health Care in Low-Resource Settings
Rice University, United States
Monday, 25 April, 09:00 - 09:45
Abstract: Quality healthcare begins with accurate diagnosis. Despite advances in laboratory medicine, many patients do not have access to high quality diagnostics, either because they live in a region of the world where they are unavailable or because they cannot access to existing healthcare systems. Low-cost optical diagnostics that can be performed at the point-of-care have the potential to eliminate disparities in access to diagnostics. Using examples from the US and sub-Saharan Africa, this talk will highlight existing diagnostic challenges, discuss successful strategies to develop and deploy low-cost diagnostic tools to meet these needs, and review barriers to future success.
Commercialization of OCT: Some Views on the Past, Present, and Future
Wednesday, 27 April, 09:20 - 10:00
Abstract: The commercialization and growth of OCT which has occurred over the past 25 years has been highly impactful, scientifically, clinically, and economically. Many factors have helped drive this success starting with the clinical need for new cost-effective high-resolution minimally-invasive imaging solutions for various diagnostic and therapeutic applications. But equally important to this success was the intertwined role of researchers, professional societies, government agencies, government funding, regulatory bodies, entrepreneurs, venture capitalists, and small and large corporate entities within biomedical optics industry and in completely adjacent areas such as telecommunication, computer, and software industries. This talk will review some of the history, current status, and speculate on what looks like a very exciting future for OCT with so many novel technological advances on the horizon and so many promising applications remaining to be commercialized that will further benefit healthcare and improve quality of life.
25 Years of OCT: A Revolution in Ophthalmic Care
Duke University, United States
Wednesday, 27 April, 08:40 - 09:20
Abstract: The first human applications of optical coherence tomography were reported in the eye 25 years ago. This technology has revolutionized the patient examination and the diagnosis of the vast majority of retinal and optic nerve diseases. Evolution of the technology has included spectral domain OCT and swept source OCT which alone provided new possibilities in imaging due to increase in speed of image acquisition and depth of penetration in ocular tissues. Image processing and segmentation are just a few of the visualization and analytic methods which have enabled the precise assessment of tissues of interest. Together, these have been critical for staging of disease and monitoring response to therapy. This ophthalmic technology continues to evolve with OCT angiography as just one of the new non-invasive applications which has displaced conventional intravenous dye injection for retinal evaluation. Furthermore, the technology is shifting from the photography suite to applications for intrasurgical visualization and more importantly for microsurgical guidance. Ophthalmology is the perfect field for the application of OCT-guided surgery as will be demonstrated in this presentation. OCT imaging of the retina (part of the central nervous system) is also capable of revealing brain injury from disease or maldevelopment in both children and adults. Thus across a spectrum of ophthalmic care, OCT is the first line of visualization of disease processes within the eye and determination of response to treatment. It is expected to play an even greater role in guiding future treatment in real time. As seen over the past 25 years, areas of ophthalmic OCT research today are likely to progress to routine OCT applications of tomorrow.
Photoacoustic Tomography: Ultrasonically Beating Optical Diffusion and Diffraction
Washington University in St Louis, United States
Tuesday, 26 April, 08:45 - 09:30
Abstract: Photoacoustic tomography (PAT), combining optical and ultrasonic waves via the photoacoustic effect, provides in vivo functional, metabolic, molecular, and histologic imaging. PAT has the unique strength of high-resolution imaging across the length scales of organelles, cells, tissues, organs, and small-animal organisms with consistent contrast. PAT has the potential to empower holistic omniscale biology research and accelerate translation from microscopic laboratory discoveries to macroscopic clinical practice. Broad applications include imaging of the breast, brain, skin, esophagus, colon, vascular system, and lymphatic system in both animals and humans.