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Novel combined miniature optical coherence tomography ultrasound probe for in vivo intravascular imaging

Abstract
Atherosclerosis is the leading cause of morbidity and mortality in the United States and is becoming the preeminent health problem worldwide. Definitive detection and diagnosis of atherosclerosis relies on a medical imaging technique, Intravascular ultrasound (IVUS). IVUS has become a standard imaging modality for atherosclerosis diagnosis since it provides direct visualization of vessel walls. Recently, optical coherence tomography (OCT) has been applied to intravascular imaging because it offers new insights into the microstructure of atherosclerosis and tissue response to stent implantation. Research has been conducted to compare diagnostic accuracy of OCT and IVUS during which separate OCT and IVUS systems were used to image the same sites of interest. OCT and IVUS are complementary in the application of intravascular imaging, and the combination of the two can offer advantages which cannot be achieved by using either modality alone.

We have developed a miniature integrated optical coherence tomography (OCT) ultrasound (US) probing system for intravascular imaging applications (LAMMP TRD-3). In the OCT probe, the light coming out of a single mode fiber is focused by a gradient-index lens and then reflected by a right-angle prism from the side of the probe into the sample. It was combined with a 35 MHz PMN-PT side-viewing ultrasound transducer to obtain the ultrasound image as well. The OCT and ultrasound probes were integrated as a single probe to obtain OCT and ultrasound images simultaneously. The integrated probe has an outer diameter of 0.69 mm which, to our knowledge, is the smallest integrated OCT-US probe reported. Fast data acquisition and processing was implemented for real-time imaging. In vitro OCT and US images of human coronary artery with pathology, as well as in vivo images of normal rabbit abdominal aorta, were obtained using the integrated OCT-US probe to demonstrate its capability.

Impact
An integrated OCT ultrasound (US) system is capable of offering high resolution, which is essential for visualizing the microstructure of a plaque, and also large penetration depth which is necessary for visualizing structures deep within the vessel wall. Thus, enhanced diagnostic accuracy can be obtained. Moreover, improved safety for the patient can be achieved since only a minimum amount of flushing agent is needed for OCT under the guidance of US. An integrated OCT-US probe that provides both OCT and ultrasound imaging simultaneously has important cost-effectiveness implications since both cost per procedure and physician time are reduced significantly compared to procedures using separate probes. Because information is displayed simultaneously and is co-registered, diagnostic accuracy and patient outcomes should be improved compared to serial use or single technology procedures.

Citation
Yin J, Li X, Jing J, Li J, Mukai D, Mahon S, Edris A, Hoang K, Shung KK, Brenner M, Narula J, Zhou Q, Chen Z. Novel combined miniature optical coherence tomography ultrasound probe for in vivo intravascular imaging. J Biomed Opt. 2011 Jun;16(6):060505. PMC3124531

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