Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Vienna, Austria.
Medical University of Vienna, Christian Doppler Laboratory OPTRAMED, Vienna, Austria.
J Biomed Opt. 2021 Oct;26(10). doi: 10.1117/1.JBO.26.10.100601.
After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance.
Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis.
A comprehensive review of state-of-the-art accomplishments in OCT has been performed.
The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential.
With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.
经过三十年的发展，发表了超过 75000 篇出版物，数十家公司参与了其商业化，全球市场规模在 2023 年达到 15 亿美元左右，光学相干断层扫描（OCT）已成为转化最为成功的成像技术之一，具有重大的临床和经济效益，并得到广泛认可。
我们的观点聚焦于具有颠覆性和前瞻性的创新和关键技术，以进一步提升 OCT 的性能，从而实现显著增强的医学诊断。
对 OCT 的最新成就进行了全面的综述。
最具颠覆性的未来 OCT 创新包括成像分辨率和速度（单光束光栅扫描与并行化）的提高、双模甚至多模系统的新实现，以及在这些针对分子和代谢成像的混合 OCT 系统中使用内源性或外源性对比。除了 OCT 血管造影外，没有其他功能或对比度增强的 OCT 扩展实现了可比的临床和商业影响。一些最近开发的扩展，如光相干弹性成像、动态对比 OCT、光视网膜成像和人工智能增强的 OCT 也被认为具有很高的未来潜力。此外，OCT 的小型化用于便携式、紧凑、手持式和/或具有成本效益的基于胶囊的 OCT 应用、家庭 OCT 和基于微光学组件或光子集成电路的自我 OCT 系统，将在不久的将来彻底改变新的应用和可用性。最后，OCT 的临床转化，包括医疗设备监管挑战，将继续是绝对必要的。
OCT 具有出色的非侵入性、微米分辨率的深度分层能力，特别颠覆了眼科诊断，因此是眼科史上采用最快的成像技术。尽管如此，OCT 尚未被完全开发利用，具有巨大的增长潜力——无论是在学术界还是在工业界。这不仅适用于眼科应用领域，尤其适用于 OCT 的原始动机，即能够进行光学活检，即在无需组织切除的情况下，以接近组织学分辨率的分辨率对组织微观结构进行原位成像。
