Stanford University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Stanford, California, United States.
Stanford University School of Engineering, Department of Electrical Engineering, Stanford, California, United States.
J Biomed Opt. 2023 Jun;28(6):066003. doi: 10.1117/1.JBO.28.6.066003. Epub 2023 Jun 16.
Cholesteatoma is an expansile destructive lesion of the middle ear and mastoid, which can result in significant complications by eroding adjacent bony structures. Currently, there is an inability to accurately distinguish cholesteatoma tissue margins from middle ear mucosa tissue, causing a high recidivism rate. Accurately differentiating cholesteatoma and mucosa will enable a more complete removal of the tissue.
Develop an imaging system to enhance the visibility of cholesteatoma tissue and margins during surgery.
Cholesteatoma and mucosa tissue samples were excised from the inner ear of patients and illuminated with 405, 450, and 520 nm narrowband lights. Measurements were made with a spectroradiometer equipped with a series of different longpass filters. Images were obtained using a red-green-blue (RGB) digital camera equipped with a long pass filter to block reflected light.
Cholesteatoma tissue fluoresced under 405 and 450 nm illumination. Middle ear mucosa tissue did not fluoresce under the same illumination and measurement conditions. All measurements were negligible under 520 nm illumination conditions. All spectroradiometric measurements of cholesteatoma tissue fluorescence can be predicted by a linear combination of emissions from keratin and flavin adenine dinucleotide. We built a prototype of a fluorescence imaging system using a 495 nm longpass filter in combination with an RGB camera. The system was used to capture calibrated digital camera images of cholesteatoma and mucosa tissue samples. The results confirm that cholesteatoma emits light when it is illuminated with 405 and 450 nm, whereas mucosa tissue does not.
We prototyped an imaging system that is capable of measuring cholesteatoma tissue autofluorescence.
胆脂瘤是中耳和乳突的一种扩张性破坏性病变，可通过侵蚀相邻骨结构而导致严重并发症。目前，人们无法准确区分胆脂瘤组织边缘和中耳黏膜组织，导致复发率很高。准确区分胆脂瘤和黏膜组织将能够更彻底地切除组织。
开发一种成像系统，以提高手术中胆脂瘤组织和边缘的可视性。
从患者内耳切除胆脂瘤和黏膜组织样本，并分别用 405nm、450nm 和 520nm 窄带光照射。用配备一系列不同长通滤波器的分光辐射计进行测量。用配备长通滤光片以阻挡反射光的红-绿-蓝（RGB）数字相机获取图像。
胆脂瘤组织在 405nm 和 450nm 照射下发出荧光。中耳黏膜组织在相同的照射和测量条件下不发荧光。在 520nm 照射条件下，所有测量值均可以忽略不计。胆脂瘤组织荧光的所有分光辐射计测量值都可以通过角蛋白和黄素腺嘌呤二核苷酸的发射线性组合来预测。我们使用 495nm 长通滤光片和 RGB 相机构建了荧光成像系统的原型。该系统用于捕获胆脂瘤和黏膜组织样本的校准数字相机图像。结果证实，胆脂瘤在 405nm 和 450nm 照射下会发出光，而黏膜组织则不会。
我们原型设计了一种能够测量胆脂瘤组织自发荧光的成像系统。
