Interdisciplinary Endoscopy, Medical Department 1, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Institute of Biomedical Optics, University of Luebeck, Luebeck, Germany.
Sci Rep. 2024 Feb 26;14(1):4672. doi: 10.1038/s41598-024-55338-5.
Colonoscopy and endoscopic ultrasound play pivotal roles in the assessment of rectal diseases, especially rectal cancer and inflammatory bowel diseases. Optical coherence tomography (OCT) offers a superior depth resolution, which is a critical factor for individualizing the therapeutic concept and evaluating the therapy response. We developed two distinct rectoscope prototypes, which were integrated into a 1300 nm MHz-OCT system constructed at our facility. The rapid rotation of the distal scanning probe at 40,000 revolutions per minute facilitates a 667 Hz OCT frame rate, enabling real-time endoscopic imaging of large areas. The performance of these OCT-rectoscopes was assessed in an ex vivo porcine colon and a post mortem human in-situ colon. The OCT-rectoscope consistently distinguished various layers of the intestinal wall, identified gut-associated lymphatic tissue, and visualized a rectal polyp during the imaging procedure with 3D-reconstruction in real time. Subsequent histological examination confirmed these findings. The body donor was preserved using an ethanol-glycerol-lysoformin-based technique for true-to-life tissue consistency. We could demonstrate that the novel MHZ-OCT-rectoscope effectively discriminates rectal wall layers and crucial tissue characteristics in a post mortem human colon in-situ. This real-time-3D-OCT holds promise as a valuable future diagnostic tool for assessing disease state and therapy response on-site in rectal diseases.
结肠镜检查和内镜超声在评估直肠疾病方面发挥着关键作用，尤其是直肠癌和炎症性肠病。光学相干断层扫描（OCT）提供了卓越的深度分辨率，这是个体化治疗概念和评估治疗反应的关键因素。我们开发了两种不同的直肠镜原型，将其集成到我们实验室构建的 1300nmMHz-OCT 系统中。远端扫描探头以每分钟 40000 转的快速旋转，实现了 667Hz 的 OCT 帧率，能够实时对大面积进行内镜成像。我们在离体猪结肠和尸检原位人结肠中评估了这些 OCT-直肠镜的性能。OCT-直肠镜能够一致地区分肠壁的各个层，识别肠道相关淋巴组织，并在成像过程中实时进行 3D 重建，可视化直肠息肉。随后的组织学检查证实了这些发现。该尸体捐献者使用基于乙醇-甘油-溶菌酶的技术进行保存，以保持逼真的组织一致性。我们能够证明，新型 MHz-OCT-直肠镜能够有效地在尸检原位人结肠中区分直肠壁层和关键的组织特征。这种实时 3D-OCT 有望成为评估直肠疾病现场疾病状态和治疗反应的有价值的未来诊断工具。
