OFFICE BASED REAL-TIME HIGH SPEED 3-D OCT SYSTEM FOR DIAGNOSIS OF EARLYLARYNGEAL - Laryngeal carcinoma is the most common primary head and
neck malignancy. Flexible fiber-optic or rigid endoscopes are normally inserted through the nose or into
the pharynx for conventional physical examinations, but endoscopy alone cannot be used to
differentiate between benign, pre-malignant and early malignant lesions, which are characterized by
identical symptoms such as throat pain, coughing, or hoarseness, and nearly identical physical
appearance. Both conventional examination and endoscopy lack the ability to visualize the depth of
penetration of disease into the deeper layers of the tissue, and provide information on vocal fold
epithelial structure. Therefore, laryngeal cancer diagnosis has to rely on biopsies, which requires
general anesthesia and surgical endoscopy. Multiple and repeated biopsies are common in order to
increase diagnostic yield, and with this increasing morbidity form surgery. Regardless of the toll
exacted on patients and their families, there are major costs associated with surgery, and significant
patient time away from work. Hence, there is a huge need to develop a fast, mobile and noninvasive
technology to aid in the early detection and monitoring of laryngeal malignant lesions, assist in selecting
patients to undergo surgical biopsy. The use of OCT in managing early laryngeal epithelial cancer will
be analogous to the use of macroscopic imaging modalities (i.e., MR, CT) in managing large solid
tumors in the body. Using several licensed patents, OCT Medical Imaging Inc (OCTMI) proposes to
address the treatment and diagnosis of early laryngeal cancer using light based fiber optic imaging
technology known as optical Coherence tomography (OCT), which produces a cross- sectional images
at near histopathological resolution(Fujimoto et.al 2000). The first in vivo endoscopic OCT images in
animals and humans were reported in 1997 (Tearney et.al., 1997)). Many clinical applications require a
large area or 3-D imaging, which is difficult to achieve with the Time Domain (TD) OCT. Hence, OCTMI
proposes to use advanced Fourier domain (FD) OCT technology which provides 3D imaging at high
speed and sensitivity (Leitgeb et.al, 2003). Second, the paradigm shift from OR based to office-based
imaging is necessary to make OCT a useful technology for head and neck cancer screening, early
detection, and monitoring of disease progression. Incorporating this technology, OCTMI proposes to
develop an advanced compact, cost-effective office based real-time 3D-functional Fourier domain
functional OCT system that will not only acquire images at near histopathological resolution, but also
will provide clinically important structural information on suspect lesions, potential biopsy sites, and
cancer margins of larynx in the office without the need for general anesthesia or sedation. OCTMI is
well positioned to develop this technology since its founders and collaborators have developed several
office-based real-time 3D-OCT systems and were first to conduct large scale clinical trials on laryngeal
cancer to the best of our knowledge.
