Neurological cancer surgeries require specialized tools that enhance imaging for precise cutting and removal of tissue without damaging adjacent neurological structures. The novel combination of high-resolution fast optical coherence tomography (OCT) alongside short pulsed nanosecond thulium (Tm) lasers offers stark advantages utilizing the superior beam quality, high volumetric tissue removal rates of thulium lasers with minimal residual thermal footprint in the tissue and avoiding damage to delicate sub-surface structures (e.g., nerves and microvessels); which has not been showcased before. A bench-top system is constructed, using a 15W 1940nm nanosecond pulsed Tm fiber laser (500uJ pulse energy, 100ns pulse duration, 30kHz repetition rate) for removing tissue and a swept source laser (1310±70nm, 100kHz sweep rate) is utilized for OCT imaging, forming a combined Tm/OCT system – a smart laser knife. The OCT image-guidance informs the Tm laser for cutting/removal of targeted tissue structures. Tissue phantoms were constructed to demonstrate surgical incision with blood vessel avoidance on the surface where 2mm wide 600um deep cuts are executed around the vessel using OCT to guide the procedure. Cutting up to delicate subsurface blood vessels (2mm deep) is demonstrated while avoiding damage to their walls. A tissue removal rate of 5mm^3/sec is obtained from the bench-top system. We constructed a blow-off model to characterize Tm cut depths taking into account the absorption coefficients and beam delivery systems to compute Arrhenius damage integrals. The model is used to compare predicted tissue removal rate and residual thermal injury with experimental values in response to Tm laser-tissue modification.
State-of-the-art treatment for joint diseases like osteoarthritis focus on articular cartilage repair/regeneration by stem cell implantation therapy. However, the technique is limited by a lack of precision in the physician’s imaging and cell deposition toolkit. We describe a novel combination of high-resolution, rapid scan-rate optical coherence tomography (OCT) alongside a short-pulsed nanosecond thulium (Tm) laser for precise cell seeding in cartilage. The superior beam quality of thulium lasers and wavelength of operation 1940 nm offers high volumetric tissue removal rates and minimizes the residual thermal footprint. OCT imaging enables targeted micro-well placement, precise cell deposition, and feature contrast. A bench-top system is constructed using a 15 W, 1940 nm, nanosecond-pulsed Tm fiber laser (500 μJ pulse energy, 100 ns pulse duration, 30kHz repetition rate) for removing tissue, and a swept source laser (1310 ± 70 nm, 100 kHz sweep rate) for OCT imaging, forming a combined Tm/OCT system – a “smart laser knife”. OCT assists the smart laser knife user in characterizing cartilage to inform micro-well placement. The Tm laser creates micro-wells (2.35 mm diameter length, 1.5 mm width, 300 μm deep) and micro-incisions (1 mm wide, 200 μm deep) while OCT image-guidance assists and demonstrates this precision cutting and cell deposition with real-time feedback. To test micro-well creation and cell deposition protocol, gelatin phantoms are constructed mimicking cartilage optical properties and physiological structure. Cell viability is then assessed to illustrate the efficacy of the hydrogel deposition. Automated OCT feedback is demonstrated for cutting procedures to avoid important surface/subsurface structures. This bench-top smart laser knife system described here offers a new image-guided approach to precise stem cell seeding that can enhance the efficacy of articular cartilage repair.
We present development of a nanosecond Q-switched Tm3+-doped fiber laser with 16 W average power and 4.4 kW peak power operating at 1940 nm. The laser has a master oscillator power amplifier design, and uses large mode area Tm3+-doped fibers as the gain medium. Special techniques are used to splice Tm3+-doped fibers to minimize splice loss. The laser design is optimized to reduce non-linear effects, including modulation instability. Pulse width broadening due to high gain is observed and studied in detail. Medical surgery is a field of application where this laser may be able to improve clinical practice. The laser together with scanning galvanometer mirrors is used to cut precisely around small footprint vessels in tissue phantoms without leaving any visible residual thermal damage. These experiments provide proof-of-principle that this laser has promising potential in the laser surgery application space.
Optical coherence tomography (OCT) retinal imaging contributes to understanding central nervous system (CNS)
diseases because the eye is an anatomical “window to the brain” with direct optical access to nonmylenated retinal
ganglion cells. However, many CNS diseases are associated with neuronal changes beyond the resolution of standard
OCT retinal imaging systems. Though studies have shown the utility of scattering angle resolved (SAR) OCT for particle
sizing and detecting disease states ex vivo, a compact SAR-OCT system for in vivo rodent retinal imaging has not
previously been reported. We report a fiber-based SAR-OCT system (swept source at 1310 nm ± 65 nm, 100 kHz scan
rate) for mouse retinal imaging with a partial glass window (center aperture) for angular discrimination of backscattered
light. This design incorporates a dual-axis MEMS mirror conjugate to the ocular pupil plane and a high collection
efficiency objective. A muring retina is imaged during euthanasia, and the proposed SAR-index is examined versus time.
Results show a positive correlation between the SAR-index and the sub-cellular hypoxic response of neurons to
isoflurane overdose during euthanasia. The proposed SAR-OCT design and image process technique offer a contrast
mechanism able to detect sub-resolution neuronal changes for murine retinal imaging.