Most medical imaging provides diagnostic views of anatomical structures in a noninvasive manner. Anatomical structures may be identified and assessed prior to any kind of invasive procedure. Such technologies generally involve a propagated wave medium that reflects or refracts off anatomical features for qualitative assessment thereof. Typical imaging technologies include Ultrasound (US), CT (Computed Tomography), MRI (Magnetic Resonance Imaging) and X-Ray, each having various features and costs. More recently, Optical Coherence Tomography (OCT) is emerging for beneficial properties of portability and high resolution.
A robotically driven OCT scanning and imaging system provides a 3-dimensional (3D) image rendering based on a 2-dimensional (2D) surface traversal of a Region of Interest (ROI) for immediate depiction of tissue health with an accuracy and portability not available with conventional imaging approaches. A comprehensive scan over the surface of the ROI ensures complete coverage, and a signal indicative of attenuation of the optical scan indicates penetration of the OCT stimulus. The received signal for each location is aggregated, or “stitched” together with the signal received from adjacent locations to provide a full mapping of the scanned region, and rendered as a color or shading map for showing anomalies or sudden variances in tissue health.
Configurations herein are based, in part, on the observation that medical imaging provides a valuable diagnostic tool for non-invasive visualization of tissue health and for locating unhealthy regions prior to more invasive procedures. Unfortunately, conventional approaches to medical scanning suffer from the shortcoming that the expense and size of certain scanning mediums limit their effectiveness in time-sensitive contexts. Accordingly, configurations herein substantially overcome the shortcomings of conventional approaches by providing an OCT scanning system for precise, portable imaging deployable in an operating room or similar specialized environment for fast, high resolution images of the ROI. A wide-field OCT system provides for biological subject inspection which enables 1) automatic wide-field OCT scan and 2) 3D visualization of the scanned area.
Optical Coherence Tomography (OCT) is a high-resolution, real-time, non-invasive medical imaging modality. OCT has been frequently adopted in skin and eye disease diagnosis. Many other emerging clinical applications include real-time OCT guidance/monitoring for endovascular procedures such as percutaneous coronary intervention (PCI) and atrial fibrillation ablation, etc. Moreover, researchers show that OCT can offer histopathological information of organs (kidney, liver, lung, etc.) that is impossible to obtain using conventional procedures.
In a particular example, organ transplant procedures are time sensitive due to the health and viability of a transplanted organ. Confirmation of organ health ensures a successful procedure, however 3D images via MRI incur a substantial time delay, and are too large to deploy in an operating room. Ultrasound may be performed on-site, but may lack the resolution needed to properly ascertain organ health. In a kidney transplant, for example, an OCT scan as disclosed herein is achievable in a timely manner, using co-located equipment with an accuracy sufficient for assessing kidney health by rendering 3D structures in the kidney indicative of the health (or absence thereof).
OCT scanning is viable for desktop usage with a limited, sub-centimeter level field of view (FOV) in lateral and elevational directions. For better clinical flexibility, portable OCT systems have emerged for hand-held manual guidance of the OCT probe. While a greater area of biological tissue can be covered using the hand-held probe, the collected OCT images still lack localization information (where the images are captured on the organ/tissue), hence it is impossible for global visualization and quantification of the interested features in locally acquired images. It would be beneficial to provide an OCT scan guided in a comprehensive manner to ensure complete assessment of the ROI.
Configurations discussed below provide a method for scanning tissue, which provides for traversing an OCT probe according to a scan path over a tissue specimen including a region of interest (ROI), the scan path including a plurality of parallel segments, and receiving a signal indicative of a tissue property of the tissue specimen along the scan path, such that the signal is based on an attenuation at a tissue location where the signal was received. An image processor coalesces a plurality of the received signals over the ROI for generating a 2-dimensional (2D) rendering of 3-dimensional (3D) structures in the tissue specimen indicative of a health of the tissue specimen.
The foregoing and other objects, features and advantages of the invention will be apparent from the following description of particular embodiments of the invention, as illustrated in the accompanying drawings in which like reference characters refer to the same parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention.
The description below presents an example of OCT pre-transplant kidney monitoring is invoked as an example to illustrate the clinical needs for wide-field and spatially localized OCT imaging. Other clinical procedures using OCT can also benefit from this technology. With respect to pre-transplant kidney assessment application, the predominantly used clinical trial is anatomical feature-based pathological scoring obtained from a conventional biopsy. However, the biopsy only evaluates a few spots on the kidney, leading to potentially biased results. In contrast, the disclosed approach can function as a type of “optical biopsy”, providing OCT cross-sectional images of tissue morphology in situ and in real-time. In kidney transplantation, the kidney pathology can be obtained with OCT and used for pre-transplant prediction of delayed graft function (DGF), which is detrimental to the patient's survival. Studies further reveal that an increased tubular lumen diameter suggests a higher possibility of DGF. To fully capture the kidney microstructures (tubular lumens) for better prediction of kidney viability, a system with spatially resolved imaging capability is preferable.
In conventional approaches, OCT systems have traditionally been used for desktop usage with a limited, sub-centimeter level FOV in lateral and elevational directions. For better clinical flexibility, portable OCT systems are emerging, allowing physicians to hold the probe and perform the scan. While a greater area of biological tissue can be covered using the hand-held probe, the collected OCT images still lack localization information (where the images are captured on the organ/tissue), hence it is impossible for global visualization and quantification of the interested features in locally acquired images.
It is extremely challenging for existing OCT systems to scan the entire kidney. To achieve comprehensive kidney evaluation, it would be beneficial to develop a platform with trackable OCT probe pose in 3-dimension so that each OCT image can be registered to the common global coordinate frame.
Continuing to refer to
In a pre-scan phase, the tissue sample 140 is placed in the designated area 101 in the RGB-depth camera's FOV when the robot 102 is at home configuration. As kidney transplant surgery is a time-sensitive task, the boundary area of the kidney, which is hard to determine and may not contain as much information as the central area in the OCT image, can be ignored from the scan to realize higher time efficiency. Therefore, the square or rectangular shape ROI 132 with height hROI and width wROI in millimeters is drawn through a graphic user interface (GUI) to exclude the outskirt of the sample in the camera FOV.
A scan path plan is needed to ensure that the ROI will be scanned comprehensively. Orienting the y, z-axis of the OCT image frame to the opposite direction of the y, z-axis of the robot base frame at the home configuration, the scan path 134 consists of multiple scan lines, each corresponding to a pixel 155, in parallel with the x-axis of the robot base frame. This scan path 134 is formally defined as n number of lengths, or segments 150′-1 . . . 150′-N (150′ generally) and starting coordinates for the scan lines [ln×1, sn×1], each corresponding to a respective vertical section 150, where n is calculated based on the overlap between consecutive scan lines wol in millimeter, the lateral FOV of the OCT image woct in millimeter, and wROI as:
All scan lines are set to be the equal length of hROI. Each starting coordinate si∈R3 is first obtained as the pixel positions in R2 by distributing the scan lines along the lateral direction of the camera FOV with the left-most scan line being
away from the ROI left boundary, then projected to 3D positions relative to the camera frame utilizing the depth information and the camera intrinsic.
Accurate execution of the path plan is beneficial for acquiring OCT images from the desired ROI. In the intra-scan procedure, the robot 102 needs to move the OCT probe 120 to each starting coordinate of the scan line and perform the scanning motion. Since the starting coordinates are initially with respect to the camera frame, the following transformation is applied to bring them to the robot base frame 105:
Without changing the orientation of the end-effector at the robot's home configuration, we implemented a Proportional-Derivative (PD) controller to control the Cartesian space velocity of the OCT image frame. The controller first locates the OCT probe 120 to an entry pose which is above the starting coordinate with a safety distance in the vertical direction. This step is to factor out inaccurate depth sensing of the camera, which may cause the probe to collide with the tissue if directly proceeding the robot to the starting coordinates. Next, a landing motion is designed to drop the OCT probe gradually towards the tissue at a constant linear velocity in z-axis with respect to the robot base frame. When the probe is close enough to the tissue, the tissue surface will appear in the OCT image, which can be easily captured using pixel intensity thresholding. A tissue height measurement μ is formulated to track the tissue surface in the OCT image as:
where H and h are depicted in
To avoid the tissue being lost in the OCT image view or making contact with the OCT probe throughout the scanning motion, a fixed distance between the OCT image frame and the tissue surface is desired, depicted by h. Hence, an automatic probe height compensation controller maintains the tissue height h at 65% by controlling the z-axis linear velocity relative to the robot base. The current velocity vz at time step t is computed as:
v
z
[t]=f·p·tan h(0.65−μ)+(1−f)·vz[t−1]
where f is a constant parameter ranging from 0 to 1 such that a low pass filter is embedded to avoid velocity jittering, p is the empirically assigned proportional control gain. The tan h(*) is the hyperbolic tangent function used to guarantee the smoothness of the velocity profile.
The serial robotic arm (active positioning) is employed as a representative design choice to demonstrate the proposed autonomous wide-field OCT imaging functionality. Furthermore, pre-transplant kidney monitoring is used as an example clinical application.
In the configurations herein, the robot 102 and actuator 130 are used to move and track the OCT probe 120 accurately. The robotics automates the OCT scan path planning and execution, therefore, achieves fast, comprehensive kidney monitoring without requiring human input. A particular configuration employs a robotic OCT system with real-time 2D OCT image sampling and OCT image-based probe pose update pipeline. Because the 2D OCT images defining each segment 150′ are streamed while the robot 102 is dynamically optimizing the probe pose at high frequency, every OCT image is comprehensive and of a width to coalesce or “stitch” to the adjacent segment. In addition, depth-encoded mapping (
The information from the OCT scan information mapped to corresponding locations on the tissue specimen 140 can serve as clinically valuable information to identify the health status of the kidney thoroughly. This can be done via a GUI by displaying the organ's camera view picture overlaid with the robot scan trajectory and the corresponding OCT image side by side. However, configurations herein substantially improve this by extracting the cross-sectional slices 150 of the kidney from individual OCT images and stitch them in 3D to i) demonstrate the OCT probe tracking accuracy; and ii) provide an intuitive spatial representation of the organ. The stitching process contains three steps: i) extract tissue pixels from the OCT image as point cloud data; ii) calculate the real-world tissue pixel positions under the OCT image frame by incorporating their pixel-wise positions and the OCT probe parameter; iii) transform the tissue positions to robot base frame for 3D visualization. While i) can be achieved using the same pixel intensity thresholding described above, ii) and iii) are done jointly to acquire the tissue point cloud [xbase ybase ]T. In the ith collected OCT image. The tissue point cloud is obtained via:
where m is the total number of pixels with intensity above the threshold, cOCT and rOCT are the tissue positions in pixel relative to the OCT image frame, W is the width of the OCT image in pixel, hOCT is the axial FOV of the OCT image in millimeters. Finally, the resultant point cloud is randomly downsampled by 10% and spatially denoised to remove the outliers.
This includes generating the scan path 134 based on a separation between the parallel segments 150′, where the separation is selected for combining information corresponding to a scanned tissue location to information corresponding to a tissue location in an adjacent segment to generate an imaged indication of a 3D structure common to both tissue locations, as depicted at step 606. Thus, the adjacent segments 150′ define a width for coalescing or stitching the information from the scan signal to combine with the signal from an adjacent location or segment to compute and render a full image, shown below in
In response to the emitted signal 121, the OCT probe 120 receives a signal indicative of a tissue property of the tissue specimen 140 along the scan path 134, such that the signal is based on an attenuation at a tissue location where the signal was received, as shown at step 608. The received signal is based on an attenuation of the optical signal 121 directed towards the tissue specimen, as the emitted signal is subject to scattering based on the tissue quality and variable penetration of the emitted signal 121, as disclosed at step 610.
From the scan signals, the image processor 124 coalesces a plurality of the received signals over the ROI for generating a 2-dimensional (2D) rendering of 3-dimensional (3D) structures in the tissue specimen indicative of a health of the tissue specimen 140, as depicted at step 612. This includes forming a point cloud 152 representation based on the received signals at each of a plurality of locations at each of the segments 150′ on the scan path 134, as shown at step 614 and
The system can automatically maintain a constant height h of the sample surface 132 in 2D OCT images by regulating the distance between the probe 120 and the specimen 140, hence guaranteeing the quality of individual image. The axial attenuation map is used to verify the localization accuracy of the 2D OCT images. The system generated a whole kidney axial attenuation map 194 by compounding 10 attenuation maps from all the scan lines using the OCT probe's localization information. The central region of the map clearly showed vessel-like microstructures. A smaller area on the kidney (5 mm-by-5 mm) was imaged using a traditional 3D OCT probe and the corresponding ground truth map 192 was generated for comparison. Qualitative comparison between the ground truth and part of the whole kidney attenuation map showed no significant distortion in the shape of the vessel structures, indicating that the OCT probe localization is reliable.
Those skilled in the art should readily appreciate that the programs and methods defined herein are deliverable to a user processing and rendering device in many forms, including but not limited to a) information permanently stored on non-writeable storage media such as ROM devices, b) information alterably stored on writeable non-transitory storage media such as solid state drives (SSDs) and media, flash drives, floppy disks, magnetic tapes, CDs, RAM devices, and other magnetic and optical media, or c) information conveyed to a computer through communication media, as in an electronic network such as the Internet or telephone modem lines. The operations and methods may be implemented in a software executable object or as a set of encoded instructions for execution by a processor responsive to the instructions, including virtual machines and hypervisor controlled execution environments. Alternatively, the operations and methods disclosed herein may be embodied in whole or in part using hardware components, such as Application Specific Integrated Circuits (ASICs), Field Programmable Gate Arrays (FPGAs), state machines, controllers or other hardware components or devices, or a combination of hardware, software, and firmware components.
While the system and methods defined herein have been particularly shown and described with references to embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims.
This patent application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent App. No. 63/323,181, filed Mar. 24, 2022, entitled “ROBOTIC-ASSISTED OPTICAL COHERENCE TOMOGRAPHY (OCT),” both incorporated herein by reference in entirety.
This invention was made with government support under grant R01 DK133717, awarded by the National Institute for Health (NIH). The government has certain rights in the invention
Number | Date | Country | |
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63323181 | Mar 2022 | US |