Optical coherence tomography (OCT) for intraoperative examination of tissue samples

Introduction:

In tumor resection in the head and neck region, it is imperative to secure an R0 resection by means of intraoperative frozen sections. Optical coherence tomography (OCT) is an imaging technique that could enable intraoperative, non-invasive and non-contact examination of tissue in a high resolution. This application and feasibility study examined whether OCT can distinguish tumor tissue from tumor-free tissue.

Methods:

Four patients were analyzed using OCT. One patient underwent transoral laser microsurgery with intraoperative frozen sections and three patients incisional surgical biopsy from the larynx or tongue as part of a microlaryngoscopy or panendoscopy. Pathological work-up revealed squamous cell carcinoma in three patients and leukoplakia with inflammatory alteration in one patient. A total of 20 histological samples were examined immediately after excision in the operating room with a Thorlabs Telesto OCT. The raw data was converted into DICOM format and processed with the software MEVISLAB (version 3.0.1).

Results:

In OCT squamous cell carcinomas were characterized by an increase in the thickness of the epithelial cell layer compared to tumor-free tissue. In addition, architectural changes of the epithelium were visible in OCT. The leukoplakia also had a thickened layer of epithelial cells and was therefore not safely distinguished from squamous cell carcinoma.

Conclusion:

The OCT has the potential to support the surgeon to recognize margins of lesions. For intraoperative use, however, it is necessary to develop an easy-to-use OCT system for real-time in vivo measurement.

Publication History

Publication Date:
18 April 2018 (online)