This PDF file contains the front matter associated with SPIE Proceedings Volume 8805, including the Title Page, Copyright Information, Table of Contents, and the Conference Committee listing.

Introduction: Endoscopic imaging can be used in the assessment of cancer and precancerous lesions of the upper aerodigestive tract. The objective of this presentation is to describe vertical imaging methods. Methods: The working principle and technique of optical coherence tomography (OCT) as well as endosonography (EUS) are briefly illustrated. Results: The main indications, normal and pathologic findings of each method, frequent pitfalls, and clinical results up to now are presented in detail. Conclusions: Endosonography helps in determining the exact extension of advanced carcinomas beyond 3 mm, while OCT, due to its better resolution, is superior in the assessment of precancerous and early cancerous lesions up to 2 mm thickness.

Optical coherence tomography (OCT) is a non-invasive imaging technique which can create optical tissue sections, enabling diagnosis of vocal cord tissue. To take full advantage from the non-contact imaging technique, OCT was adapted to an indirect laryngoscope to work on awake patients. Using OCT in a handheld diagnostic device the challenges of rapid working distance adjustment and tracking of axial motion arise. The optical focus of the endoscopic sample arm and the reference-arm length can be adjusted in a range of 40 mm to 90 mm. Automatic working distance adjustment is based on image analysis of OCT B-scans which identifies off depth images as well as position errors. The movable focal plane and reference plane are used to adjust working distance to match the sample depth and stabilise the sample in the desired axial position of the OCT scans. The autofocus adjusts the working distance within maximum 2.7 seconds for the maximum initial displacement of 40 mm. The amplitude of hand tremor during 60 s handheld scanning was reduced to 50 % and it was shown that the image stabilisation keeps the position error below 0.5 mm. Fast automatic working distance adjustment is crucial to minimise the duration of the diagnostic procedure. The image stabilisation compensates relative axial movements during handheld scanning.

The efforts aimed at early diagnosis of oral cancer should be prioritized towards developing a new screening instrument, based on optical coherence tomography (OCT), to be used directly intraorally, able to perform a fast, real time, 3D and non-invasive diagnosis of oral malignancies. The first step in this direction would be to optimize the OCT image interpretation of oral tissues. Therefore we propose plastination as a tissue preparation method that better preserves three-dimensional structure for study by new optical imaging techniques. The OCT and the synchrotron radiation computed microtomography (micro-CT) were employed for tissue sample analyze. For validating the OCT results we used the gold standard diagnostic procedure for any suspicious lesion – histopathology. This is a preliminary study of comparing features provided by OCT and Micro-CT. In the conditions of the present study, OCT proves to be a highly promising imaging modality. The use of x-ray based topographic imaging of small biological samples has been limited by the low intrinsic x-ray absorption of non-mineralized tissue and the lack of established contrast agents. Plastination can be used to enhance optical imagies of oral soft tissue samples.

Optical coherence tomography (OCT) and confocal endomicroscopy (CEM) have a well-established potential for early diagnosis of pre-malignant and early malignant lesions of the upper aerodigestive tract mucosa. Additional applications in ENT-diagnostics might facilitate a more widespread use by making the investment into the devices more economic. Both imaging techniques might also provide valuable information in nasal pathologies. OCT images were generated with a surgical microscope (Möller-Wedel Hi-R 1000) with an integrated high-speed-OCT camera (Optomedical GmbH). For the CEM a Heidelberg Retina tomograph II scanner (Heidelberg Engineering GmbH) was used. Both during sinus surgery in vivo and from removed material ex vivo OCT and CEM images were taken and correlated with histopathological analysis after hematoxylin and eosin staining. Patients with inverted papillomas and chronic rhinosinusitis (CRS) were evaluated. Inverted papillomas show a variably thick epithelial layer on OCT and densely packed epithelial cells on CEM. They can be clearly distinguished from nasal polyps that show a very thin epithelial layer upon loose subepithelial tissue. In CRS CEM can distinguish areas with intact from areas with destroyed ciliated epithelium by directly visualizing ciliary movement. OCT sometimes showed thin superficial dense structures that might correspond to biofilms. OCT and CEM might provide valuable information in the follow-up care of patients with inverted papillomas and in diagnostics of CRS.

Background: Malignancies of the upper aerodigestive tract (UADT) are conventionally diagnosed by white light endoscopy, biopsy and histopathology. Probe-based Confocal Laser Endomicroscopy (pCLE) is a novel non-invasive technique which offers in vivo surface and sub-surface imaging of tissue. It produces pictures of cellular architecture comparable to histology without the need for biopsy. It has already been successfully used in different clinical subspecialties to help in the diagnosis and treatment planning of inflammatory and neoplastic diseases. PCLE needs to be used in combination with specific or non-specific contrast agents. In this study we evaluated the potential use of pCLE in combination with non-specific and specific contrast agents to distinguish between healthy mucosa and invasive carcinoma. Methods: Tissue samples from healthy mucosa and squamous cell carcinoma of the head and neck were taken during surgery. After topical application of three different contrast agents, samples were examined using different pCLE-probes and a Confocal Laser Scanning Microscope (CLSM). Images were then compared to the corresponding histological slides and cryosections. Results: Initial results show that pCLE in combination with fluorophores allows visualization of cellular and structural components. Imaging of different layers was possible using three distinct pCLEprobes. Conclusion: pCLE is a promising non-invasive technique that may be a useful adjunct in the evaluation, diagnosis and treatment planning of head and neck malignancies.

Vibrations of the tympanic membrane (TM) play a key role for the transmission of sound to the inner ear. Today, there exist still problems in measuring the movement of the TM and there are unresolved issues in understanding the TM and its behavior. A non-invasive and contact-free in vivo investigation of the structure and the functional behavior of the TM would be a big step forward. In the presented study, the suitability of optical coherence tomography (OCT) for measuring the oscillation patterns of the TM in the frequency range covering the range of the human speech perception should be tested. For functional imaging a sound chirp was generated in the frequency range between 0.4 kHz - 6.4 kHz. To obtain the movement within a sufficient resolution, a grid of 25 x 25 measurement points was generated over the whole TM. The information of the oscillatory movement was encoded in the Doppler signal, provided by M-scans at several points of the TM. The frequency response functions of each frequency showed different oscillation patterns on the TM. The acquisition time of one single M-scan was only 8.5 ms and of the entire TM 5.3 s, emphasizing the potential of the method for future in vivo applications. Furthermore, the morphology was acquired with the same OCT-system, showing the feasibility for structural imaging and differentiation between typical regions of the TM. Thus, OCT was shown as a suitable method for the simultaneous measurement of the functional and structural behavior of the TM.

This study was performed in order to evaluate in vivo the applicability of Laser Doppler Flowmetry (LDF) in recording the gingival blood flow and to assess the changes of gingival blood flow following gingival reshaping performed with Er:YAG and 980 nm diode lasers. The LDF evaluation was performed on 20 anterior teeth, which underwent reshaping of gingiva, corresponding to 5 female patients (4 anterior teeth/patient), aged between 20 and 35. One part of the mouth was treated with Er:YAG laser (LP, VLP modes, 140 - 250 mJ, 10 - 20 Hz, using cylindrical sapphire tips) and other part with 980 nm diode laser (CW, 4 W, contact mode and saline solution cooling). The gingival blood flow was monitored using a MoorLab laser Doppler equipment (Moor Instruments Ltd., Axminster, UK) with a straight optical probe, MP3b, 10 mm. The data were processed using statistical analysis software SPSS v16.0.1. The investigation showed an evident decrease in perfusion for both areas in comparison with the baseline values 24 hours after treatment. The microvascular blood flow increased significantly after 7 days in both areas but mostly in diode area (p<0.001). After 14 days for the Er:YAG area the blood perfusion returned to the initial value. The results in diode area remained at a high level after 14 days. Both lasers proved efficiency in the surgical treatment of gingival tissue. Moreover, Laser Doppler Flowmetry is adequate for recording changes in gingival blood flow following periodontal surgery.