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Oscar Carrasco-Zevallos, Brenton Keller, Christian Viehland, Paul Hahn, Anthony N Kuo, Philip J DeSouza, Cynthia A Toth, Joseph A Izatt; Real-time 4D visualization of surgical maneuvers with 100kHz swept-source Microscope Integrated Optical Coherence Tomography (MIOCT) in model eyes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1633.
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© ARVO (1962-2015); The Authors (2016-present)
Previous implementations of intrasurgical optical coherence tomography required 3-5 seconds for full volumetric data acquisition and limited imaging to pauses in surgery. Next generation swept-source OCT technology allows for 5-10x faster data acquisition, and would thus allow visualization of surgical maneuvers over a three-dimensional field in real time. To this end, we evaluate a prototype swept-source MIOCT (SS-MIOCT) system for real-time volumetric imaging during simulated surgical maneuvers.
The SS-MIOCT engine employed a swept source centered at 1040 nm and a 100,000 A-scans/sec scan rate with an SNR of 101.8 dB, an axial resolution of 7.7 μm, and an axial imaging range of 3.7 mm. Custom software was developed to process and render multiple data visualizations (volumetric, B-scan, and summed-voxel projection) simultaneously in real time. To test 4D visualization performance, volumetric images of a surgical tool moving across a simulated retinal surface were acquired at varying voxel dimensions and volume rates. Two graders evaluated volume sampling/rate tradeoffs by scoring image quality and fluidity of tool movement. Real-time volumetric datasets were also acquired during simulated surgery in an excised porcine eye.
At all voxel dimension/volume rate combinations tested, high quality image data of surgical tools and retinal structure were obtained (Figs. 1,2). Figure 1 depicts volumetric images with 32, 64, 96, and 128 B-scans per volume, corresponding to volume rates of 10.41 Hz, 5.21 Hz, 3.27 Hz, 2.60 Hz, respectively. Rows A-D depict different acquisitions, and the volumes in each panel were acquired at the indicated time points. Red arrows denote motion artifacts. Volumetric imaging at 5.21 Hz resulted in the best scored image quality. Figure 2 illustrates imaging of a diamond-dusted membrane scraper scraping the surface of a porcine retina at a volume rate of .90 Hz with rows (A-C) corresponding to volumes acquired at sequential time points.
SS-MIOCT enables real-time, volumetric, dynamic tracking of surgical tools in model eyes.
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