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      Optical coherence elastography in ophthalmology

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          Abstract.

          Optical coherence elastography (OCE) can provide clinically valuable information based on local measurements of tissue stiffness. Improved light sources and scanning methods in optical coherence tomography (OCT) have led to rapid growth in systems for high-resolution, quantitative elastography using imaged displacements and strains within soft tissue to infer local mechanical properties. We describe in some detail the physical processes underlying tissue mechanical response based on static and dynamic displacement methods. Namely, the assumptions commonly used to interpret displacement and strain measurements in terms of tissue elasticity for static OCE and propagating wave modes in dynamic OCE are discussed with the ultimate focus on OCT system design for ophthalmic applications. Practical OCT motion-tracking methods used to map tissue elasticity are also presented to fully describe technical developments in OCE, particularly noting those focused on the anterior segment of the eye. Clinical issues and future directions are discussed in the hope that OCE techniques will rapidly move forward to translational studies and clinical applications.

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          Most cited references155

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          Stress-strain measurements of human and porcine corneas after riboflavin-ultraviolet-A-induced cross-linking.

          To evaluate the biomechanical effect of combined riboflavin-ultraviolet A (UVA) treatment on porcine and human corneas. Department of Ophthalmology, Technical University of Dresden, Dresden, Germany. Corneal strips from 5 human enucleated eyes and 20 porcine cadaver corneas were treated with the photosensitizer riboflavin and irradiated with 2 double UVA diodes (370 nm, irradiance = 3 mW/cm2) for 30 minutes. After cross-linking, static stress-strain measurements of the treated and untreated corneas were performed using a microcomputer-controlled biomaterial tester with a prestress of 5 x 10(3) Pa. There was a significant increase in corneal rigidity after cross-linking, indicated by a rise in stress in treated porcine corneas (by 71.9%) and human corneas (by 328.9%) and in Young's modulus by the factor 1.8 in porcine corneas and 4.5 in human corneas. The mean central corneal thickness was 850 microm +/- 70 (SD) in porcine corneas and 550 +/- 40 microm in human corneas. Riboflavin-UVA-induced collagen cross-linking led to an increase in mechanical rigidity in porcine corneas and an even greater increase in human corneas. As collagen cross-linking is maximal in the anterior 300 microm of the cornea, the greater stiffening effect in human corneas can be explained by the relatively larger portion of the cornea being cross-linked in the overall thinner human cornea.
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            Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics.

            Shear wave elasticity imaging (SWEI) is a new approach to imaging and characterizing tissue structures based on the use of shear acoustic waves remotely induced by the radiation force of a focused ultrasonic beam. SWEI provides the physician with a virtual "finger" to probe the elasticity of the internal regions of the body. In SWEI, compared to other approaches in elasticity imaging, the induced strain in the tissue can be highly localized, because the remotely induced shear waves are attenuated fully within a very limited area of tissue in the vicinity of the focal point of a focused ultrasound beam. SWEI may add a new quality to conventional ultrasonic imaging or magnetic resonance imaging. Adding shear elasticity data ("palpation information") by superimposing color-coded elasticity data over ultrasonic or magnetic resonance images may enable better differentiation of tissues and further enhance diagnosis. This article presents a physical and mathematical basis of SWEI with some experimental results of pilot studies proving feasibility of this new ultrasonic technology. A theoretical model of shear oscillations in soft biological tissue remotely induced by the radiation force of focused ultrasound is described. Experimental studies based on optical and magnetic resonance imaging detection of these shear waves are presented. Recorded spatial and temporal profiles of propagating shear waves fully confirm the results of mathematical modeling. Finally, the safety of the SWEI method is discussed, and it is shown that typical ultrasonic exposure of SWEI is significantly below the threshold of damaging effects of focused ultrasound.
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              Magnetic resonance elastography: non-invasive mapping of tissue elasticity.

              Magnetic resonance elastography (MRE) is a phase-contrast-based MRI imaging technique that can directly visualize and quantitatively measure propagating acoustic strain waves in tissue-like materials subjected to harmonic mechanical excitation. The data acquired allows the calculation of local quantitative values of shear modulus and the generation of images that depict tissue elasticity or stiffness. This is significant because palpation, a physical examination that assesses the stiffness of tissue, can be an effective method of detecting tumors, but is restricted to parts of the body that are accessible to the physician's hand. MRE shows promise as a potential technique for 'palpation by imaging', with possible applications in tumor detection (particularly in breast, liver, kidney and prostate), characterization of disease, and assessment of rehabilitation (particularly in muscle). We describe MRE in the context of other recent techniques for imaging elasticity, discuss the processing algorithms for elasticity reconstruction and the issues and assumptions they involve, and present recent ex vivo and in vivo results.
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                Author and article information

                Journal
                J Biomed Opt
                J Biomed Opt
                JBOPFO
                JBO
                Journal of Biomedical Optics
                Society of Photo-Optical Instrumentation Engineers
                1083-3668
                1560-2281
                23 December 2017
                December 2017
                : 22
                : 12
                : 121720
                Affiliations
                [a ]University of Washington , Department of Bioengineering, Seattle, Washington, United States
                [b ]Akademia Górniczo-Hutnicza University of Science and Technology , Krakow, Poland
                [c ]University of Washington , Department of Chemical Engineering, Seattle, Washington, United States
                [d ]University of Washington , Department of Ophthalmology, Seattle, Washington, United States
                Author notes
                [* ]Address all correspondence to: Matthew O’Donnell, E-mail: odonnel@ 123456uw.edu
                Author information
                https://orcid.org/0000-0001-6823-9139
                https://orcid.org/0000-0002-2313-6678
                https://orcid.org/0000-0002-5288-0949
                https://orcid.org/0000-0003-4323-9321
                https://orcid.org/0000-0001-8780-7613
                Article
                JBO-170626SSVR 170626SSVR
                10.1117/1.JBO.22.12.121720
                5745712
                29275544
                96c5bd9b-97ee-4849-914a-0b12e95fd9e7
                © The Authors.

                Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

                History
                : 27 September 2017
                : 14 December 2017
                Page count
                Figures: 25, Tables: 1, References: 169, Pages: 28
                Funding
                Funded by: National Institutes of Health (NIH) http://dx.doi.org/10.13039/100000002
                Award ID: R01EY026532
                Award ID: R01EY024158
                Award ID: R01EB016034
                Award ID: R01CA170734
                Award ID: R01HL093140
                Funded by: Life Sciences Discovery Fund
                Award ID: 3292512
                Funded by: Coulter Translational Research Partnership Program
                Funded by: Research to Prevent Blindness, Inc.
                Funded by: Department of Bioengineering at the University of Washington http://dx.doi.org/10.13039/100007812
                Funded by: Narodowe Centrum Nauki (NCN) http://dx.doi.org/10.13039/501100004281
                Award ID: UMO-2014/13/B/ST7/00690
                Funded by: National Science Foundation (NSF) http://dx.doi.org/10.13039/100000001
                Award ID: DGE-1256082
                Categories
                Special Section on 25 years of OCT
                Paper
                Custom metadata
                Kirby et al.: Optical coherence elastography in ophthalmology

                Biomedical engineering
                optical coherence tomography,optical coherence elastography, acoustic radiation force,air-coupled ultrasound,phase-sensitive optical coherence tomography,tissue elasticity,ocular biomechanics,speckle tracking,mechanical wave imaging

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