The optical design for a dual modality endoscope based on piezo scanning fiber technology is presented including a novel technique to combine forward-viewing navigation and side viewing OCT. Potential applications include navigating body lumens such as the fallopian tube, biliary ducts and cardiovascular system. A custom cover plate provides a rotationally symmetric double reflection of the OCT beam to deviate and focus the OCT beam out the side of the endoscope for cross-sectional imaging of the tubal lumen. Considerations in the choice of the scanning fiber are explored and a new technique to increase the divergence angle of the scanning fiber to improve system performance is presented. Resolution and the necessary scanning density requirements to achieve Nyquist sampling of the full image are considered. The novel optical design lays the groundwork for a new approach integrating side-viewing OCT into multimodality endoscopes for small lumen imaging.

As lesões vasculares estão entre as anormalidades congênitas e neonatais mais comuns. Cerca de 60% estão localizadas na região da cabeça e pescoço. A identificação e a classificação adequadas de cada tipo de lesão, tem um impacto direto no diagnóstico e, no tratamento destes pacientes. A técnica de Tomografia por Coerência Óptica (Optical coherence tomography: OCT) obtém imagens em alta resolução, geradas em tempo real que permitem visualizar de forma não invasiva, estruturas celulares e extracelulares, com uma resolução espacial da ordem de 10μm, que é 20 vezes maior que a de um ultrassom, aproximando-se do nível histológico convencional, razão pela qual é considerada biópsia óptica. Com o objetivo de fornecer imagens que possibilitassem avaliar as diferenças na arquitetura dos vasos em diferentes tipos de lesões localizadas, no tecido cutâneo e na mucosa, em regiões da cabeça e pescoço, foram tomadas imagens de lesões de 27 pacientes usando um sistema de OCT com Doppler (1325nm). Os resultados deste estudo clínico comprovaram a viabilidade da OCT permitindo distinguir entre a pele normal e a pele com lesão. Na má-formação capilar, os vasos sanguíneos tiveram diâmetro médio de 114\\μm ± 92μm e apresentaram uma profundidade média de 304 μm ± 99 μm. Os hemangiomas apresentaram vasos sanguíneos com diâmetro médio de 39μm ± 19 μm e profundidade média de 298 μm ± 133 μm. Nas lesões diagnosticadas pelo clínico como Hemangioma da mucosa labial, medimos diâmetro médio dos vasos de 45μm ± 16 μm com profundidade média de 520,5μm ± 189,5μm. Na má-formação linfática de lábio, os vasos sanguíneos apresentaram diâmetro médio de 157,5μm ± 90μm e, uma profundidade média 695μm ± 136μm. Na má-formação vascular de lábio, os vasos sanguíneos apresentaram diâmetro médio de 128μm±63μm e, uma profundidade média 689 μm ± 217μm. Com estas informações obtidas das imagens de OCT indicando fluxo, foi possível avaliar diferenças peculiares da lesão de cada paciente, promovendo o diagnóstico diferencial das lesões vasculares da superfície tecidual da pele e mucosa oral. / Vascular lesions are among the most common congenital and neonatal abnormalities. About 60% are in the head and neck region. The proper identification and classification of each type of lesion has a direct impact on the diagnosis and consequently on the treatment of these patients. The Optical Coherence Tomography (OCT) technique obtains high resolution, real time generated images that allow non-invasive visualization of bio tissue structures with a spatial resolution of the order of 10μm, which is 20 times greater than that of an ultrasound, approaching the conventional histological level. That is why it is considered an optical biopsy. In this thesis, images of lesions from 27 patients were obtained using a Doppler OCT system operating at 1325nm, with the purpose of providing images that allowed to evaluate the differences in the architecture of the vessels in different types of lesions located in the cutaneous and mucosa tissue in head and neck regions. The results of this clinical study proved the viability of OCT to distinguish between normal skin and lesioned skin. In vascular malformation, the blood vessels had an average diameter of 114 μm ± 92 μm and had a mean depth of 304,3 μm ± 99 μm. The skin hemangiomas had blood vessels with a mean diameter of 38,6 μm ± 19 μm and a mean depth of 297,8 μm ± 132 μm. In the lesions clinically diagnosed as oral mucosa hemangioma (lips), the mean vessel diameter was 45 μm ± 16 μm and a mean depth of 520,5 μm ± 189,5 μm. In lip lymphatic malformation, the blood vessels had a mean diameter of 157,5 μm ± 90 μm and a mean depth of 695 μm ± 136 μm. In lip vascular malformation, the blood vessels had a mean diameter of 128 μm ± 63 μm and a mean depth of 689 μm ± 217 μm. With this information obtained from the Doppler OCT images indicating flow, it was possible to evaluate peculiar differences of the lesion of each patient, promoting the differential diagnosis of vascular lesions of the tissue surface of the skin and oral mucosa.

A detecção de lesões cariosas nos estágios iniciais possibilita a escolha de tratamentos baseados na preservação da estrutura dental. Dessa forma, a utilização de exames capazes de diagnosticar precocemente essas lesões, como a Tomografia por Coerência Óptica (OCT Optical Coherence Tomography) é adequada. Assim, o objetivo do trabalho foi avaliar a capacidade da OCT em quantificar os estágios de desmineralização do esmalte durante o desenvolvimento de lesões simuladas de cárie, tendo como padrão de referência o teste de microdureza seccional. Foram utilizados 53 dentes terceiros molares hígidos, os quais tiveram as coroas seccionadas para obtenção de 210 amostras. Para avaliar as possíveis alterações sofridas por cada amostra, essas foram examinadas através da técnica de OCT no início do experimento e novamente examinadas após o término do período de ciclagem estabelecido para cada grupo, utilizando os coeficientes de atenuação óptica total e o cálculo de área em gráficos de intensidade de sinal de OCT, como parâmetros de análise. Posteriormente, as amostras foram submetidas a testes de microdureza seccional. A diferença entre os coeficientes de atenuação óptica obtidos antes e depois da ciclagem de pH apresentou elevado grau de correlação com os resultados de microdureza seccional. Por meio da análise das áreas provenientes de gráficos de intensidade de sinal de OCT e microdureza Knoop, ambos em função da profundidade, foi observada relação de linearidade entre os resultados e elevada correlação entre as técnicas avaliadas (ρ = 0,99). De acordo com os resultados, a técnica de OCT foi capaz de detectar diferentes graus de desmineralização do esmalte dental humano em lesões simuladas de cárie. / The detection of carious lesions in early stages enables treatment choose based on dental structure preservation. This way, the utilization of exams capable of early diagnosis of these lesions, like OCT (Optical Coherence Tomography), is appropriate. Therefore, the objective of this work was to assess the capability of OCT in quantifying the enamel demineralization stages during the development of simulated caries lesions, having as reference standard the sectional microhardness test. There were used 53 sound third molars, which had their crowns sectioned to obtain 210 samples. To assess possible changes in each sample, these were examined by the OCT technique in the beginning of the experiment and again in the end of the cycling period established to each group, using the total optical attenuation coefficient and the area calculations using OCT signal intensity as analysis parameters. After that, the samples were submitted to sectional microhardness test. The difference between optical attenuation coefficients taken before and after the pH cycling, showed a high level of correlation with the microhardness results. Through areas analysis of OCT signal intensity and Knoop microhardness against depth, it was observed linearity relation between results and high correlation among assessed techniques (ρ=0,99). According to the results, the OCT technique was capable of detecting different degrees of demineralization of the human enamel in carious simulated lesions.

Introdução: O tratamento do buraco macular idiopático ainda é acompanhado de incertezas em relação ao seu prognóstico. Ao longo dos últimos anos, têm sido utilizados o tempo de história, o tamanho e a acuidade visual pré-operatória dos buracos como critérios de orientação quanto ao resultado visual final. O aspecto final da parte mais externa da retina foveal tem merecido especial atenção em relatos recentes. Neste trabalho, avaliou-se, por meio da tomografia de coerência óptica, a integridade da camada de fotorreceptores, correlacionando o seu aspecto final com a acuidade visual obtida em casos de buraco macular idiopático, fechados cirurgicamente. Métodos: Pacientes operados com sucesso e com seguimento mínimo de 12 meses foram submetidos à avaliação oftalmológica completa incluindo a medida da acuidade visual final em escala logMar, biomicroscopia de mácula, oftalmoscopia indireta e angiofluoresceinografia. Colheram-se dados sobre idade, sexo, raça, tempo de história e tamanho do buraco além da acuidade visual pré-operatória. Para a classificação das lesões, utilizaram-se os critérios definidos por Gass. Imagens tomográficas da camada correspondente aos fotorreceptores da retina na região foveal foram criteriosamente obtidas através da tomografia de coerência óptica. Uma avaliação qualitativa desta camada foi realizada por examinador experiente, de forma mascarada, com os pacientes então classificados em três grupos (1, 2 e 3), em ordem crescente de integridade. Resultados: Foram incluídos no estudo 39 olhos de 37 pacientes, sendo eles 22 mulheres (59,5%) e 15 homens (40,5%). A idade média foi de 68,2 anos variando entre 51 e 83 anos. O tempo de seguimento pós-operatório médio foi de 38,5 meses. Entre todos os olhos estudados, 12 foram incluídos no grupo 1 (menor integridade); sete, no grupo 2 e vinte, no grupo 3. Na comparação entre os grupos 1 e 3, a acuidade visual final melhorou em ambos; porém, com maior intensidade no grupo 3 (p<0,001). O tamanho pré-operatório do buraco e o tempo de história da doença não impactaram significativamente o resultado visual final (p=0,223 e p=0,559, respectivamente). A acuidade visual pré-operatória média foi maior no grupo 3 que no grupo 1 (p=0,012). Conclusões: Os dados obtidos através deste estudo sugerem correlação entre uma maior integridade da camada dos fotorreceptores e um melhor resultado visual de longo prazo, em pacientes com buraco macular idiopático, operados com sucesso. Embora a visão tenha melhorado em todos os grupos, a melhora foi significativamente maior no grupo 3 que no grupo 1. Em relação ao tamanho pré-operatório da lesão e o tempo de história da doença, não se observou impacto significativo no resultado. Uma melhor acuidade visual inicial pré-operatória pode influenciar positivamente a acuidade visual final. / Purpose: To evaluate the integrity of the retina photoreceptor layer as determined by optical coherence tomography and its relationship with final visual outcome in successfully closed idiopathic macular holes. Methods: Successfully operated patients with a minimal follow-up of 12 months, underwent complete ophthalmic exam involving post-operative best corrected visual acuity using logMar scale, macula biomicroscopy and indirect ophthalmoscopy and fluorescein angiography. Complete epidemiologic data was collected as well as time duration, pre-op visual acuity, and size and Gass classification of the holes. Optical coherence tomography images of the layer corresponding to the transition between inner and outer segments of the photoreceptors were meticulously generated using commercially available Stratus OCT (OCT3). Qualitative analysis of this layer was carried out, in a masked fashion, by a certified and well experienced examiner. Based on increasing integrity showed in the images, patients were then distributed in 3 groups: 1, 2 and 3. Group 1 integrity from 1 to 33%, group 2 from 34 to 66%, and group 3 from 67 to 100%. Results: A total of 39 eyes of 37 patients were included in the study. Among all patients, 12 were included in group 1, 7 in group 3 and 20 in group 3. There were 22 female (59,5%) and 15 male (40,5%). Mean age was 68.2 years varying from 51 to 83 years of age. Mean post-op follow-up time was 38.5 months. When comparing groups 1 and 3, best corrected final visual acuity improved in both groups but dramatically in group 3 (better integrity) (p<0.001). Pre-operative size and time duration of the hole did not correlate with better visual acuity (p=0.223 and p=0.559 respectively). Mean pre-op visual acuity was better in group 3 than in group 1 (p=0.012). Conclusion: Data obtained in our study indicate that there is a strong correlation between better integrity of the photoreceptor layer, as determined by optical coherence tomography, and a more successful final, long term, visual acuity in patients with idiopathic macular hole successfully operated. Although final visual acuity has improved in all groups, there was statistical difference between groups 1 and 3. Pre-operative size and time duration of the hole did not have impact on final visual acuity. Better pre-op visual acuity may have an effect on final outcome.

A Tomografia por Coerência Óptica (OCT) baseia-se na propriedade de retroespalhamento dos meios para construir imagens tomográficas do interior das amostras. De maneira similar, a técnica LIDAR (Light Detection and Range) faz uso desta propriedade para determinar as características da atmosfera, em especial o coeficiente de extinção do sinal. Explorar esta similaridade permitiu aplicar métodos de inversão utilizados na técnica LIDAR às imagens OCT, permitindo construir imagens de coeficiente de extinção, resultado inédito até o momento. Este trabalho teve o objetivo de estudar, propor, desenvolver e implementar algoritmos de métodos de inversão do sinal OCT para determinação do coeficiente de extinção em função da profundidade. Foram utilizados três métodos de inversão, da inclinação, do ponto de contorno e da profundidade óptica, com implementação em ambiente LABView&reg; . Estudo dos erros associados aos métodos de inversão foi realizado e, amostras reais (homogêneas e estratificadas) foram utilizadas para análises em uma e duas dimensões. As imagens de coeficiente de extinção obtidas pelo método da profundidade óptica claramente foram capazes de diferenciar o ar da amostra. As imagens foram estudadas empregando PCA e análise de clusters que avaliou a robustez da técnica em determinar o valor do coeficiente de extinção da amostra. Além disso, o método da profundidade óptica proposto foi empregado para estudar a hipótese de que existe correlação entre o coeficiente de extinção do sinal e a desmineralização de esmalte dental durante o processo cariogênico. Com a aplicação desta metodologia foi possível observar a variação do coeficiente de extinção em função da profundidade e sua correlação com a variação da microdureza, além de mostrar que em camadas mais profundas o valor do coeficiente de extinção valor tende ao de um dente sadio, comportando-se da mesma maneira que a microdureza do dente. / Optical Coherence Tomography (OCT) is based on the media backscatering properties in order to obtain tomographic images. In a similar way, LIDAR (Light Detection and Range) technique uses these properties to determine atmospheric characteristics, specially the signal extinction coeficient. Exploring this similarity allowed the application of signal inversion methods to the OCT images, allowing to construct images based in the extinction coeficient, original result until now. The goal of this work was to study, propose, develop and implement algorithms based on OCT signal inversion methodologies with the aim of determine the extinction coeficient as a function of depth. Three inversion methods were used and implemented in LABView&reg; : slope, boundary point and optical depth. Associated errors were studied and real samples (homogeneous and stratified) were used for two and three dimension analysis. The extinction coeficient images obtained from the optical depth method were capable to diferentiate air from the sample. The images were studied applying PCA and cluster analysis that established the methodology strength in determining the sample´s extinction coefficient value. Moreover, the optical depth methodology was applied to study the hipothesis that there is some correlation between signal extinction coeficient and the enamel teeth demineralization during a cariogenic process. By applying this methodology, it was possible to observe the variation of the extinction coefficient as depth function and its correlation with microhardness variation, showing that in deeper layers its values tends to a healthy tooth values, behaving as the same way that the microhardness.

Cette thèse porte sur la segmentation et la caractérisation des artères coronaires et des endoprothèses (stent) en imagerie de Tomographie par Cohérence Optique (OCT). L’OCT est une imagerie de très haute résolution qui permet d’apprécier des structures fines comme la couche intimale de la paroi vasculaire et les mailles du stent (struts). L’objectif de cette thèse est de proposer des outils logiciels autorisant l’analyse automatique d’un examen avec un temps d’exécution compatible avec une utilisation peropératoire. Ces travaux font suite à la thèse de Dubuisson en OCT, qui avait proposé un premier formalisme pour la segmentation de la lumière et la détection des struts pour les stents métalliques. Nous avons revisité la chaine de traitement pour ces deux problèmes et proposé une méthode préliminaire de détection de stents en polymère biorésorbable. Une modélisation surfacique du stent a permis d’estimer une série d’indices cliniques à partir des diamètres, surfaces et volumes mesurés sur chaque coupe ou sur l’ensemble de l’examen. L’apposition du stent par rapport à la paroi est également mesurée et visualisée en 3D avec une échelle de couleurs intuitive. La lumière artérielle est délimitée à l’aide d’un algorithme de recherche de plus court chemin de type Fast Marching. Son originalité est d’exploiter l’image sous la forme hélicoïdale native de l’acquisition. Pour la détection du stent métallique, les maxima locaux de l’image suivis d’une zone d’ombre ont été détectés et caractérisés par un vecteur d’attributs calculés dans leur voisinage (valeur relative du maximum, pente en niveau de gris, symétrie...). Les pics correspondant à des struts ont été discriminés du speckle environnant par une étape de régression logistique avec un apprentissage à partir d’une vérité terrain construite par un expert. Une probabilité d’appartenance des pics aux struts est construite à partir de la combinaison des attributs obtenue. L’originalité de la méthode réside en la fusion des probabilités des éléments proches avant d’appliquer un critère de décision lui aussi déterminé à partir de la vérité terrain. La méthode a été évaluée sur une base de données de 14 examens complets, à la fois au niveau des pixels et des struts détectés. Nous avons également validé de façon exhaustive une méthode de recalage non rigide d’images OCT exploitant des amers appariés par un expert sur les examens source et cible. L’objectif de ce recalage est de pouvoir comparer les examens coupe à coupe et les indices calculés aux mêmes positions à des temps d’acquisition différents. La fiabilité du modèle de déformation a été évaluée sur un corpus de quarante-quatre paires d’examens OCT à partir d’une technique de validation croisée par Leave-One-Out. / This thesis deals with the segmentation and characterization of coronary arteries and stents in Optical Coherence Tomography (OCT) imaging. OCT is a very high resolution imaging that can appreciate fine structures such as the intimal layer of the vascular wall and stitches (struts). The objective of this thesis is to propose software tools allowing the automatic analysis of an examination with a runtime compatible with an intraoperative use. This work follows Dubuisson's thesis in OCT, which proposed a first formalism for light segmentation and strut detection for metal stents. We revisited the treatment chain for these two problems and proposed a preliminary method for detecting bioabsorbable polymer stents. Surface modeling of the stent made it possible to estimate a series of clinical indices from the diameters, surfaces and volumes measured on each section or on the entire examination. Applying the stent to the wall is also measured and visualized in 3D with an intuitive color scale. The arterial lumen is delineated using a Fast Marching short path search algorithm. Its originality is to exploit the image in the native helical form of the acquisition. For the detection of the metallic stent, the local maxima of the image followed by a shadow zone have been detected and characterized by a vector of attributes calculated in their neighborhood (relative value of the maximum, slope in gray level, symmetry ...). Peaks corresponding to struts were discriminated from the surrounding speckle by a logistic regression step with learning from a field truth constructed by an expert. A probability of belonging to the peaks to struts is constructed from the combination of attributes obtained. The originality of the method lies in the fusion of the probabilities of the close elements before applying a decision criterion also determined from the ground truth. The method was evaluated on a database of 14 complete examinations, both at the level of pixels and struts detected. We have also extensively validated a method of non-rigid registration of OCT images using bitters matched by an expert on the source and target exams. The objective of this registration is to be able to compare cut-to-cut examinations and indices calculated at the same positions at different acquisition times. The reliability of the strain model was evaluated on a corpus of forty-four pairs of OCT exams from a Leave-One-Out cross validation technique.

Relatively new technology called optical coherence tomography allows direct and non invasive in vivo imaging of retinal anatomy in human subjects. There are several interesting applications of this technique, including testing models relating retinal anatomy (structural measures) to behavioral thresholds of light sensitivity (functional measures). In addition to potentially improving our understanding of this relationship and how it changes during the course of neurodegenerative diseases of the eye such as glaucoma, analyses of these data may allow for early identification of glaucomatous neural damage in the retina, which has considerable clinical relevance. Here, the underlying assumptions and generalization of a previously developed model of the structure function relationship in glaucoma was tested by applying this model to a novel dataset. This model has been influential in the literature because it purports to accurately estimate the number of retinal ganglion cells; however, it was found to have several questionable assumptions and did not generalize well. Next, a new method of estimating the number of retinal ganglion cells from optical coherence tomography was developed. This method uses fewer and more defensible assumptions and demonstrated good agreement with independent histological estimates. Finally, a new method, using computer simulations, was developed for analyzing data from optical coherence tomography in order to distinguish early signs of glaucomatous changes in retinal anatomy from variability in structure among healthy retinas, and this method performed better than previously published techniques.

In the past decades, the performance of swept source optical coherence tomography (SS-OCT) has experienced an unprecedented improvement which is mainly driven by the rapidly evolving laser technologies: the state-of-art SS-OCT is now tens of dB more sensitive, six orders of magnitude faster, and seeing ten times deeper than the original version of time domain OCT. Regardless of the abovementioned progress, the phase instability is always considered the biggest weakness of SS-OCT and the mainstream belief often states that the mechanical tuning mechanism of the swept source is to blame. In my study, I first developed a high-speed phase-stable SS-OCT based on a new-generation akinetic laser source, which is electrically tuned in wavelength, in the hope of reducing the phase noise to a shot-noise limited level. The experimental results turned out to be contradicted to the conventional phase noise theory, which inspires my discovery of a completely new interpretation for the phase noise in SS-OCT: I proposed that the timing jitter and scanning variability has to be taken into the consideration in the noise model as multiplicative noises. The theory was later validated by another SS-OCT using a different light source. This study for the first time articulated the phase noise’s origin and composition in the SS-OCT. Although the SS-OCT performs relatively worse in phase stability compared with its spectral-domain counterpart (SD-OCT), it is still valuable since it images at a much faster rate than SD-OCT. Therefore, a better temporal resolution could be achieved, which is particularly attractive in areas such as time lapse imaging. I therefore utilize the system along with other two systems to conduct ex vivo imaging on human tracheobronchial epithelium. It is shown that the SS-OCT system could achieve equally good performance in this task. Moreover, thanks to the higher temporal and temporal frequency resolution, finer structure within the frequency response of the ciliary motion is picked up by our system. During the study of ex vivo ciliary imaging, one of the challenges I was confronted with was the enormous amount of data generated by the SS-OCT, especially when high temporal frequency resolution is required. We thus came up with an idea of applying the compressive sensing (CS) to reduce the data size. Currently, we have demonstrated some preliminary results with using CS on reference k-clock channel compression. In the future, we will apply the same theory to compress the sample channel data, especially or time lapse OCT imaging.

Over the past 25 years of development and innovation, optical coherence tomography (OCT) has successfully fills the gap between the ex vivo high-resolution optical microscopy technologies and in vivo low-resolution medical imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US). Ultrahigh resolution (UHR) OCT categorizes OCT systems with an axial resolution below 3 µm in tissue. With the improved resolution, UHR OCT may impart the knowledge of detailed structures of the tissues that are almost close to what histology may provide. This is how UHR OCT can act as a bridge between radiology and histology. This thesis will present an ultrahigh-resolution (UHR) spectral domain (SD) OCT system that features both high axial resolution and long imaging range, and will demonstrate its applications in human myocardium and breast tissue imaging. The UHR OCT system accommodates a supercontinuum light source, and a home-built spectrometer designed to achieve optimized imaging performance. Specifically, the spectrometer features a customized focusing lenses that are comprised of off-the-shelf optics and a 2k-pixel camera to minimize the cost of the instrument. The system manifests an axial resolution of 2.72 µm and a lateral resolution of 5.52 µm, with a large imaging range of 1.78 mm. The sensitivity of the system is 93 dB with a 6-dB sensitivity fall-off range of 0.89 mm. For human myocardium, currently there is no high-resolution non-destructive real-time imaging modality available for biopsy guidance. As a real-time and non-destructive imaging tool, UHR OCT offers additional benefits compared with standard OCT, which are illustrated by successful delineation of micro-structures such as thin elastic fibers and Purkinje fibers in the endomyocardial side. These structures are otherwise not visible within standard-resolution OCT images. Moreover, by adding the cross-polarization (CP) functionality to the UHR SD system, different types of myocardial tissue can be better delineated through the CP contrast. The functional information provided by CP-OCT may also facilitate automatic tissue classification by using A-line signals. For breast tissue imaging, we show qualitatively and quantitatively that UHR OCT images may enable better visualization of detailed features in different types of breast tissue, including healthy and cancerous ones. UHR OCT images of new breast cancer types such as phyllodes tumor, necrotic tumor and fibrotic focus carcinoma are provided for future references. Features developed from UHR OCT images enable a better yield from relevance vector machine (RVM) based stochastic classification model, compared with that from standard resolution OCT images. UHR OCT shows a great promise for automated classification of different tissue types in human breast tissue based off on UHR OCT images. Lastly, we present our endeavor to miniaturize the UHR OCT system on chip. We explore a chip-based optical frequency comb source that may enable UHR OCT at longer wavelengths to achieve better signal penetration in the future. We characterize the performance of the novel source, including the axial resolution and noise, and show that it holds the promise to be adopted in UHR OCT imaging. In addition, we also demonstrate an on-chip tunable reference arm that allows high-topology high-resolution OCT imaging. The compactness of the devices pave the way to the ultimate miniaturization of OCT system.

Catheter ablation therapy attempts to restore sinus rhythm in arrhythmia patients by producing site-specific tissue modification along regions which cause abnormal electrical activity. This treatment, though widely used, often requires repeat procedures to observe long-term therapeutic benefits. This limitation is driven in part by challenges faced by conventional schemes in validating lesion adequacy at the time of the procedure. Optical techniques are well-suited for the interrogation and characterization of biological tissues. In particular, optical coherence tomography (OCT) relies on coherence gating of singly-scattered light to enable high-resolution structural imaging for tissue diagnostics and procedural guidance. Alternatively, optical reflectance spectroscopy (ORS) is a point measurement technique which makes use of incoherent, multiply-scattered light to probe tissue volumes and derive important data from its optical signature. ORS relies on the fact that light-tissue interactions are regulated by absorption and scattering, which directly relate to the intrinsic tissue biochemistry and cellular organization. In this thesis, we explore the integration of these modalities into ablation catheters for obtaining procedural metrics which could be utilized to guide catheter ablation therapy. We first present the development of an accelerated computational light transport model and its application for guiding ORS catheter design. A custom ORS-integrated ablation catheter is then implemented and tested within porcine specimens in vitro. A model is proposed for real-time estimation of lesion size based on changes in spectral morphology acquired during ablation. We then fabricated custom integrated OCT M-mode RF catheters and present a model for detecting contact status based on deep convolutional neural networks trained on endomyocardial images. Additionally, we demonstrate for the first time, tracking of RF-induced lesion formation employing OCT Doppler micro-velocimetry; this response is shown to be commensurate with the degree of treatment. We further demonstrate for the first time spectroscopic tracking of kinetics related to the heme oxidation cascade during thermal treatment, which are linked to tissue denaturation. The pairing of these modalities into a single RF catheter was also validated for guiding lesion delivery in vitro and within live pigs. Finally, we conclude with a proof-of-concept demonstration of ORS as a mapping tool to guide epicardial ablation in human donor hearts. These results showcase the vast potential of ORS and OCT empowered RF catheters for aiding intraprocedural guidance of catheter ablation procedures which could be utilized alongside current practices.