KR20170062237A - Polarization-sensitive optical coherence tomography imaging system - Google Patents
Polarization-sensitive optical coherence tomography imaging system Download PDFInfo
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- KR20170062237A KR20170062237A KR1020150167798A KR20150167798A KR20170062237A KR 20170062237 A KR20170062237 A KR 20170062237A KR 1020150167798 A KR1020150167798 A KR 1020150167798A KR 20150167798 A KR20150167798 A KR 20150167798A KR 20170062237 A KR20170062237 A KR 20170062237A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0062—Arrangements for scanning
- A61B5/0064—Body surface scanning
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/43—Detecting, measuring or recording for evaluating the reproductive systems
- A61B5/4375—Detecting, measuring or recording for evaluating the reproductive systems for evaluating the male reproductive system
- A61B5/4381—Prostate evaluation or disorder diagnosis
Abstract
The present invention provides a polarization-sensitive optical coherent tomography imaging system capable of visualizing the connective tissue membrane and nerve of the prostate in real time, comprising a light source and a light splitting unit for splitting the light provided from the light source into reference light and irradiation light, A sample arm which is connected to the light dividing unit and is connected to the reference arm and the light dividing unit provided with the reference light from the light dividing unit to polarize the irradiation light provided from the light dividing unit into normal light and vertical light, A detection unit which forms an irradiation path for the light to be irradiated toward the prostate gland and an incident path for reflected light from the prostate gland, and a detector for detecting the reflected light incident on the detection unit to obtain birefringence image information of the prostate, A detector for acquiring structural image information of the prostate with an interference signal of the reflected light; It includes. Therefore, it is possible to visualize the connective tissue membrane and the nerve to provide real-time images to the operator, which can reduce nerve damage during the removal of the lesion, thereby reducing the deterioration of the organ function after surgery and increasing the success rate of surgery .
Description
The present invention relates to a polarization-sensitive optical coherence tomography imaging system, and more particularly, to a polarization-sensitive optical coherence tomography imaging system for use in peripheral neuroimaging in the removal of a prostate lesion.
In general, minimization of damage to important parts of the organ function such as nerve, blood vessel, ureter and bile duct as well as removal of lesion is required to improve the success rate of precision surgery. In particular, since nerve damage can lead to postoperative complications such as chronic pain and research paralysis, various researches and developments have been actively carried out for nerve preservation during surgery.
However, because the nerve is difficult to detect with the naked eye, electromyography is used to detect neurons, which can easily be damaged when the lesion is removed. The electromyography test is characterized in that the state of the nerve is confirmed by applying electrical stimulation to the region where the nerve is supposed to be located based on the anatomical relation.
The prior art for such EMG examination has already been disclosed in Korean Patent Laid-Open Publication No. 2002-0077346 (Electromyography Inspection System, October 11, 2002). The present invention is characterized by confirming the state of the nerve adjacent to the probe tip based on the probe.
However, the conventional electromyography test has a problem in that it is difficult to intuitively detect the nerve, and thus it is difficult to apply it to an operation requiring visual position detection of the nerve. In particular, prostate-related surgery, such as prostatectomy, is surrounded by multiple layers of connective tissue and multiple layers of connective tissue, so that the connective tissue membranes and nerves are visualized in real time A technology that can be used is required.
It is an object of the present invention to provide a polarization sensitive optical coherence tomography imaging system capable of visualizing in real time the connective tissue membranes and nerves of the prostate gland.
A polarization-sensitive optical coherent tomography imaging apparatus according to the present invention includes a light source and a light splitting unit that splits light provided from the light source into reference light and irradiation light, and a reference arm connected to the light splitting unit to form a path of the reference light, A sample arm including an optical member that forms a path provided to the prostate portion as a target position and that polarizes the irradiation light into a horizontal component and a vertical component, and a reference arm that passes through the reference arm, And a detector for receiving reflected light reflected from the sample arm and detecting image information of the prostate part, wherein the detector acquires structural image information of the prostate region using an interference signal between the reference light and the reflected light, Using the horizontal component reflected from the prostate part and the vertical component And acquires birefringence image information of the prostate region.
The horizontal arm and the vertical arm of the sample arm are irradiated to the prostate part with an optical path difference, and the horizontal component and the vertical component reflected from the prostate part are respectively received with an optical path difference.
The horizontal component and the vertical component irradiated from the sample arm are reflected from the prostate part and tissue characteristic information of the connective tissue membrane and the nerve of the prostate part may be detected based on the birefringence characteristic of the prostate part .
The polarized light sensitive optical coherent tomographic imaging apparatus further includes an image processing unit connected to the detection unit and displaying a birefringence image and a structural image of the nerve tissue and the nerve respectively, Can be displayed in mutually different forms in a birefringence image.
In the birefringence image, the nerve may be displayed in fibrous form on the connective tissue membrane to be distinct from the connective tissue membrane.
The birefringence image information includes tissue characteristic information on the nerve bundles of the forked nerve from the ganglion to the bladder, rectum, and penis, and the structure image information includes the gland structure around the prostate gland and the structure Information.
The detection unit may detect tissue characteristic information on the penile sponge nerve from the reflected light.
Meanwhile, the polarization-sensitive optical coherent tomography imaging method according to the present invention includes the steps of dividing light provided from a light source into reference light and irradiation light, polarizing the irradiation light into a horizontal component and a vertical component, And detecting the image information of the prostate part by receiving the reflected light reflected from the reference light and the prostate part and detecting the image information of the prostate part, Obtains the structural image information of the prostate region using the interference signal, and obtains the birefringence image information of the prostate region using the horizontal component and the vertical component reflected from the prostate region.
In the step of irradiating, the horizontal component and the vertical component may be irradiated to the prostatic segment, with the optical path difference, and the horizontal component and the vertical component reflected from the prostate portion may be respectively received with an optical path difference.
In the detecting step, the horizontal component and the vertical component are reflected from the prostate part, and the tissue characteristic information of the connective tissue membrane and the nerve of the prostate part may be detected based on the birefringence characteristic of the prostate part.
Wherein the polarization sensitive optical coherent tomography imaging method further comprises displaying the combined tissue membrane and the birefringent image and the structural image of the nerve after the detecting step, As shown in FIG.
The displaying may be displayed in a fibrous form on the connective tissue membrane such that the nerve is distinct from the connective tissue membrane in the birefringence image.
The birefringence image information includes tissue characteristic information on the nerve bundles of the forked nerve from the ganglion to the bladder, rectum, and penis, and the structure image information includes the gland structure around the prostate gland and the structure Information.
The detecting step may detect tissue characteristic information on the penile cavernosal nerve from the reflected light.
The polarization-sensitive optical coherent tomographic imaging system according to the present invention visualizes connective tissue membranes and nerves and provides real-time images to the practitioner. It can reduce nerve damage during lesion removal, It is possible to increase the success rate of the operation.
The technical effects of the present invention are not limited to the effects mentioned above, and other technical effects not mentioned can be clearly understood by those skilled in the art from the following description.
FIG. 1 is a configuration diagram illustrating a polarization-sensitive optical coherent tomographic imaging apparatus according to an embodiment of the present invention,
FIG. 2 is a flowchart illustrating a polarization-sensitive optical coherent tomographic imaging method according to the present embodiment,
FIG. 3 is a photograph of the prostate and surrounding tissues of an animal model using the polarization-sensitive optical coherent tomography imaging system according to the present embodiment,
FIG. 4 is a photograph of a patient's prostate and surrounding tissues using the polarization-sensitive optical coherent tomography imaging system according to the present embodiment.
Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. However, it should be understood that the present invention is not limited to the disclosed embodiments, but may be implemented in various forms, and the present embodiments are not intended to be exhaustive or to limit the scope of the invention to those skilled in the art. It is provided to let you know completely. The shape and the like of the elements in the drawings may be exaggerated for clarity, and the same reference numerals denote the same elements in the drawings.
1 is a block diagram illustrating a polarization-sensitive optical coherent tomography imaging apparatus according to an embodiment of the present invention.
As shown in FIG. 1, the polarization-sensitive optical coherent
The
First, the
The first
On the other hand, the light amount of 3 to 7% divided from the first
A first
On the other hand, the amount of light having the intensity of 93 to 97% divided from the first
Meanwhile, the light provided to the
The reference light reflected through the
The light provided to the
The passive
Meanwhile, an optical cable (C) and a light reflecting path (143c) are sequentially disposed between the manual light edge portion (143a) and the detecting portion (150). Here, a third
The horizontal and vertical lights supplied from the passive
The
On the other hand, the
The
Here, the structural image can provide the gland structure and the fat information around the prostate, and the birefringence image can start from the ganglion and provide information on all the nerve bundles that are directed to the bladder, rectum, penis, . In particular, in the case of birefringence images, it is possible to display the nerve image of the cavernous surface of the penis in relation to the foot function toward the penis, which is advantageous in preserving the prostate nerve when the prostate lesion is removed. In addition, the
Meanwhile, the present embodiment describes an embodiment in which the
In contrast, in the conventional optical coherent tomographic imaging system and the
However, the
Hereinafter, a tomographic imaging method using the polarization-sensitive optical coherent tomographic imaging system according to the present embodiment will be described in detail. However, the detailed description of the above-described components is omitted, and the same reference numerals are given thereto.
2 is a flowchart illustrating a polarization-sensitive optical coherent tomography imaging method according to an embodiment of the present invention.
As shown in FIG. 2, the polarization-sensitive optical coherent tomography (hereinafter, referred to as imaging method) according to the present embodiment can display a structural image and a birefringence image of the prostate in real time when the prostate lesion is removed.
Prostate lesion removal may be a prostatectomy that surgically removes the entire prostate gland. In recent years, as the number of younger patients increases, the quality of life, sexual function, have. Neurogenic preserved prostatectomy for neurological preservation has been performed, and neuro - conservative prostatectomy has the advantage of minimizing side effects such as urinary incontinence and erectile dysfunction.
Laparoscopic and robotic surgeries are the most common types of prostatectomy, and the advantages of minimally invasive surgery are increasing in laparoscopic and robotic surgery. However, the nerve is basically difficult to distinguish from the surrounding tissue, and in the case of minimally invasive surgery based on laparoscopy, there is a problem that it is difficult to detect the nerve because of the limitation of the viewing angle and the endoscope.
Particularly, in the case of the conventional optical coherent tomographic imaging system, the contrast of the image according to the degree of intensity of the scatter signal generated at the interface of the medium having a different refractive index is observed. Basically, the nerve with a tubular morphology, The blood vessels were observed similarly and confusion could occur. In addition, the nerves have a structure in which a large number of nerve fibers are dense and have similar problems as observed in the adipocyte structure of adipose tissue.
However, in the case of the
Meanwhile, in the imaging method according to the present embodiment, a neuroimaging method of the prostate using the imaging device is provided.
First, the light emitted from the
Meanwhile, the light provided to the interferometer 140 is divided into the
On the other hand, the
At this time, the
When these imaging devices and imaging methods are used, the connective tissue membranes and nerves of the prostate gland are displayed differently. That is, in the case of the connective tissue membrane, it is displayed in a wide membrane form, and in the case of the nerve, it is displayed in the fibrous form. Thus, the practitioner can intuitively recognize the connective tissue membrane and the nerve according to the displayed information, thereby improving the success rate of prostate lesion removal and preserving the nerve.
Hereinafter, an experimental example using the polarization-sensitive optical coherent tomographic imaging system according to the present embodiment will be described.
FIG. 3 is a photograph of the prostate and surrounding tissues of an animal model using the polarization-sensitive optical coherent tomography imaging system according to the present embodiment. And FIG. 4 is a photograph of a patient's prostate and surrounding tissues using the polarization-sensitive optical coherent tomography imaging system according to the present embodiment.
As shown in FIGS. 3 and 4, the polarized-sensitive optical coherent tomographic imaging system (hereinafter, referred to as an imaging system) according to the present embodiment is used to detect an animal model, for example, a prostate and surrounding tissue of a rat, The human prostate and surrounding tissues were observed from patients at the time of surgery.
As shown in FIG. 3, the structure and birefringence images of the animal model can be obtained by utilizing the imaging system according to the present embodiment. At this time, it was confirmed that the structure and the birefringence images can acquire the real time information of the corpus cavernosum, the grand structure and the fat around the nerve.
More specifically, referring to FIG. 3, FIG. 3 is a 1-mm-scale rat prostate gland biopsy image. Where a and b are frontal polarization sensitive optical interference tomographic images in the X-Y plane, c to f are cross-sectional polarization sensitive optical coherent tomographic images in the x-z plane, and g is an immunofluorescence stained image. In this case, D1 and D2 in FIG. 3 mark the positions of the cross sections of c, d, e, and f, respectively, and A1 labels the birefringent fiber. In FIG. 3, C1 denotes the local birefringence region, and A2 denotes the prostate region. Here, the nuclei were colored (blue) by DAPI and the nerves were colored (green) by neuron-specific β-Ⅲ Tublin antibodies.
Also, as shown in FIG. 4, the prostate-structure image and the birefringence image of the human model can be obtained by utilizing the imaging system according to the present embodiment. At this time, a neurovascular bundle region including the penile corpus cavernosum that affects the foot function was obtained.
More specifically, referring to FIG. 4, FIG. 4 is an image of a 1 mm scale human prostate specimen. Where a and b are frontal polarization sensitive optical interference tomographic images in the X-Y plane, c to f are cross-sectional polarization sensitive optical interference tomographic images in the X-Y plane, and g is an immunofluorescent stained image. At this time, D3 and D4 in FIG. 4 mark the positions of the cross sections of c, d, e, and f, A3 denotes birefringent fiber, and A4 denotes birefringent sheet structure. C2 marks the local birefringence area, and A5 marks the fat surrounding the prostate. Here, nuclei were colored (blue) by DAPI and nerves were colored (green) by neuron-specific antibodies.
As a result, a neurovascular bundle and its surrounding fat were observed. When using the imaging system according to the present embodiment, real-time imaging of the connective tissue membrane and nerve of the prostate can be performed, There is an advantage that the operator can be more precisely aware of the position of the patient.
As described above, the polarization-sensitive optical coherent tomographic imaging system according to the present embodiment visualizes the connective tissue membrane and the nerve to provide real-time images to the operator, which can reduce nerve damage during the removal of the lesion, And to increase the success rate of the operation.
One embodiment of the invention described above and shown in the drawings should not be construed as limiting the technical idea of the present invention. The scope of protection of the present invention is limited only by the matters described in the claims, and those skilled in the art will be able to modify the technical idea of the present invention in various forms. Accordingly, such improvements and modifications will fall within the scope of the present invention as long as they are obvious to those skilled in the art.
110: Light source
120:
130: Trigger signal generator
140: Interferometer
150:
160:
170:
180:
Claims (14)
A light splitting unit splitting the light provided from the light source into reference light and irradiation light;
A reference arm connected to the light splitting unit to form a path of the reference light;
A sample arm including an optical member forming a path provided to the portion of the prostate that is a target position and provided by the light dividing unit and polarizing the irradiation light to a horizontal component and a vertical component; And
And a detector for receiving the reference light having passed through the reference arm and the reflected light reflected from the sample arm to detect image information of the prostate part,
The detection unit
Acquiring image information of the prostate region using the interference signal of the reference light and the reflected light and acquiring birefringence image information of the prostate region using the horizontal component and the vertical component reflected from the prostate portion, Optical coherence tomography.
Wherein the sample arm has the horizontal component and the vertical component having an optical path difference to be irradiated to the prostate part,
Wherein the horizontal component and the vertical component reflected from the prostate part are received with an optical path difference, respectively.
The horizontal component and the vertical component irradiated from the sample arm are reflected from the prostate part and the tissue characteristic information of the connective tissue membrane and the nerve of the prostate part is detected based on the birefringence characteristic of the prostate part Polarized light interference interference tomographic imaging device.
Further comprising an image processor coupled to the detector for displaying a birefringent image and a structural image of the nerve tissue and the nerve, respectively,
Wherein the combined tissue membrane and the nerve are displayed in a mutually different form in the birefringence image.
Wherein the nerve in the birefringence image is displayed in a fibrous form on the connective tissue membrane to be distinct from the connective tissue membrane.
The birefringence image information includes tissue characteristic information on the nerve bundles of the fork from the ganglion to the bladder, rectum, and penis,
Wherein the structure image information includes a gland structure around the prostate gland and structural information about fat.
Wherein the detection unit detects tissue characteristic information on the penile ganglion nerve from the reflected light.
Polarizing the irradiation light to a horizontal component and a vertical component;
Irradiating the horizontal component and the vertical component to a portion of the prostate that is a target position; And
Receiving the reference light and the reflected light reflected from the prostate part and detecting image information of the prostate part,
The detecting step
Acquiring image information of the prostate region using the interference signal of the reference light and the reflected light and acquiring birefringence image information of the prostate region using the horizontal component and the vertical component reflected from the prostate portion, Optical coherence tomography.
The step of examining
Wherein the horizontal component and the vertical component have an optical path difference and are irradiated to the prostatic group,
Wherein the horizontal component and the vertical component reflected from the prostate part are received with an optical path difference, respectively.
The detecting step
Wherein the horizontal component and the vertical component are reflected from the portion of the prostate and tissue characteristic information of the connective tissue membrane and the nerve of the prostate portion is detected based on the birefringence characteristic of the prostate portion. Tomographic imaging method.
After the detecting step,
Further comprising the step of displaying a birefringent image and a structural image of said connective tissue film and said nerve, respectively,
Wherein the combined tissue membrane and the nerve are displayed in different forms in the birefringence image.
The step of displaying
Wherein the birefringence image is displayed in fibrous form on the connective tissue membrane such that the nerve is distinct from the connective tissue membrane.
The birefringence image information includes tissue characteristic information on the nerve bundles of the fork from the ganglion to the bladder, rectum, and penis,
Wherein the structure image information includes a gland structure around the prostate gland and structural information about fat.
The detecting step
And tissue characteristic information on the corpus cavernosal nerve is detected from the reflected light.
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