The Journal of Biomedical Optics (JBO) publishes peer-reviewed papers on the use of novel optical systems and techniques for improved health care and biomedical research.

Caries, the world’s most common chronic disease, remains a major cause of invasive restorative dental treatment. To take advantage of the diagnostic potential of optical coherence tomography (OCT) in contemporary dental prevention and treatment, an intraorally applicable spectral-domain OCT probe has been developed based on an OCT hand-held scanner equipped with a rigid 90°-optics endoscope. The probe was verified in vitro. In vivo, all tooth surfaces could be imaged with the OCT probe, except the vestibular surfaces of third molars and the proximal surface sections of molars within a "blind spot" at a distance greater than 2.5 mm from the tooth surface. Proximal surfaces of 64 posterior teeth of four volunteers were assessed by intraoral OCT, visual-tactile inspection, bitewing radiography and fiber-optic transillumination. The agreement in detecting healthy and carious surfaces varied greatly between OCT and established methods (18.2–94.7%), whereby the established methods could always be supplemented by OCT. Direct and indirect composite and ceramic restorations with inherent imperfections and failures of the tooth-restoration bond were imaged and qualitatively evaluated. The intraoral OCT probe proved to be a powerful technological approach for the non-invasive imaging of healthy and carious hard tooth tissues and gingiva as well as tooth-colored restorations.

Due to wavelength-specific water absorption, infrared lasers like the thulium laser emitting at 1940 nm wavelength proved to be suitable for coagulation in neurosurgery. Commonly bipolar forceps used for intraoperative haemostasis can cause mechanical and thermal tissue damage, whilst thulium laser can provide a tissue-gentle haemostasis through non-contact coagulation. The aim of this work is a less-damaging blood vessel coagulation by pulsed thulium laser radiation in comparison to standard bipolar forceps haemostasis. Ex vivo porcine blood vessels in brain tissue (0.34 ± 0.20 mm diameter) were irradiated in non-contact with a thulium laser in pulsed mode (1940 nm wavelength, 15 W power, 100–500 ms pulse duration), with a CO₂ gas flow provided simultaneously at the distal fibre tip (5 L/min). In comparison, a bipolar forceps was used at various power levels (20–60 W). Tissue coagulation and ablation were evaluated by white light images and vessel occlusion was visualised by optical coherence tomography (OCT) B-scans at a wavelength of 1060 nm. Coagulation efficiency was calculated by means of the quotient of the difference between the coagulation and ablation radius to the coagulation radius. Pulsed laser application achieved blood vessel occlusion rate of 92% at low pulse duration of 200 ms with no occurrence of ablation (coagulation efficiency 100%). Bipolar forceps showed an occlusion rate of 100%, however resulted in tissue ablation. Tissue ablation depth with laser application is limited to 40 μm and by a factor of 10 less traumatising than with bipolar forceps. Pulsed thulium laser radiation achieved blood vessel haemostasis up to 0.3 mm in diameter without tissue ablation and has proven to be a tissue-gentle method compared to bipolar forceps.

Laser photocoagulation is one of the most frequently used treatment approaches in ophthalmology for a variety of retinal diseases. Depending on indication, treatment intensity varies from application of specific micro injuries down to gentle temperature increases without inducing cell damage. Especially for the latter, proper energy dosing is still a challenging issue, which mostly relies on the physician’s experience. Pulsed laser photoacoustic temperature measurement has already proven its ability for automated irradiation control during laser treatment but suffers from a comparatively high instrumental effort due to combination with a conventional continuous wave treatment laser. In this paper, a simplified setup with a single pulsed laser at 10 kHz repetition rate is presented. The setup combines the instrumentation for treatment as well as temperature measurement and control in a single device. In order to compare the solely pulsed heating with continuous wave (cw) tissue heating, pulse energies of 4 µJ were applied with a repetition rate of 1 kHz to probe the temperature rise, respectively. With the same average laser power of 60 mW an almost identical temporal temperature course was retrieved in both irradiation modes as expected. The ability to reach and maintain a chosen aim temperature of 41 °C is demonstrated by means of model predictive control (MPC) and extended Kalman filtering at a the measurement rate of 250 Hz with an accuracy of less than ±0.1 °C. A major advantage of optimization-based control techniques like MPC is their capability of rigorously ensuring constraints, e.g., temperature limits, and thus, realizing a more reliable and secure temperature control during retinal laser irradiation.

Objective: Optical coherence elastography (OCE) has been introduced for several medical applications to determine tissue mechanical parameters. However, in order to measure sensitive healthy tissue like brain in vivo, the excitation force needs to be carefully controlled and as low as possible (under 100 µN). Preferably, the excitation should be applied in a non-contact manner. Methods: In this work, an air-jet excitation source for this specific purpose has been developed and characterized. The design focus was set on the exact measurement and control of the generated excitation force to better comply with in vivo medical safety requirements during surgery. Results: Therefore, an excitation force control and measurement system based on the applied gas flow was developed. Conclusion: This system can generate short, high dynamic air-puffs lasting fewer than 5 ms, as well as quasi-static excitation forces lasting 700 ms. The force range covers 1µN to 40 mN with a force error margin between 0.1% and 16% in the relevant range. The excitation source, in conjunction with a 3.2 MHz optical coherence system, enables phase-based, dynamic, and quasi steady-state elastography, as well as robust non-contact classical indentation measurements. Significance: The presented system is a preliminary prototype intended for further development into a clinical version to be used in situ during brain tumor surgery.