Since its introduction, optical coherence tomography (OCT) technology has advanced from the laboratory bench to the clinic and back again. Arising from the fields of low coherence interferometry and optical time- and frequency-domain reflectometry, OCT was initially demonstrated for retinal imaging and followed a unique path to commercialization for clinical use. Concurrently, significant technological advances were brought about from within the research community, including improved laser sources, beam delivery instruments, and detection schemes. While many of these technologies improved retinal imaging, they also allowed for the application of OCT to many new clinical areas. As a result, OCT has been clinically demonstrated in a diverse set of medical and surgical specialties, including gastroenterology, dermatology, cardiology, and oncology, among others. The lessons learned in the clinic are currently spurring a new set of advances in the laboratory that will again expand the clinical use of OCT by adding molecular sensitivity, improving image quality, and increasing acquisition speeds. This continuous cycle of laboratory development and clinical application has allowed the OCT technology to grow at a rapid rate and represents a unique model for the translation of biomedical optics to the patient bedside. This work presents a brief history of OCT development, reviews current clinical applications, discusses some clinical translation challenges, and reviews laboratory developments poised for future clinical application.

Contrast agents are utilized in virtually every imaging modality to enhance diagnostic capabilities. We introduce a novel class of optical contrast agent, namely, encapsulating microspheres, that are based not on fluorescence but on scattering nanoparticles within the shell or core. The agents are suitable for reflection- or scattering-based techniques such as optical coherence tomography, light microscopy, and reflectance confocal microscopy. We characterize the optical properties of gold-, melanin-, and carbon-shelled contrast agents and demonstrate enhancement of optical coherence tomography imaging after intravenous injection of such an agent into a mouse.

Molecularly-specific contrast can greatly enhance the biomedical utility of optical coherence tomography (OCT). We describe a contrast mechanism, magnetomotive OCT (MMOCT), where a modulated magnetic field induces motion of magnetic nanoparticles. The motion of the nanoparticles modifies the amplitude of the OCT interferogram. High specificity is achieved by subtracting the background fluctuations of the specimen, and sensitivity to 220 microg/g magnetite nanoparticles is demonstrated. Optically and mechanically correct tissue phantoms elucidate the relationships between imaging contrast and nanoparticle concentration, imaging depth, tissue optical scattering, and magnetic field strength. MMOCT is demonstrated in a living Xenopus laevis tadpole where the results were consistent with corresponding histology.

Au(core)/Ag(shell) and AuAg alloy nanoparticles are synthesized with stoichiometric control through digestive ripening, a potentially general approach for synthesizing core/shell and alloy nanoparticles. AuAg alloy nanoparticles are obtained by annealing Au(core)/Ag(shell) nanoparticles. These bimetal nanoparticles have a tunable surface plasmon resonance absorbance and are of interest for use in catalysis and as taggants for security applications.

Plasmon-resonant gold nanorods are demonstrated as low backscattering albedo contrast agents for optical coherence tomography (OCT). We define the backscattering albedo, a', as the ratio of the backscattering to extinction coefficient. Contrast agents which modify a' within the host tissue phantoms are detected with greater sensitivity by the differential OCT measurement of both a' and extinction. Optimum sensitivity is achieved by maximizing the difference between contrast agents and tissue, |a'(ca) - a'(tiss)|. Low backscattering albedo gold nanorods (14x 44 nm; lambda(max) = 780 nm) within a high backscattering albedo tissue phantom with an uncertainty in concentration of 20% (randomized 2+/-0.4% intralipid) were readily detected at 82 ppm (by weight) in a regime where extinction alone could not discriminate nanorods. The estimated threshold of detection was 30 ppm.

Optics has played a key role in the rapidly developing field of molecular imaging. The spectroscopic nature and high-resolution imaging capabilities of light provide a means for probing biological morphology and function at the cellular and molecular levels. While the use of bioluminescent and fluorescent probes has become a mainstay in optical molecular imaging, a large number of other optical imaging modalities exist that can be included in this emerging field. In vivo imaging technologies such as optical coherence tomography and reflectance confocal microscopy have had limited use of molecular probes. In the last few years, novel nonfluorescent and nonbioluminescent molecular imaging probes have been developed that will initiate new directions in coherent optical molecular imaging. Classes of probes reviewed in this work include those that alter the local optical scattering or absorption properties of the tissue, those that modulate these local optical properties in a predictable manner, and those that are detected utilizing spectroscopic optical coherence tomography (OCT) principles. In addition to spectroscopic OCT, novel nonlinear interferometric imaging techniques have recently been developed to detect endogenous molecules. Probes and techniques designed for coherent molecular imaging are likely to improve the detection and diagnostic capabilities of OCT.

The availability of a real-time non-destructive modality to interrogate the mechanical properties of viscoelastic materials would facilitate many new investigations. We introduce a new optical method for measuring elastic properties of samples which employs magnetite nanoparticles as perturbative agents. Magnetic nanoparticles distributed in silicone-based samples are displaced upon probing with a small external magnetic field gradient and depth-resolved optical coherence phase shifts allow for the tracking of scatterers in the sample with nanometer-scale sensitivity. The scatterers undergo underdamped oscillations when the magnetic field is applied step-wise, allowing for the measurement of the natural frequencies of oscillation of the samples. Validation of the measurements is accomplished using a commercial indentation apparatus to determine the elastic moduli of the samples. This real-time non-destructive technique constitutes a novel way of probing the natural frequencies of viscoelastic materials in which magnetic nanoparticles can be introduced.

Mechanical forces such as adhesion, shear stress and compression play crucial roles in tissue growth, patterning and development. To understand the role of these mechanical stimuli, it is of great importance to measure biomechanical properties of developing, engineered, and natural tissues. To enable these measurements on the micro-scale, a novel, dynamic, non-invasive, high-speed optical coherence elastography (OCE) system has been developed utilizing spectral-domain optical coherence tomography (OCT) and a mechanical wave driver. Experimental results of OCE on silicone phantoms are in good agreement with those obtained from a standardized indentation method. Using phase-resolved imaging, we demonstrate OCE can map dynamic elastic moduli of normal and neoplastic ex vivo human breast tissue with a sensitivity of 0.08%. Spatial micro-scale mapping of elastic moduli of tissue offers the potential for basic science and clinical investigations into the role biomechanics play in health and disease.