- 學位論文
光學同調斷層掃瞄之口腔癌診斷
In vivo Oral Cancer Diagnosis with Optical Coherence Tomography
摘要
近幾年來，國內外許多的研究團體，積極的針對光學同調斷層掃瞄系統在醫學影像上的應用進行不少的研究，從眼球的病變、皮膚燒燙傷診斷，到搭配內視鏡的胃腸癌細胞診斷…等，都獲得相當的成果，然而，在這些相關的研究中，主要著重在新的光學系統架構、後端即時電腦影像處理及醫療探頭的設計上，除了在眼球的病變上有較多的影像資料及較完整的攜帶式系統外，鮮少有其他針對特定疾病所建構的專門系統及影像資料。在本論文中，我們針對台灣相較於其他先進國家，病發比例偏高的口腔癌掃瞄進行系統及探頭的設計，並且展示我們實驗所得的影像和比較正常及病變細胞的差異。 在整個研究中，因為口腔的組織分布狀態及腔體的大小形狀，為了讓掃瞄時能夠輕易的取得不同位置的細胞結構，我們朝著微小化、操作便利、快速掃瞄等的發展方向，相繼設計了三款探頭，此外，為了達到醫院臨床空間的靈活運用，我們選擇超光二極體(superluminescent diode)作為光源、建構光纖式的系統，並將整套系統架在避震推車上，以方便系統的移動。 我們在進行口腔病變細胞掃瞄前，先以人體的皮膚掃瞄進行測試，由於人體皮膚的結構大致分明，樣品取得也較容易，可方便我們在測試時進行系統參數的調整。從我們掃出來的皮膚影像中，可清楚的分辨角質層、表皮、乳突及真皮的四個構造，在深度上，也達到了0.5公厘。 在口腔細胞的掃瞄上，我們先針對了咀嚼黏膜、內襯黏膜等不同地方，做正常細胞的造影，在這些正常細胞的影像中，全部都可以清楚看到上皮層及固有層，部分能看到次黏膜的結構，深度最深可達到0.9公厘。在臨床的掃瞄上，我們針對數位口腔癌病人進行病變細胞的掃瞄，並比較這些病人正常細胞的掃瞄影像，由影像的比較中，可初步的判斷出病變細胞的背散射強度較不均勻，其上皮層與固有層的介面也較不明顯等的結構差異。
並列摘要
Recently, a lot of research groups around the world have focused their research on the biomedical applications of optical coherence tomography, covering from the diagnosis of human eyes and skin to gastrointestinal with endoscope. Among such research, the major efforts include optical system improvement, real-time imaging process, and probe design. Little research focused on a specific disease to build up image database for medical usage. However, except the diseases of the eyes. In our research, we develop an OCT system and suitable probes to diagnose oral cavity cancer, which has a high population rate than other developed countries. We will demonstrate the images of oral mucosa and compare the differences between the normal tissues with diseased ones. In this study, to reach tissues at different location in a oral cavity, we develop three probes of the features of miniature, convenience, and fast-scanning. Besides, by choosing a superluminescent diode as the light source, designing a fiber-based system, and integrating the whole system on a damping handcart, we can move this OCT system easily to meet the clinical environment. Before the application to oral cavity cancer, we use a human skin as the sample for test. From our human skin images, we can clearly distinguish the structures such as stratum corneum, epidermis, papilla, and dermis. The scanning depth of 0.5 mm can be reached. In our OCT imaging on oral cavity tissues, we first scan normal tissues located at several different positions such as masticatory mucosa and lining mucosa. We can clearly distinguish the epithelium, lamina propria, and submucosa. The scanning depth of 0.9 mm can be reached. In clinical scanning, the oral cancer tissues on several patients have been imaged. From the comparison between the cancerous and normal tissues, we find that the backscattered intensities of diseased tissues are stranger. Also, the interface between epithelium and lamina propria is more unclear.
參考文獻
延伸閱讀
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