Mark Brezinski MD,PHD and Team

 
Dr. Brezinski’s contributions to OCT began in 1993, the founder of cardiovascular OCT. At that time, Dr. Brezinski approached James Fujimoto PhD to collaborate on pursuing OCT for plaque rupture and guiding stent placement. At that time, OCT was generally felt not to be useful in nontransparent tissue (i.e. only the eye). Additional disadvantages at the time were it’s penetration of only a few hundred microns and acquisition rate of 30 seconds per image, its inability to be performed through catheters/endoscopes, limited detection sensitivity and few adjuvant approaches. After over a decade of work (in collaboration with James Fujimoto PhD, Eric Swanson M.S., and others) the technology is now being used in clinical trials with a wide range of medical applications and is being commercialized by multiple companies. One such company is Lightlab Imaging, of which Dr. Brezinski was a founder. Our team has reached many major milestones in our research. The first was our paper published in Circulation that was the first demonstration of successful OCT imaging in nontransparent tissue (Circulation 93,1206-1213, 1996). In the same paper, we demonstrated the ability of OCT to identify vulnerable plaque, a question of serious relevance to health care. We were also the first to show that OCT imaging could be performed through a catheter (Optics Letters 21,543-545, 199). Further, we demonstrated the first subcellular in vivo imaging (Proc. Natl. Acad. Sci. 94, 4256-4261, 1997). We demonstrated the first in vivo endoscopic-based imaging (Science 276:2037-2039, 1997) that included video rate acquisition as well as a detection sensitivity of 100 decibels, which is near the quantum noise limit. Based on imaging a wide range of tissue pathology, we established the classification system for clinical areas where OCT is likely to have its greatest impact. This classification system remains in effect today (IEEE J. Select Top Quantum Electron. 5,1185-92, 1999), with the exception of tissue engineering which was not addressed. We also demonstrated the first in vivo vascular imaging (Heart 82:128-133, 1999). This work has now been extended to the intra-coronary imaging of over 500 patients, with FDA approval pending. As the technology transitioned to commercial applications in cardiology, my work has moved in four major leading-edge directions. These include: • Investigation of additional clinical applications (principally musculo-skeletal disease). • Continuing the advancement of the diagnostic capability of the technology for use in coronary arteries, such as the development of polarization sensitive imaging (PS-OCT) for assessing collagen. • The development of adjuvant techniques such as PS-OCT, elastography, dispersion analysis, second order correlation (SOC) for lipid, and ultrasound enhanced OCT. • The rigorous investigation of the physics of the technology, down to the quantum level, to further improve its performance. Several of the ongoing basic projects are demonstrating considerable potential. Single detector polarization sensitive imaging,that has been pioneered by our group has demonstrated substantial feasibility as a diagnostic tool through its real time assessment of organized collagen. Our illustration of the ability of combined OCT and ultrasound to reduce multiple scattering appears currently as the only effective method for substantially increasing imaging penetration. Through examination of the quantum mechanical properties of the dispersive nature of light, we may have developed a new technique for tissue characterization. Understanding the mechanical properties of tissue is often of significant clinical relevance. Our work with OCT elastography has become forefront. In the last few years, new embodiments of OCT have become of interest to the research community. Through extensive theoretical analysis, both at the classical and quantum levels, we have been able to establish the superior detection sensitivity with time domain OCT, contrary to the previous belief of the general research community. Finally, we have put extensive efforts into understanding the quantum nature of OCT imaging in order to take advantage of the unusual properties of this science to increase the diagnostic capability of OCT.
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