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0Multimodal OCT detection of uterine tissue pathologies
A.A. Plekhanov1*, M.M. Loginova1, E.A. Avetisyan2, A.A. Shepeleva2, A.A. Sovetsky3, A.A. Moiseev3, M.M. Karabut1, S.V. Gamayunov2, G.V. Gelikonov3, G.O. Grechkanev1, M.A. Sirotkina1, V.Y. Zaitsev3, N.D. Gladkova1
1- Privolzhsky Research Medical University, Nizhny Novgorod, Russia 2- Nizhny Novgorod Regional Oncologic Hospital, Nizhny Novgorod, Russia 3- Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
* strike_gor@mail.ru
Pathologies of the uterine tissue are widespread and lead to serious consequences from impaired reproductive function of a woman to cancer burden [1]. However, the most of them pathologies are considered to have a favorable prognosis with the possibility of preserving reproductive function by implementation of timely primary diagnosis and optimal treatment tactics during the early stage of disease. The most clinically significant pathologies of uterine tissue are associated with changes in the endometrium [2]. A generally accepted and reliable diagnosis of endometrial pathologies involves highly traumatic procedures of blind collecting material (pipelle biopsy / dilation and curettage) for realization of histological examination [3]. Recently, the endometrial biopsy under hysteroscopy is increasingly being chosen to reduce trauma and increase the targeting of pathologies diagnosis. Nevertheless, the ambiguity of visual hysteroscopic assessment and the incorrect selection of a suspicious endometrial area for subsequent histological examination often leads to a false pathological diagnosis and underestimating endometrial cancer [4]. Therefore, there is a need for a new diagnostic tool for highly accurate and minimally invasive morphological assessment of endometrial tissue.
Our study is aimed at identifying the capabilities of the Multimodal Optical Coherence Tomography (MM OCT) in diagnosing pathologies of uterine tissue. Recent pilot studies by colleagues have shown the promise of identifying qualitative differences between various endometrial pathologies using structural OCT [5,6]. Our research is focused to differentiation of the morphological structures of uterine tissue under normal conditions (endometrium and myometrium) and pathologies (endometrial hyperplasia, adenomyosis and cancer) by studying the characteristic polarization (by cross-polarization OCT [7]) and elastic (by compression OCT-elastography [8]) tissue properties. Cross-polarization OCT imaging of ex vivo uterine tissue samples made it possible to differentiate normal endometrium from myometrium and identify foci of adenomyosis by calculating the original attenuation coefficient (described earlier [9]). Compression OCT-elastography made it possible to differentiate sites of endometrial hyperplasia and cancer by decreasing and increasing of absolute stiffness values, respectively [10]. The obtained results indicate the potential for detecting uterine tissue pathologies using MM OCT and the relevance of further development of the technology for non-traumatic diagnosis/treatment monitor of uterine disease and targeted endometrial biopsy.
The study was funded by the Russian Science Foundation, grant No. 23-25-00405.
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