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Visualization of prostatic nerves by polarization-sensitive optical coherence tomography.

Yeoreum Yoon1, Seung Hwan Jeon2, Yong Hyun Park2

  • 1Department of Mechanical Engineering, Pohang University of Science and Technology, San 31, Hyoja-dong, Nam-gu, Pohang, Gyeongbuk 790-784, South Korea.

Biomedical Optics Express
|October 5, 2016
PubMed
Summary

Polarization-sensitive optical coherence tomography (PS-OCT) can identify crucial prostatic nerves. This imaging technique shows promise for improving nerve-sparing radical prostatectomy outcomes and preserving sexual function.

Keywords:
(170.3880) Medical and biological imaging(170.4500) Optical coherence tomography(170.7230) Urology(180.4315) Nonlinear microscopy(230.5440) Polarization-selective devices(260.5430) Polarization

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Area of Science:

  • Biomedical Optics
  • Surgical Technology
  • Urology

Background:

  • Prostatic nerve preservation is vital for sexual potency recovery after radical prostatectomy.
  • Nerve-sparing radical prostatectomy (NSRP) requires effective methods for real-time nerve identification.
  • Current imaging techniques may lack the resolution or specificity for intraoperative nerve guidance.

Purpose of the Study:

  • To evaluate the feasibility of polarization-sensitive optical coherence tomography (PS-OCT) for detecting prostatic nerves.
  • To assess PS-OCT's capability in distinguishing nerves from surrounding tissues in ex vivo prostate specimens.
  • To establish a foundation for the potential intraoperative application of PS-OCT in NSRP.

Main Methods:

  • Ex vivo analysis of rat and human prostate specimens using PS-OCT.
  • PS-OCT imaging to capture both structural and birefringence properties of tissues.
  • Histological analysis and multiphoton microscopy (MPM) for confirmation of nerve identification.

Main Results:

  • PS-OCT visualized distinct, highly scattering, and birefringent fibrous structures in rat prostate specimens, confirmed as nerves.
  • In human prostatectomy specimens, PS-OCT identified both fibrous structures (nerves) and sheet-like structures (fascias).
  • PS-OCT demonstrated the ability to differentiate nerves from prostatic glands and fat, and showed anatomical variations in nerve distribution.

Conclusions:

  • PS-OCT is a feasible method for detecting prostatic nerves.
  • The technique can distinguish nerves from other tissue types and delineate fascial structures.
  • This study supports the potential of PS-OCT as an intraoperative tool for enhancing nerve-sparing radical prostatectomy.