Load-dependent optical coherence tomography attenuation imaging: How tissue mechanics can influence optical scattering

Mechanical load imparted to tissue, for example via handheld imaging probes, leads to tissue deformation, altering the distribution of tissue microstructure and, consequently, attenuation of light and image formation in optical imaging. In mechanically heterogeneous tissue, the load can result in spatially varying deformation and, therefore, spatially varying changes in the attenuation of light, which may provide additional image contrast. To investigate this potential, an assessment of the spatially resolved impact of mechanical deformation of the tissue on optical imaging is critical; however, it is challenging to incorporate stress mapping into optical imaging without obscuring the detection of photons. To address this, we present the novel integration of stress imaging using optical palpation with attenuation imaging based on optical coherence tomography (OCT). The method was implemented using a compliant silicone sensor incorporated into a custom handheld OCT probe, providing two-dimensional stress imaging with concurrent attenuation imaging. Attenuation imaging with varying mechanical loads was demonstrated on 19 tissue regions acquired from eight freshly excised human breast specimens. The results demonstrated distinct characteristics for different breast tissue types: benign stroma showed relatively large increases in attenuation (e.g., ∼0.3 to 0.4 mm−1/kPa) over a low stress range (∼2 to 10 kPa), while cancerous tissue showed markedly small increases in attenuation (e.g., ∼0.005 to 0.02 mm−1/kPa) mainly over a medium to high stress range (∼10 to 90 kPa). The integration of stress imaging with attenuation imaging provided a pilot assessment of the spatially resolved impact of tissue mechanical heterogeneity on optical attenuation, providing novel image contrast by encoding variations in mechanical properties on optical attenuation in tissue.