Improving Endo-Myocardial Biopsy by Real-Time Spectral Tissue Sensing: A Feasibility Study

The aim of this research is to integrate spectral tissue sensing technology inside a cardiac bioptome for real-time measurements of tissue characteristics. Bioptome tip and handle components were designed and manufactured to house and guide optical fibers. The designed components were assembled on a cardiac bioptome together with optical fibers. A technical feasibility test was carried out to study the functionality of the instrument and the effect of the optical technology on the biopsy performance. Biopsy samples were taken from five different tissue types in a porcine heart and the resulting optical spectra were compared. Spectral tissue sensing fibers were successfully integrated inside a conventional cardiac bioptome. The integrated instrument allowed differentiation between ventricular tissue, blood, and cardiac fat tissue based on blood and fat percentage and amount of scattering. Moreover, differences between scarred and nonscarred tissue were clearly visible. A first step has been made in the use of spectral tissue sensing for the detection of different tissue structures for endo-myocardial biopsy (EMB). The instrument was able to differentiate between various tissues, as well as between healthy and diseased cardiac tissues. Future research should focus on measurements of naturally diseased cardiac tissue, repeated measurements with statistical value, and improvements to the instrument design. Having the ability to measure tissue characteristics prior to acquiring a biopsy sample will not only allow easier positioning of the bioptome at the correct location but can also prevent sampling undesired tissue or scar tissue from previous biopsies.