Today, the 2023 Lasker~DeBakey Clinical Medical Research Award honored James Fujimoto and Eric Swanson of the Massachusetts Institute of Technology and David Huang of Oregon Health and Science University. The award recognizes the researchers’ development of optical coherence tomography (OCT), a noninvasive imaging technique that uses light waves to visualize biological tissues such as the retina in microscopic detail.
“I’m really thrilled and honored to have been selected as a corecipient,” Fujimoto said.
Fujimoto, an electrical engineer specializing in advanced laser systems, realized that this technology offered important advantages for medical imaging. “We were aware that ultrasound can be used for imaging, but if it's possible to use light instead of sound, then the resolution can be improved to the microscopic scale, and imaging can be performed without contact,” he said.
Fujimoto and Huang, then an MD-PhD student, harnessed light interference (a phenomenon in which multiple light waves are superimposed) to amplify the signals reflected by bodily structures. They enlisted Swanson, an expert in satellite optical communication, to apply his experience tracking signals from far-off satellites to increase the imaging speed and sensitivity. In a pivotal study published in Science in 1991, the team demonstrated that by scanning the light beam across the sample, they could construct cross-sectional images of a retina and coronary artery from cadavers (1).
The team adapted the equipment for imaging in live patients, and after clinical studies demonstrated its potential to identify ocular pathologies, commercial OCT instruments became available to ophthalmologists in 1996. “None of this would have been possible without very close collaboration with clinician scientists,” Fujimoto said. “That’s absolutely critical in an area where you’re applying technologies and methods to healthcare.”
As clinicians adopted OCT to image the retina, “the ability to see the [cross-sectional] structure, which is analogous to histology, was very important, both from the viewpoint of detecting disease as well as management,” Fujimoto said. OCT became instrumental in the early diagnosis of several leading causes of blindness, including macular degeneration, diabetic retinopathy, and glaucoma. Ophthalmologists have also relied on the technique to predict and assess responses to anti-VEGF therapy, treatment with an antibody that inhibits the formation of abnormal blood vessels that cause vision loss in wet age-related macular degeneration.
For the biophotonics community, it was a very important message that... it is possible to propose something that can have this direct impact on society and can be converted to real high quality products in medicine and other applications.
- Maciej Wojtkowski, International Center for Translational Eye Research
The clinical success of OCT also served as a beacon of hope for translational scientists. “For the biophotonics community, it was a very important message that... it is possible to propose something that can have this direct impact on society and can be converted to real high quality products in medicine and other applications,” said Maciej Wojtkowski, a physical optics and biomedical imaging researcher at the International Center for Translational Eye Research.
Today, these applications extend beyond the eye. Clinicians perform OCT using catheter probes to visualize the coronary arteries, and researchers explore the technique for other imaging purposes in dermatology, gastroenterology, and surgical guidance. Additionally, Fujimoto envisions that by uncovering biomarkers associated with disease progression, OCT can help illuminate effective drugs more rapidly. “The potential to accelerate pharmaceutical development is also very exciting,” he said.
- Huang, D. et al. Optical coherence tomography. Science 254, 1178-1181 (1991).