OCT in Oncology and Precision Medicine: From Nanoparticles to Advanced Technologies and AI

Abstract

Optical Coherence Tomography (OCT) is a relatively new medical imaging device that provides high-resolution and real-time visualization of biological tissues. Initially designed for ophthalmology, OCT is now being applied in other types of pathologies, like cancer diagnosis. This review highlights its impact on disease diagnosis, biopsy guidance, and treatment monitoring. Despite its advantages, OCT has limitations, particularly in tissue penetration and differentiating between malignant and benign lesions. To overcome these challenges, the integration of nanoparticles has emerged as a transformative approach, which significantly enhances contrast and tumor vascularization at the molecular level. Gold and superparamagnetic iron oxide nanoparticles, for instance, have demonstrated great potential in increasing OCT's diagnostic accuracy through enhanced optical scattering and targeted biomarker detection. Beyond these innovations, integrating OCT with multimodal imaging methods, including magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasound, offers a more comprehensive approach to disease assessment, particularly in oncology. Additionally, advances in artificial intelligence (AI) and biosensors have further expanded OCT's capabilities, enabling real-time tumor characterization and optimizing surgical precision. However, despite these advancements, clinical adoption still faces several hurdles. Issues related to nanoparticle biocompatibility, regulatory approvals, and standardization need to be addressed. Moving forward, research should focus on refining nanoparticle technology, improving AI-driven image analysis, and ensuring broader accessibility to OCT-guided diagnostics. By tackling these challenges, OCT could become an essential tool in precision medicine, facilitating early disease detection, real-time monitoring, and personalized treatment for improved patient outcomes.

Keywords: artificial intelligence (AI); nanoparticles; optical coherence tomography (OCT); targeted imaging and precision medicine.

Figure 1

Imaging of morpheaform basal cell carcinoma (BCC) on the forehead above the eyebrow (Case 2), using dynamic and structural OCT alongside dermoscopy and histopathology. (A1) D-OCT of adjacent normal skin shows evenly distributed linear, dotted, and branching vessels. (A2) D-OCT of the central tumor region reveals increased vessel density and diameter, with serpiginous and branching patterns. (B) Dermoscopy image showing the clinical appearance of the lesion. (C1) Structural OCT of normal skin displays an intact dermoepidermal junction (DEJ) and hair follicles with shadowing. (C2,C3) OCT images near tumor borders (proximal and distal) show disrupted layering and partial DEJ loss, indicating tumor extension. Black arrows mark regions of architectural disruption and tumor nests; white arrows indicate areas of preserved layering and an intact DEJ. (D1,D2) Histopathology at distal (D3) and proximal (P3) scan sites reveals no visible tumor, in contrast to OCT-detected abnormalities. (D3) Histology from the tumor center confirms BCC with infiltrative basaloid strands [31].

Figure 2

Exemplary cross-sectional images of murine skin were obtained by (b) OCT and (c) HFUS and corresponding (a) histology (H&E staining). Enlarged cross-sections, as indicated by the orange rectangles, are depicted in (d,e). Dashed orange lines in images (a,d,e) indicate the skin layers corresponding to (a) epidermis, (b) papillary dermis, (c) reticular dermis, (d) subcutis, (e) sebaceous glands and hair follicles, and (f) muscle. Skin layers with letters labeled with an asterisk are not distinguishable [32].