Imagerie des tissus à haute résolution en profondeur par tomographie de cohérence optique plein champ : approches instrumentales et multimodales pour l'application au diagnostic per-opératoire du cancer

摘要

Among medical imaging techniques, optical imaging methods have been significantly developped during the past decades. More specifically, among recently proposed optical imaging techniques, Full-Field Optical Coherence Tomography – or FFOCT – provides unique capabilities, in particular regarding resolution and instrumental simplicity, which allows to consider its application to cancer diagnosis. This thesis demonstrates the design and implementation of new FFOCT devices for use in a clinical context, targeting improvement and optimization of the technique. Two major development parts have been realized : A translational part, comprising the development of a FFOCT microscope adapted to a clinical use for intraoperative diagnosis of cancer on tissue biopsies, and the assessment of its diagnosis performance for several clinical cases : the intraoperative diagnosis of breast tissue, of brain resections, and the preoperative qualification of corneal grafts. A research part - mainly instrumental - targeting the improvement of the diagnosis performance of the technique, based on new multimodal (fluorescence contrast, dynamic contrast) and multiscale approaches, or on the miniaturization of the device by developing a handheld rigid endoscope for clinical use.