Miao Wins the American Society for Laser Medicine and Surgery 2020 Best of Session: Genitourinary Health

Imaging-Assisted Vaginal Laser Device Guides Treatment in Real-Time Via Digital Histology and
Angiography

Yusi Miao, Neha T. Sudol, Afiba Arthur, Jason J. Chen, Yan Li, Saijun Qiu, Yona Tadir, Felicia L. Lane,
Zhongping Chen

Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA; University of California –
Irvine, Irvine, CA

Background: Genitourinary Syndrome of Menopause (GSM) affects up to 50% of women with regard to
general health and sexual function. Energy-based treatment such as ablative laser has demonstrated
promising short-term outcomes in relieving GSM symptoms. However, the safety and effectiveness of
energy therapy remain controversial, and most treatment protocols are not backed up by scientific data.
Since invasive biopsy cannot be “ethically” justified, and single samples are not scientifically
representative, histological evidence is lacking in this area. In the present study, we developed a non-
invasive optical biopsy device, integrated within a commercial vaginal laser probe to perform optical
histology and angiography.

Study Design/Materials and Method: This abstract reports on the clinical translation of the image-
assisted laser device, and the on-going human study to evaluate histological and blood vessel changes
post vaginal laser ablation. Imaging data are collected from patients undergoing a fractional-pixel
CO 2  laser treatment. In-house high-speed optical coherence tomography (OCT) imaging system is
integrated into the handle part of the laser treatment device to acquire imaging parameters; epithelium
thickness and blood vessel density in the lamina propria. 3D imaging data from the proximal and distal
vagina are acquired from each patient in parallel to the treatment every 6 weeks.

Results: The proposed imaging-assisted vaginal laser device showed exceptional accuracy, imaging area,
acquisition speed to assess tissue histology and angiogram in real-time. The spatial resolution was 2–3
orders of magnitude higher than the clinical ultrasound imaging device enough to resolve micrometer
changes in tissue. The imaging area from a single acquisition was 12 × 12 mm. The data acquisition
speed was less than 20 seconds with GPU-accelerated advanced processing. Preliminary data
demonstrated that laser treatment effects highly depend on the initial epithelium thickness and vascular
density. Patients with severe atrophy were more sensitive to laser treatment and showed pronounced
tissue proliferation.

Conclusion: The present study demonstrated a non-invasive optical histology technique for assessing
the effects of vaginal rejuvenation device. We anticipate the integrated treatment, monitoring device
will allow both physicians and laser industries to design a safer and more effective laser procedure
based on the histological evidence.

Click here to view the ASLMS 2020 abstracts.