A Leading Light
January 31, 2013
Prof. Maciej Wojtkowski from the Nicolaus Copernicus University in Toruń, head of the Experimental Biophysics and Optical Biomedical Imaging Teams, and winner of a major award from the Foundation for Polish Science in 2012, talks to Karolina Olszewska.
The award you received from the Foundation for Polish Science is dubbed the “Polish Nobel Prize. ” Specifically, what is it for in your case?
The judges granted the award for “the development and introduction to ophthalmic practice of an optical tomography method using a Fourier detection technique.” In simple terms, I designed and built a tomography device scanner for an innovative method of examining the retina. I think anyone who has problems with their eyesight has or will come across such an examination method sooner or later. In this method, we shine low-power laser light into the eye and from the very weak light which reflects from the eye, we are able—with the help of a computer—to reconstruct the structure of the retina. In the computer, an ophthalmologist will find a three-dimensional virtual reconstruction of the retina and will be able to freely analyze it and watch all the details under large magnification. The layers of the retina, which are 10 times thinner than a hair, are clearly visible and any lesions that influence the eyesight can be mapped out and identified by a physician.
The award from the Foundation for Polish Science sums up our work so far in a way. At the moment, we are dealing with completely new imaging methods that may come in handy in microscopy, biology and medicine.
When was the first optical tomography device built?
Three prototypes were tested between 2003 and 2006 in ophthalmic clinics in Boston, Pittsburgh, and in Bydgoszcz, Poland. Since 2005, I have been working with Polish company Optopol from Zawiercie—in 2009, the company was acquired by the Canon corporation—on the industrial production of the scanner. For several years, the device has been used by eye clinics worldwide.
As the inventor of this pioneering device, you have provided doctors with a painless tool for examining the eye. How did doctors cope before?
Previously, the standard diagnostic procedure was microscopy. It magnifies biological elements sufficiently to see single cells. However, it has many limitations, because it does not make it possible to distinguish layers of the retina and accurately locate trouble spots. In addition, the instruments were not accurate enough to enable quantitative analysis, which means determine some values that characterize diseases and their progress. Examinations were therefore more subjective and the progress of the disease could be assessed differently by two different ophthalmologists. Sometimes differences in diagnostic assessment may result in delayed therapy and deterioration in the patient’s condition. This is especially important when the health service is governed by the rules of economics and access to diagnostic equipment is difficult.
Optical engineering offers far more opportunities; this is because it looks for ways to enable non-invasive observation of living cells. In particular, this applies to cells that can undergo easy degeneration. Biomedical imaging methods in the case of the eye allow for non-invasive and rapid observations of trouble spots in the retina caused by diseases such as glaucoma, macular degeneration, macular holes, and retina detachment.
You are pressing ahead with research into the nature of light, looking for new opportunities when it comes to the application of optical tomography in other fields of medicine. In which other diseases is optical tomography useful?
Light is a physical phenomenon of primary importance to the existence of the universe. It is the best carrier of information known to humanity. The fact that it is very complex in nature allows for the use of its properties in a variety of ways. We are still trying to discover and understand these properties and control them. And that’s a big challenge for us.
And when it comes to other uses of optical tomography, it can be used to examine the cell structure of many organs and tissue systems in humans or animals. We are currently working to use such a method to study the blood flow in the brain, for example.
While examining the complex nature of light, we are striving to ensure the best possible use of its properties in the imaging of biological structures. And we want to do that in the least invasive way, which means with as little harm to the patient as possible.
Together with our team we are building— from the ground up—the appropriate instruments that enable us to prove that the new methods of using light are working. Our efforts, within a short time, have been applied in practice and led to the production of new diagnostic devices.
What are the prospects for putting the methods you are working on into use in medicine?
Our work is multi-pronged. Our methods make it possible to scan relatively large stretches of tissue—a piece of intestine, esophagus, coronary vessels. This is mainly about early detection of neoplastic changes [cancer] in the digestive system, which is relatively long and it is hard to exactly pinpoint the location of the trouble spots there with other methods. But the digestive system is accessible to light when you place an appropriate viewing device into the body’s interior. Our unique method provides information about relatively large sections of tissue, which are usually the most difficult to examine.
In cardiology, it is possible to use these methods for observing the interior of the blood vessels after stent implantation.
Research into carcinogenic processes is not only important for medical diagnostics, but also makes it possible to better understand these disease processes in order to look for ways to prevent them in the future. One example is the study of the dynamics with which new blood vessels are created around the tumor. Biomedical imaging methods are also useful for studies on animal disease models thanks to which it is possible to better understand the origin of the disease and its effects.
What about work on putting this technology to commercial use in cardiology and endoscopic diagnostics of cancer?
The methods for using the technology in cardiology are being dynamically developed around the world; in Poland, however, difficulties have cropped up, mostly financial in nature. Such research is mainly being developed by big and rich American companies, and the first instruments have already hit the world market.
The method developed by Maciej Wojtkowski for ophthalmology has contributed to a dynamic development of clinical procedures worldwide. It has significantly improved the comfort of patients and the accuracy of diagnostic results. It has dramatically increased the speed of diagnostic procedures and brought them to a level previously unachievable in clinical conditions. Within a few years, this method has practically replaced previously used technology for the diagnosis of retina disorders. It has become the basis for the production of $1 billion worth of medical equipment in the United States and another $1 billion in other countries. Optical scanners based on this technology are also produced in the Polish town of Zawiercie; they are used in clinics throughout Poland and sold throughout the world.