Significance: After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance. Aim: Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis. Approach: A comprehensive review of state-of-the-art accomplishments in OCT has been performed. Results: The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential. Conclusions: With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential—in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.

中文翻译：

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增强医生的医学诊断：光学相干断层扫描的视角

意义：经过 30 年、超过 75,000 篇出版物、数十家公司参与其商业化以及 2023 年全球市场规模约为 15 亿美元的前景，光学相干断层扫描 (OCT) 已成为最快成功转化的成像技术之一实质性的临床和经济影响和接受度。目标：我们的观点侧重于颠覆性的前瞻性创新和关键技术，以进一步提高 OCT 性能，从而显着增强医学诊断。方法：对华侨城最先进的成就进行了全面审查。结果：未来最具颠覆性的 OCT 创新包括成像分辨率和速度（单光束光栅扫描与并行化）的改进，双模态甚至多模态系统的新实现，以及在这些针对分子和代谢成像的混合 OCT 系统中使用内源或外源对比。除了 OCT 血管造影术之外，没有其他功能性或对比增强 OCT 扩展具有可比的临床和商业影响。一些最近开发的扩展，例如光学相干弹性成像、动态对比 OCT、视光学和人工智能增强 OCT 也被认为在未来具有很高的潜力。此外，便携式、紧凑型、手持式和/或具有成本效益的基于胶囊的 OCT 应用、家庭 OCT 和基于微光学组件或光子集成电路的自 OCT 系统的 OCT 小型化将彻底改变新的应用和可用性不久的将来。最后，OCT 的临床翻译（包括医疗器械监管方面的挑战）将继续是绝对必要的。结论：OCT 凭借其精湛的非侵入性、微米级分辨率深度切片能力，特别彻底改变了眼科诊断，因此是眼科历史上采用最快的成像技术。尽管如此，OCT 尚未得到完全开发，并且在学术界和工业界都具有巨大的增长潜力。这不仅适用于眼科应用领域，尤其适用于 OCT 实现光学活检的最初动机，即组织微结构的原位成像，其分辨率接近组织学分辨率，但无需组织切除。结论：OCT 凭借其精湛的非侵入性、微米级分辨率深度切片能力，特别彻底改变了眼科诊断，因此是眼科历史上采用最快的成像技术。尽管如此，OCT 尚未得到完全开发，并且在学术界和工业界都具有巨大的增长潜力。这不仅适用于眼科应用领域，尤其适用于 OCT 实现光学活检的最初动机，即组织微结构的原位成像，其分辨率接近组织学分辨率，但无需组织切除。结论：OCT 凭借其精湛的非侵入性、微米级分辨率深度切片能力，特别彻底改变了眼科诊断，因此是眼科历史上采用最快的成像技术。尽管如此，OCT 尚未得到完全开发，并且在学术界和工业界都具有巨大的增长潜力。这不仅适用于眼科应用领域，尤其适用于 OCT 实现光学活检的最初动机，即组织微结构的原位成像，其分辨率接近组织学分辨率，但无需组织切除。OCT 尤其彻底改变了眼科诊断，因此是眼科史上采用最快的成像技术。尽管如此，OCT 尚未得到完全开发，并且在学术界和工业界都具有巨大的增长潜力。这不仅适用于眼科应用领域，尤其适用于 OCT 实现光学活检的最初动机，即组织微结构的原位成像，其分辨率接近组织学分辨率，但无需组织切除。OCT 尤其彻底改变了眼科诊断，因此是眼科史上采用最快的成像技术。尽管如此，OCT 尚未得到完全开发，并且在学术界和工业界都具有巨大的增长潜力。这不仅适用于眼科应用领域，尤其适用于 OCT 实现光学活检的最初动机，即组织微结构的原位成像，其分辨率接近组织学分辨率，但无需组织切除。