Toward high performance endoscopic optical coherence tomography — technologies and applications

Endoscopic optical coherence tomography (OCT) integrates fiber-optic interferometry with miniaturized catheter-based probes to enable high-resolution, real-time, and minimally invasive volumetric imaging of internal tissue microstructures. Since its first demonstrations in the late 1990s, endoscopic OCT has evolved from early feasibility studies into a clinically valuable tool for tissue characterization and disease diagnosis. Over the past decade, the field has undergone a transformative shift toward high-performance systems, driven by advances in probe miniaturization, ultrahigh-resolution optics, extended-depth-of-focus designs, multimodal integration, and intelligent control strategies, such as robotic actuation and novel steering methods. This review provides a comprehensive overview of recent advances in endoscopic OCT from both technological and translational perspectives. First, we review the evolution of the field and key enabling technologies, including miniaturized probe architectures, high-resolution and extended-depth-of-focus imaging strategies, multimodal platforms, and intelligent or robotic systems. Second, we summarize established and emerging applications across major organ systems and several novel interventional settings. Finally, we discuss persistent technical challenges and outline promising future directions.