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Summary form only given. Optical coherence tomography (OCT) is a new and powerful technology that can overcome many of the limitations of excisional biopsy. OCT is a recently developed optical imaging technique for performing high-resolution cross-sectional imaging tomography of microstructures in biological systems. OCT performs imaging by using low-coherence interferometry to measure the optical backscattering of tissue as a function of echo delay and transverse position. The resulting two-dimensional data can be displayed as a gray scale or false color image. OCT functions as a type of optical biopsy to provide cross-sectional images of tissue structure on the micron scale. OCT is a powerful imaging technology because it can provide images of tissue in situ and in real time, without the need for tissue excision and processing. This presentation will review recent advances in OCT technology and possible future clinical applications such as arterial imaging, the detection of early neoplastic changes, and guiding surgical intervention.