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Summary form only given. Optical coherence tomography (OCT) imaging can resolve many of the changes associated with neoplasia and may provide a tool for in vivo real-time evaluation of tissue and biopsy guidance to help improve the diagnosis of early neoplasias, resulting in more successful treatment. OCT is a new imaging technology that allows cross-sectional imaging of nontransparent tissue. A low-coherence Michelson interferometer is used to measure echo time delays of reflected light from scattering tissue. The light beam is scanned across the tissue to produce two- and three-dimensional data sets. This technique has been extensively applied to imaging in ophthalmology and more recently to nontransparent tissues. High-resolution and high-speed OCT imaging has been achieved using broad bandwidth mode-locked lasers as short-coherence light sources. Recently, in vivo catheter/endoscope based imaging of the gastrointestinal and pulmonary tracts has been demonstrated in a rabbit model. In order to evaluate the ability of OCT to image cellular morphology in vivo, an animal model was used. OCT imaging in vitro was also performed on a series of human tissues of varying degrees of neoplastic infiltration, including colon, cervix, uterus, and lung.