Abstract: Techniques and technologies for guiding medical instruments during medical procedures using real-time imaging technologies are disclosed. A representative apparatus includes a medical instrument, an imaging system, a stage assembly, and a control system. The medical instrument includes an elongated portion configured to be inserted into a body portion and having an optical fiber that includes a tip portion that is extendable beyond a distal end of the elongated portion. The imaging system provides a sampling energy that is emitted from the tip portion. The stage assembly actuates the tip portion to perform scanning of one or more tissues with the sampling energy. The imaging system receives a reflected energy, providing a plurality of one-dimensional arrays of intensity values of the reflected energy.