Three-dimensional optical coherence tomography of Barrett’s esophagus and buried glands beneath neosquamous epithelium following radiofrequency ablation

 

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Introduction

Ablative therapies including photodynamic therapy, argon plasma coagulation, and radiofrequency ablation (RFA) are increasingly performed for Barrett’s esophagus. Residual Barrett’s esophagus from incomplete ablation and buried Barrett’s esophagus glands beneath regenerative neosquamous epithelium are often found, to varying degrees, on follow-up [1]. While neosquamous epithelium indicates successful therapy, detection of residual disease is important for guiding additional treatments. Due to their diminutive or subsurface nature, detection of residual Barrett’s esophagus, buried glands, and neosquamous epithelium can be challenging using conventional endoscopy alone [1].

Optical coherence tomography (OCT) generates cross-sectional images of internal structure with micrometer resolutions and millimeter imaging depths by measuring the echo time delays of back-scattered light [2]. OCT can be performed with fiberoptic probes introduced through the accessory channel of standard endoscopes. Recently, endoscopic three-dimensional (3D) OCT has become possible due to dramatic increases in imaging speed [3] [4], providing an endoscopic microscopy tool with a powerful combination of high resolution, large field of view, and rapid data acquisition.

Two-dimensional OCT has been extensively studied in Barrett’s esophagus, including the detection of specialized intestinal metaplasia, dysplasia, and adenocarcinoma [5] [6]. 3D-OCT has recently been used in pilot studies for esophageal [3] and colon imaging [4]. Here we report 3D-OCT findings of Barrett’s esophagus, buried Barrett’s esophagus glands beneath neosquamous epithelium following RFA, and normal squamous mucosa.

References

• 1 Odze R D, Lauwers G Y. Histopathology of Barrett’s esophagus after ablation and endoscopic mucosal resection therapy.  Endoscopy. 2008;  40 1008-1015
  Article in Thieme ConnectPubMedGoogle Scholar
• 2 Huang D, Swanson E A, Lin C P. et al . Optical coherence tomography.  Science. 1991;  254 1178-1181
  CrossrefPubMedGoogle Scholar
• 3 Suter M J, Vakoc B J, Yachimski P S. et al . Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging.  Gastrointest Endosc. 2008;  68 745-753
  CrossrefPubMedGoogle Scholar
• 4 Adler D C, Zhou C, Tsai T-H. et al . Three-dimensional endomicroscopy of the human colon using optical coherence tomography.  Optics Express. 2009;  17 784-796
  CrossrefPubMedGoogle Scholar
• 5 Isenberg G, Sivak M V, Chak A. et al . Accuracy of endoscopic optical coherence tomography in the detection of dysplasia in Barrett’s esophagus: a prospective, double-blinded study.  Gastrointest Endosc. 2005;  62 825-831
  CrossrefPubMedGoogle Scholar
• 6 Chen Y, Aguirre A D, Hsiung P L. et al . Ultrahigh resolution optical coherence tomography of Barrett’s esophagus: preliminary descriptive clinical study correlating images with histology.  Endoscopy. 2007;  39 599-605
  Article in Thieme ConnectPubMedGoogle Scholar

J. G. FujimotoPhD 

Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics
Massachusetts Institute of Technology

Cambridge, MA 02139
USA

Fax: +01-617-253-9611

Email: jgfuji@mit.edu