title: Optical coherence tomography of the esophagus and proximal stomach in health and disease.
abstract: OBJECTIVE
  Surveillance of Barrett's esophagus is problematic, as high-grade dysplasia cannot be recognized endoscopically. Endoscopic ultrasound lacks the resolution to detect high-grade dysplasia. Optical coherence tomography (OCT) employs infrared light reflectance to provide in vivo tissue images at resolution far superior to endoscopic ultrasound, nearly at the level of histology. We have developed a catheter-based system well suited for study of the GI tract. The purpose of this study was to test this catheter-based OCT system and characterize the OCT appearance of normal squamous mucosa, gastric cardia, Barrett's esophagus, and carcinoma.
  
  
  METHODS
  The OCT catheter was passed through the operating channel of the endoscope and placed in contact with the esophageal mucosa. Image acquisition occurred in approximately 3 s. OCT images were correlated with biopsy and/or resection specimens.
  
  
  RESULTS
  OCT was used to construct 477 images of the esophagus and stomach in 69 patients. There were unique, distinct OCT appearances of squamous mucosa, gastric cardia, Barrett's esophagus, and carcinoma. Further, these OCT images were accurately recognized by observers unaware of their site of origin.
  
  
  CONCLUSIONS
  OCT provides a highly detailed view of the GI wall, with clear delineation of a multiple layered structure. It is able to distinguish squamous mucosa, gastric cardia, Barrett's esophagus, and cancer. This technique holds great potential as an adjunct to the surveillance of patients with Barrett's esophagus, ulcerative pancolitis, and other premalignant conditions.
authors.affiliation: Department of Gastroenterology, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: G
authors.initials: G
authors.lastname: Zuccaro
authors.forename: N
authors.initials: N
authors.lastname: Gladkova
authors.forename: J
authors.initials: J
authors.lastname: Vargo
authors.forename: F
authors.initials: F
authors.lastname: Feldchtein
authors.forename: E
authors.initials: E
authors.lastname: Zagaynova
authors.forename: D
authors.initials: D
authors.lastname: Conwell
authors.forename: G
authors.initials: G
authors.lastname: Falk
authors.forename: J
authors.initials: J
authors.lastname: Goldblum
authors.forename: J
authors.initials: J
authors.lastname: Dumot
authors.forename: J
authors.initials: J
authors.lastname: Ponsky
authors.forename: G
authors.initials: G
authors.lastname: Gelikonov
authors.forename: B
authors.initials: B
authors.lastname: Davros
authors.forename: E
authors.initials: E
authors.lastname: Donchenko
authors.forename: J
authors.initials: J
authors.lastname: Richter
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D001471:Barrett Esophagus / Q000473:pathology*; D002404:Catheterization; D004867:Equipment Design; D004935:Esophageal Diseases / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000473:pathology*; D004947:Esophagus / Q000033:anatomy & histology; D006801:Humans; D007259:Infrared Rays; D013270:Stomach / Q000033:anatomy & histology; D013272:Stomach Diseases / Q000473:pathology*; D014054:Tomography / Q000295:instrumentation / Q000379:methods*