Comprehensive esophageal microscopy by using optical frequency-domain imaging (with video).
BACKGROUND
Optical coherence tomography (OCT) has been used for high-resolution endoscopic imaging and diagnosis of specialized intestinal metaplasia, dysplasia, and intramucosal carcinoma of the esophagus. However, the relatively slow image-acquisition rate of the present OCT systems inhibits wide-field imaging and limits the clinical utility of OCT for diagnostic imaging in patients with Barrett's esophagus.


OBJECTIVE
This study describes a new optical imaging technology, optical frequency-domain imaging (OFDI), derived from OCT, that enables comprehensive imaging of large esophageal segments with microscopic resolution.


METHODS
A prototype OFDI system was developed for endoscopic imaging. The system was used in combination with a balloon-centering catheter to comprehensively image the distal esophagus in swine.


RESULTS
Volumetric images of the mucosa and portions of the muscularis propria were obtained for 4.5-cm-long segments. Image resolution was 7 microm in depth and 30 microm parallel to the lumen, and provided clear delineation of each mucosal layer. The 3-dimensional data sets were used to create cross-sectional microscopic images, as well as vascular maps of the esophagus. Submucosal vessels and capillaries were visualized by using Doppler-flow processing.


CONCLUSIONS
Comprehensive microscopic imaging of the distal esophagus in vivo by using OFDI is feasible. The unique capabilities of this technology for obtaining detailed information of tissue microstructure over large mucosal areas may open up new possibilities for improving the management of patients with Barrett's esophagus.
Vakoc
Benjamin J
BJ
Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts, USA.
Shishko
Milen
M
Yun
Seok H
SH
Oh
Wang-Yuhl
WY
Suter
Melissa J
MJ
Desjardins
Adrien E
AE
Evans
John A
JA
Nishioka
Norman S
NS
Tearney
Guillermo J
GJ
Bouma
Brett E
BE
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D000818:Animals; D001471:Barrett Esophagus / Q000000981:diagnostic imaging / Q000473:pathology*; D004867:Equipment Design; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008853:Microscopy; D023421:Models, Animal; D011859:Radiography; D013552:Swine; D041623:Tomography, Optical Coherence / Q000295:instrumentation* / Q000379:methods