Cervical inlet patch-optical coherence tomography imaging and clinical significance.
OBJECTIVE
To demonstrate the feasibility of optical coherence tomography (OCT) imaging in differentiating cervical inlet patch (CIP) from normal esophagus, Barrett's esophagus (BE), normal stomach and duodenum.


METHODS
This study was conducted at the Veterans Affairs Boston Healthcare System (VABHS). Patients undergoing standard esophagogastroduodenoscopy at VABHS, including one patient with CIP, one representative patient with BE and three representative normal subjects were included. White light video endoscopy was performed and endoscopic 3D-OCT images were obtained in each patient using a prototype OCT system. The OCT imaging probe passes through the working channel of the endoscope to enable simultaneous video endoscopy and 3D-OCT examination of the human gastrointestinal (GI) tract. Standard hematoxylin and eosin (H and E) histology was performed on biopsy or endoscopic mucosal resection specimens in order to compare and validate the 3D-OCT data.


RESULTS
CIP was observed from a 68-year old male with gastroesophageal reflux disease. The CIP region appeared as a pink circular lesion in the upper esophagus under white light endoscopy. OCT imaging over the CIP region showed columnar epithelium structure, which clearly contrasted the squamous epithelium structure from adjacent normal esophagus. 3D-OCT images obtained from other representative patients demonstrated distinctive patterns of the normal esophagus, BE, normal stomach, and normal duodenum bulb. Microstructures, such as squamous epithelium, lamina propria, muscularis mucosa, muscularis propria, esophageal glands, Barrett's glands, gastric mucosa, gastric glands, and intestinal mucosal villi were clearly observed with OCT and matched with H and E histology. These results demonstrated the feasibility of using OCT to evaluate GI tissue morphology in situ and in real-time.


CONCLUSIONS
We demonstrate in situ evaluation of CIP microstructures using 3D-OCT, which may be a useful tool for future diagnosis and follow-up of patients with CIP.
Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139-4307, United States.
Chao
C
Zhou
Tejas
T
Kirtane
Tsung-Han
TH
Tsai
Hsiang-Chieh
HC
Lee
Desmond C
DC
Adler
Joseph M
JM
Schmitt
Qin
Q
Huang
James G
JG
Fujimoto
Hiroshi
H
Mashimo
D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology; D004386:Duodenum / Q000033:anatomy & histology; D016145:Endoscopy, Digestive System; D004935:Esophageal Diseases / Q000473:pathology*; D004947:Esophagus / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D013270:Stomach / Q000033:anatomy & histology; D041623:Tomography, Optical Coherence