title: Volumetric laser endomicroscopy in Barrett's esophagus: a feasibility study on histological correlation.
abstract: Volumetric laser endomicroscopy (VLE) is a novel balloon-based optical coherence tomography (OCT) imaging technique that may improve detection of early neoplasia in Barrett's esophagus (BE). Most OCT studies lack a direct correlation between histology and OCT images. The aim is to investigate the optimal approach for achieving one-to-one correlation of ex-vivo VLE images of endoscopic resection (ER) specimens with histology. BE patients with and without early neoplasia underwent ER after delineating areas with electrocoagulation markers (ECM). After ER, specimens underwent additional ex-vivo marking with several different markers (ink, pin, Gold Probe) followed by ex-vivo VLE scanning. ER specimens were carefully sectioned into tissue blocks guided by the markers. Histology and VLE slides were considered a match if ≥ 2 markers were visible on both modalities and mucosal patterns aside from these markers matched on both histology and VLE. From 16 ER specimens 120 tissue blocks were sectioned of which 23 contained multiple markers. Fourteen histology-VLE matches were identified. ECMs and ink markers proved to be the most effective combination for matching. The last 6/16 ER specimens yielded 9/14 matches, demonstrating a learning curve due to methodological improvements in marker placement and tissue block sectioning. One-to-one correlation of VLE and histology is complex but feasible. The groundwork laid in this study will provide high-quality histology-VLE correlations that will allow further research on VLE features of early neoplasia in BE.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Swager
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D F
authors.initials: DF
authors.lastname: Boerwinkel
authors.affiliation: Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D M
authors.initials: DM
authors.lastname: de Bruin
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: B L
authors.initials: BL
authors.lastname: Weusten
authors.affiliation: Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D J
authors.initials: DJ
authors.lastname: Faber
authors.affiliation: Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: S L
authors.initials: SL
authors.lastname: Meijer
authors.affiliation: Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: T G
authors.initials: TG
authors.lastname: van Leeuwen
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: W L
authors.initials: WL
authors.lastname: Curvers
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Bergman
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D001471:Barrett Esophagus / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D055088:Early Detection of Cancer; D000069916:Endoscopic Mucosal Resection; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D004945:Esophagoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Barrett's esophagus; advanced imaging; early esophageal cancer; endomicroscopy; endoscopic imaging; esophageal adenocarcinoma