Ultrahigh resolution optical coherence tomography of Barrett's esophagus: preliminary descriptive clinical study correlating images with histology
Ultrahigh resolution optical coherence tomography of Barrett's esophagus: preliminary descriptive clinical study correlating images with histology
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DOI：
10.1055/s-2007-966648
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发表时间：
2007-07-01
期刊：
影响因子：
9.3
通讯作者：
Mashimo, H.
中科院分区：
文献类型：
--
作者：
Chen, Y.;Aguirre, A. D.;Mashimo, H.
背景和研究目的：内窥镜超高分辨率光学相干断层成像(UHR OCT)的轴向图像分辨率接近5 pm，是标准内窥镜OCT成像的2-3倍。本研究探讨内窥镜下超高分辨率光学断层扫描(UHR OCT)对Barrett‘s食道的成像能力。成像波长为1.3微米，轴向分辨率为-5 PM，横向分辨率为-15 PM，通过标准内窥镜的辅助通道插入1.8 mm/直径的线性扫描导管。结果：对正常食道、Barrett‘s食道、重度不典型增生和食管腺癌的OHR OCT图像进行了评价。正常食道的UHR OCT图像显示典型的层状结构，上皮均匀，而Barrett‘s食道的图像对应于隐窝样腺结构。高度不典型增生和食管腺癌图像表现出更多的不均匀结构，与扭曲的筛状或绒毛状腺结构形成的不规则、不均匀的组织形态相对应。结论：本研究对新的内窥镜OCT技术进行了评价，并论证了UHR OCT成像与标准内窥镜联合应用于Barrett‘s食道、异型增生和食管腺癌实时成像的可行性。使用迄今为止最高轴向分辨率的研究原型OCT系统对正常和异常的上胃肠道组织进行了调查，并可作为未来研究的基线。
Background and study aims: Endoscopic ultrahigh resolution optical coherence tomography (UHR OCT) achieves an axial image resolution of similar to 5 pm, which is 2 - 3 times finer than standard endoscopic OCT imaging. This study investigated the capability of endoscopic UHR OCT for imaging patients with Barrett's esophagus.Patients and methods: Fivty volunteers previously diagnosed with Barrett's esophagus underwent UHR OCT. Imaging was performed at 1.3 mu m wavelengths with - 5 pm axial and - 15 pm transverse resolutions using a 1.8 mm/ diameter linear-scanning catheter introduced through the accessory channel of a standard endoscope. OCT images were compared with endoscopic diagnosis and pinch biopsy histological appearances.Results: UHR OCT images of normal esophagus, Barrett's esophagus, high grade dysplasia and esophageal adenocarcinoma were evaluated. UHR OCT images of the normal esophagus exhibited characteristic layered architecture with uniform epithelium, while images of Barrett's esophagus corresponded to crypt-like glandular structures. High grade dysplasia and esophageal adenocarcinoma images exhibited more heterogeneous structures corresponding to irregular, heterogeneous tissue morphology from distorted and cribriform or villiform glandular architecture. Fine features can be discerned more clearly with endoscopic UHR OCT.Conclusions: This study evaluated new endoscopic OCT technology and demonstrated the feasibility of carrying out UHR OCT imaging in conjunction with standard endoscopy for in vivo real-time imaging of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma. A survey of normal and abnormal upper gastrointestinal tissues was performed using a research prototype OCT system with the highest axial resolution to date, and can serve as a baseline for future inves-