Optical coherence tomography of small intestine allograft biopsies using a handheld surgical probe.
Optical coherence tomography of small intestine allograft biopsies using a handheld surgical probe.
复制标题
使用手持式手术探头进行小肠同种异体移植活检的光学相干断层扫描。
DOI：
10.1117/1.jbo.26.9.096008
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发表时间：
2021-09
影响因子：
3.5
通讯作者：
Wax A
中科院分区：
文献类型：
--
作者：
Jelly ET;Kwun J;Schmitz R;Farris AB;Steelman ZA;Sudan DL;Knechtle SJ;Wax A
意义：目前监测小肠移植（IT）排斥反应的金标准是内镜下视觉评估和可疑病变活检；然而，这些病变只能通过内窥镜观察到。侵入性活组织检查提供组织健康的粗略抽样，而不描述任何病理的真实存在和程度。光学相干断层扫描（OCT）是一种潜在的替代方法，与传统的白光内窥镜相比具有显著的优势。目的：我们研究的目的是评估OCT表现在区分与IT移植失败相关的临床相关形态学特征中的作用。方法：应用OCT对2只接受回肠IT手术的恒河猴小肠组织进行评价。将常规组织学观察的传统评估与移植后几天使用手持式手术探针捕获的OCT进行比较，随后与组织病理学进行比较。结果：所报道的OCT系统能够识别健康肠道组织中的主要生物标志物。在IT之后，一个非人灵长类动物（NHP）模型遭受严重的移植物缺血，第二个NHP移植物由于急性细胞排斥而失败。OCT图像显示与IT排斥的组织学征象相符。结论：结果表明，OCT成像在揭示与IT排斥反应相关的形态学变化和改善患者整体预后方面具有重要的潜力。
Significance: The current gold standard for monitoring small intestinal transplant (IT) rejection is endoscopic visual assessment and biopsy of suspicious lesions; however, these lesions are only superficially visualized by endoscopy. Invasive biopsies provide a coarse sampling of tissue health without depicting the true presence and extent of any pathology. Optical coherence tomography (OCT) presents a potential alternative approach with significant advantages over traditional white-light endoscopy. Aim: The aim of our investigation was to evaluate OCT performance in distinguishing clinically relevant morphological features associated with IT graft failure. Approach: OCT was applied to evaluate the small bowel tissues of two rhesus macaques that had undergone IT of the ileum. The traditional assessment from routine histological observation was compared with OCT captured using a handheld surgical probe during the days post-transplant and subsequently was compared with histophaology. Results: The reported OCT system was capable of identifying major biological landmarks in healthy intestinal tissue. Following IT, one nonhuman primate (NHP) model suffered a severe graft ischemia, and the second NHP graft failed due to acute cellular rejection. OCT images show visual evidence of correspondence with histological signs of IT rejection. Conclusions: Results suggest that OCT imaging has significant potential to reveal morphological changes associated with IT rejection and to improve patient outcomes overall.