Title: 3442 Role of high resolution endoscopic imaging using optical coherence tomography (oct) in patients with barrett's esophagus (be).
Abstract: OCT, a novel technique for high resolution endoscopic imaging clearly delineates microscopic mucosal and submucosal structures of the GI tract. Aim: To study the ability of OCT to identify and characterize BE. Methods: OCT images were obtained using an endoscopic OCT probe (2.4 mm dia, 0.5 mm focal distance)in patients undergoing surveillance EGD for BE. Images were captured digitally and were objectively rated in terms of clarity, resolution, ease of identification of BE and to determine whether areas of dysplasia could be identified. Four quadrant large particle biopsies were taken from the area of BE at 2 cm intervals and were correlated with OCT images. Results:8 patients with BE (mean age 62.5 years, 6 men) were studied. Mean length of BE was 7.7 (SE 2.2) cms; 3 patients had focal areas of high grade dysplasia. During OCT imaging squamous epithelium and Barrett's epithelium could be readily distinguished. Also, areas with Barrett's epithelium lacked the characteristic thick, dark band which is seen with stratified squamous epithelium. The esophageal mucosa was significantly thicker in the areas of Barrett's epithelium (mean thickness 0.6 mm vs. 0.4 mm, p < 0.01) compared to areas of squamous epithelium. The squamo-columnar transition zone could be readily discerned in all except one; in this patient difficulty was experienced in correctly positioning the OCT probe due to short length of Barrett's epithelium and excessive motility at the gastroesophageal junction. Although microscopic structures such as esophageal glands and blood vessels in the submucosa were clearly visible in the OCT images, areas of dysplasia were not identified. Due to the small diameter of the OCT probe relative to the lumen, it is difficult to fully image a mucosal abnormality that has a large surface area. Conclusion: During OCT imaging of BE, histological details that corresponds to columnar changes and intestinal metaplasia were clearly seen. However, at current resolution dysplastic changes associated with BE may not be detectable. Further advances in probe technology and OCT technique may be needed to enable surveillance large mucosal areas.
Publication Year: 2000
Publication Date: 2000-04-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 19
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