Optical Coherence Tomography in the Gastrointestinal Tract

 

 Buy Article Permissions and Reprints

Optical coherence tomography (OCT) is a high-resolution, cross-sectional optical imaging technique that allows in situ imaging of tissue by measuring back-reflected light. OCT provides images in real time with a resolution approaching that of conventional histopathology, but without the need for tissue removal. OCT imaging can be performed endoscopically to visualize gastrointestinal tissue using a fiberoptic catheter passed through the instrument channel of a conventional endoscope. The resolution of OCT allows visualization of the different layers of gastrointestinal epithelium and the differentiation of Barrett's epithelium from normal gastric and squamous mucosa. OCT has also been used to image esophageal adenocarcinoma and colonic polyps. Recent developments include Doppler OCT, spectroscopic OCT, and ultrahigh-resolution OCT, which can visualize nuclei within single cells. Although still in its infancy as a clinical tool, OCT currently provides high-resolution images over the same imaging depth as conventional mucosal biopsy, and may prove to be a useful and minimally invasive technique for evaluating gastrointestinal tissue, particularly for early neoplastic changes.

References

• 1 Huang D, Swanson E A, Lin C P, et al. Optical coherence tomography.  Science. 1991;  254 (5035) 1178-1181
  CrossrefPubMedGoogle Scholar
• 2 Fercher A F, Hitzenberger C K, Drexler W, Kamp G, Sattmann H. In vivo optical coherence tomography [letter].  Am J Ophthalmol. 1993;  116 113-114
  CrossrefPubMedGoogle Scholar
• 3 Swanson E A, Izatt J A, Hee M R, et al. In vivo retinal imaging by optical coherence tomography.  Opt Lett. 1993;  18 1864-1866
  PubMedGoogle Scholar
• 4 Schmitt J M, Yadlowsky M J, Bonner R F. Subsurface imaging of living skin with optical coherence microscopy.  Dermatology. 1995;  191 93-98
  PubMedGoogle Scholar
• 5 Baumgartner A, Dichtl S, Hitzenberger C K, et al. Polarization-sensitive optical coherence tomography of dental structures.  Caries Res. 2000;  34 59-69
  CrossrefPubMedGoogle Scholar
• 6 Brezinski M E, Tearney G J, Bouma B E, et al. Imaging of coronary artery microstructure (in vitro) with optical coherence tomography.  Am J Cardiol. 1996;  77 92-93
  CrossrefPubMedGoogle Scholar
• 7 Fujimoto J G, Boppart S A, Tearney G J, et al. High resolution in vivo intra-arterial imaging with optical coherence tomography.  Heart. 1999;  82 128-133
  PubMedGoogle Scholar
• 8 Tearney G J, Brezinski M E, Southern J F, et al. Optical biopsy in human urologic tissue using optical coherence tomography.  J Urol. 1997;  157 1915-1919
  PubMedGoogle Scholar
• 9 Jesser C A, Boppart S A, Pitris C, et al. High resolution imaging of transitional cell carcinoma with optical coherence tomography: feasibility for the evaluation of bladder pathology.  Br J Radiol. 1999;  72 1170-1176
  PubMedGoogle Scholar
• 10 Boppart S A, Goodman A, Libus J, et al. High resolution imaging of endometriosis and ovarian carcinoma with optical coherence tomography: feasibility for laparoscopic-based imaging.  Br J Obstet Gynaecol. 1999;  106 1071-1077
  PubMedGoogle Scholar
• 11 Tearney G J, Brezinski M E, Southern J F, et al. Optical biopsy in human gastrointestinal tissue using optical coherence tomography.  Am J Gastroenterol. 1997;  92 1800-1884
  PubMedGoogle Scholar
• 12 Kobayashi K, Izatt J A, Kulkarni M D, Willis J, Sivak M V. High-resolution cross-sectional imaging of the gastrointestinal tract using optical coherence tomography: preliminary results.  Gastrointest Endosc. 1998;  47 515-523
  PubMedGoogle Scholar
• 13 Tearney G J, Brezinski M E, Southern J F, et al. Optical biopsy in human pancreatobiliary tissue using optical coherence tomography.  Dig Dis Sci. 1998;  43 1193-1199
  CrossrefPubMedGoogle Scholar
• 14 Pitris C, Jesser C, Boppart S A, et al. Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies.  J Gastroenterol. 2000;  35 87-92
  CrossrefPubMedGoogle Scholar
• 15 Tearney G J, Brezinski M E, Bouma B E, et al. In vivo endoscopic optical biopsy with optical coherence tomography.  Science. 1997;  276 (5321) 2037-2039
  CrossrefPubMedGoogle Scholar
• 16 Sergeev A M, Gelikonov V M, Gelikonov G V, et al. In vivo endoscopic OCT imaging of precancer and cancer states of human mucosa.  Opt Express. 1997;  1 432-440
  PubMedGoogle Scholar
• 17 Bouma B E, Tearney G J, Compton C C, Nishioka N S. High resolution of the human esophagus and stomach in vivo using optical coherence tomography.  Gastrointest Endosc. 2000;  51 467-474
  CrossrefPubMedGoogle Scholar
• 18 Sivak MV J r, Kobayashi K, Izatt J A, et al. High-resolution endoscopic imaging of the gastrointestinal tract using optical coherence tomography.  Gastrointest Endosc. 2000;  51 474-479
  PubMedGoogle Scholar
• 19 Jäckle S, Gladkova N, Feldchtein F, et al. In vivo endoscopic optical coherence tomography of esophagitis, Barrett's esophagus, and adenocarcinoma of the esophagus.  Endoscopy. 2000;  32 750-755
  Article in Thieme ConnectPubMedGoogle Scholar
• 20 Jäckle S, Gladkova N, Feldchtein F, et al. In vivo endoscopic optical coherence tomography of the human gastrointestinal tract - toward optical biopsy.  Endoscopy. 2000;  32 743-749
  Article in Thieme ConnectPubMedGoogle Scholar
• 21 Winters C, Spurling T J, Chobian S J, et al. Barrett's esophagus: a prevalent occult complication of gastroesophageal reflux disease.  Gastroenterology. 1987;  92 118-124
  CrossrefPubMedGoogle Scholar
• 22 Cameron A J, Ott B J, Payne W S. The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus.  N Engl J Med. 1985;  313 857-859
  CrossrefPubMedGoogle Scholar
• 23 Hameeteman W, Tytgat G N, Houthoff H J, van den Tweel J G. Barrett's esophagus: development of dysplasia and adenocarcinoma.  Gastroenterology. 1989;  96 1249-1256
  PubMedGoogle Scholar
• 24 Skinner D B. The incidence of cancer in Barrett's esophagus varies according to series.  New York; Springer, 1989
  Google Scholar
• 25 Eloubeidi M A, Provenzale D. Does this patient have Barrett's esophagus? The utility of predicting Barrett's esophagus at the index endoscopy.  Am J Gastroenterol. 1999;  94 937-943
  CrossrefPubMedGoogle Scholar
• 26 Brand S, Bouma B E, Tearney G J, et al. Optical coherence tomography (OCT) in the upper gastrointestinal tract [abstract].  Endoscopy. 1999;  31 E1
  Article in Thieme ConnectPubMedGoogle Scholar
• 27 Poneros J M, Brand S, Bouma B E, et al. Diagnosis of specialized intestinal metaplasia by optical coherence tomography [abstract].  Gastrointest Endosc. 2000;  51 AB226
  PubMedGoogle Scholar
• 28 Drexler W, Morgner U, Kaertner F X, et al. In vitro ultrahigh-resolution optical coherence tomography.  Opt Lett. 1999;  24 1221-1223
  CrossrefPubMedGoogle Scholar
• 29 Panjehpour M, Overholt B F, Vo-Dinh T, Haggitt R C, Edwards D H, Buckley FP I II. Endoscopic fluorescence detection of high-grade dysplasia in Barrett's esophagus.  Gastroenterology. 1996;  111 93-101
  CrossrefPubMedGoogle Scholar
• 30 Brand S, Stepp H, Ochsenkuhn T, et al. Detection of colonic dysplasia by light-induced fluorescence endoscopy: a pilot study.  Int J Colorectal Dis. 1999;  14 63-68
  CrossrefPubMedGoogle Scholar
• 31 Messmann H, Knuchel R, Baumler W, et al. Endoscopic fluorescence detection of dysplasia in patients with Barrett's esophagus, ulcerative colitis, or adenomatous polyps after 5-aminolevulinic acid-induced protoporphyrin IX sensitization.  Gastrointest Endosc. 1999;  49 97-101
  PubMedGoogle Scholar
• 32 Brand S A, Wang T D, Schomacker K T, et al. Detection of high-grade dysplasia in Barrett's esophagus by 5-aminolevulinic acid (ALA) induced protoporphyrin IX (PPIX) fluorescence spectroscopy [abstract].  Gastroenterology. 2000;  118 A193
  PubMedGoogle Scholar
• 33 Wong Kee Song L M, Shim M G, Wilson B C, et al. Identifying dysplasia within Barrett's esophagus using Raman spectroscopy [abstract].  Gastrointest Endosc. 2000;  51 AB226
  PubMedGoogle Scholar
• 34 Lovat L B, Pickard D, Novelli M, et al. A novel optical biopsy technique using elastic scattering spectroscopy for dysplasia and cancer in Barrett's esophagus [abstract].  Gastrointest Endosc. 2000;  52 AB227
  PubMedGoogle Scholar
• 35 Blot W J, Devesa S S, Kneller R W, Fraumeni JF J r. Rising incidence of adenocarcinoma of the esophagus and gastric cardia.  JAMA. 1991;  265 1287-1289
  CrossrefPubMedGoogle Scholar
• 36 Blot W J, Devesa S S, Fraumeni JF J r. Continuing climb in rates of esophageal adenocarcinoma: an update [letter].  JAMA. 1993;  27 1320
  PubMedGoogle Scholar
• 37 Vargas G, Chan E K, Barton J K, et al. Use of an agent to reduce scattering in skin.  Lasers Surg Med. 1999;  24 133-141
  CrossrefPubMedGoogle Scholar
• 38 Morgner U, Drexler W, Kartner F X, et al. Spectroscopic optical coherence tomography.  Opt Lett. 2000;  25 (2) 111-113
  PubMedGoogle Scholar
• 39 Pan Y, Farkas D L. Noninvasive imaging of living human skin with dual-wavelength optical coherence tomography in two and three dimension.  J Biomed Opt. 1998;  3 446-455
  CrossrefPubMedGoogle Scholar
• 40 Herrmann J M, Brezinski M E, Bouma B E, et al. Two- and three-dimensional high-resolution imaging of the human oviduct with optical coherence tomography.  Fertil Steril. 1998;  7 155-158
  PubMedGoogle Scholar
• 41 Boppart S A, Bouma B E, Pitris C, et al. Intraoperative assessment of microsurgery with three-dimensional optical coherence tomography.  Radiology. 1998;  208 81-86
  PubMedGoogle Scholar
• 42 Boppart S A, Brezinski M E, Pitris C. Optical coherence tomography for neurosurgical imaging of human intracortical melanoma.  Neurosurgery. 1998;  43 834-841
  PubMedGoogle Scholar
• 43 Boppart S A, Bouma B E, Pitris C, et al. In vivo cellular optical coherence tomography imaging.  Nat Med. 1998;  4 861-865
  PubMedGoogle Scholar
• 44 Tadrous P J. Methods for imaging the structure and function of living tissues and cells, 1: optical coherence tomography.  J Pathol. 2000;  191 115-119
  PubMedGoogle Scholar
• 45 Izatt J A, Kulkarni M D, Yazdanfar S, et al. In vivo bidirectional color Doppler flow imaging of picoliter blood volumes using optical coherence tomography.  Opt Lett. 1997;  22 (18) 1439-1441
  PubMedGoogle Scholar
• 46 Yazdanfar S, Kulkarni M D, Izatt J A. High resolution imaging of in vivo cardiac dynamics using color Doppler optical coherence tomography.  Opt Express. 1997;  1 13
  PubMedGoogle Scholar
• 47 Yazdanfar S, Rollins A M, Izatt J A. In vivo human retinal blood flow imaging using color Doppler optical coherence tomography. In: Optical Society of America (eds). Conference on Lasers and Electro-Optics.  Washington, DC; Optical Society of America, 1999: CPD12/1-2
  Google Scholar
• 48 American National Standards Institute. ANSI Z136.1-1993. Laser Institute of America. Orlando, FL; 1993
  Google Scholar
• 49 Nishioka N S, Schomacker K T. Mucosal exposure to light during routine endoscopy.  Gastrointest Endosc. 1999;  49 456-461
  PubMedGoogle Scholar

S. Brand,M.D. 

Gastrointestinal Unit and Wellman Laboratories of Photomedicine, BAR- 703 Massachusetts General Hospital Harvard Medical School

50 Blossom St. Boston, MA 02114 USA

Fax: Fax:+ 1- 617- 726 4103

Email: E-mail:brand@wlp.mgh.harvard.edu