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Endoscopy 2000; 32(12): 921-930
DOI: 10.1055/s-2000-9626
Original Article
© Georg Thieme Verlag Stuttgart · New York

Optical Coherence Tomography: Advanced Technology for the Endoscopic Imaging of Barrett's Esophagus

X. D. Li1 , S. A. Boppart1,2 , ,J.  Van Dam3 , , H.  Mashimo4,5 , , M.  Mutinga6 , , W.  Drexler1 , , M.  Klein7 , , C.  Pitris1,2 , , M. L. Krinsky4 , , M. E.  Brezinski5 , , J. G.  Fujimoto1
  • 1 Dept. of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
  • 2 Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
  • 3 Gastroenterology Division, Stanford University Medical Center, Stanford, California, USA
  • 4 Gastroenterology Division, West Roxbury VA Medical Center,West Roxbury, Massachusetts, USA
  • 5 Dept. of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  • 6 Gastroenterology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  • 7 Dept. of Pathology, West Roxbury VA Medical Center, West Roxbury, Massachusetts, USA
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Publication History

Publication Date:
31 December 2000 (online)

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Background and Study Aims: Endoscopic optical coherence tomography (OCT) is an emerging medical technology capable of generating high-resolution cross-sectional imaging of tissue microstructure in situ and in real time. We assess the use and feasibility of OCT for real-time screening and diagnosis of Barrett's esophagus, and also review state-of-the-art OCT technology for endoscopic imaging.

Materials and Methods: OCT imaging was performed as an adjunct to endoscopic imaging of the human esophagus. Real-time OCT (13-μm resolution) was used to perform image-guided evaluation of normal esophagus and Barrett's esophagus. Beam delivery was accomplished with a 1-mm diameter OCT catheter-probe that can be introduced into the accessory channel of a standard endoscope. Different catheter-probe imaging designs which performed linear and radial scanning were assessed. Novel ultrahigh-resolution (1.1-μm resolution) and spectroscopic OCT techniques were used to image in vitro specimens of Barrett's esophagus.

Results: Endoscopic OCT images revealed distinct layers of normal human esophagus extending from the epithelium to the muscularis propria. In contrast, the presence of gland- and crypt-like morphologies and the absence of layered structures were observed in Barrett's esophagus. All OCT images showed strong correlations with architectural morphology in histological findings. Ultrahigh-resolution OCT techniques achieved 1.1-μm image resolution in in vitro specimens and showed enhanced resolution of architectural features. Spectroscopic OCT identified localized regions of wavelength-dependent optical scattering, enhancing the differentiation of Barrett's esophagus.

Conclusions: OCT technology with compact fiberoptic imaging probes can be used as an adjunct to endoscopy for real-time image-guided evaluation of Barrett's esophagus. Linear and radial scan patterns have different advantages and limitations depending upon the application. Ultrahigh-resolution and spectroscopic OCT techniques improve structural tissue recognition and suggest future potential for resolution and contrast enhancements in clinical studies. A new balloon catheter-probe delivery device is proposed for systematic imaging and screening of the esophagus.

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Jacques Van Dam, M.D., Ph.D.

Division of Gastroenterology & Hepatology


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