Large-area spectrally encoded confocal endomicroscopy of the human esophagus in vivo.

Background and Objective: Diagnosis of esophageal diseases is often hampered by sampling errors that are inherent in endoscopic biopsy, the standard of care. Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal endomicroscopy technology that has the potential to visuali...

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Publicado en:Lasers in Surgery & Medicine Vol. 49; no. 3; pp. 233 - 240
Autores principales: Kang, Dongkyun, Schlachter, Simon C., Carruth, Robert W., Kim, Minkyu, Wu, Tao, Tabatabaei, Nima, Soomro, Amna R., Grant, Catriona N., Rosenberg, Mireille, Nishioka, Norman S., Tearney, Guillermo J.
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Mar2017
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Lasers in Surgery & Medicine
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      dt: Mar2017
      vid: 49
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/lsm.22585
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        atl: Large-area spectrally encoded confocal endomicroscopy of the human esophagus in vivo.
      aug:
        au:
          Kang, Dongkyun
          Schlachter, Simon C.
          Carruth, Robert W.
          Kim, Minkyu
          Wu, Tao
          Tabatabaei, Nima
          Soomro, Amna R.
          Grant, Catriona N.
          Rosenberg, Mireille
          Nishioka, Norman S.
          Tearney, Guillermo J.
        affil: Wellman Center for Photomedicine, Massachusetts General Hospital, Boston Massachusetts 02114
      sug:
        subj:
          Microscopy Methods
          Precancerous Conditions Pathology
          Barrett Esophagus Pathology
          Esophageal Neoplasms Pathology
          Endoscopy, Digestive System Methods
          Biopsy, Needle
          Male
          Immunohistochemistry
          Pilot Studies
          Precancerous Conditions Diagnosis
          Esophageal Neoplasms Diagnosis
          Probability Sample
          Barrett Esophagus Diagnosis
          Diagnosis, Differential
          Female
          Monitoring, Physiologic Methods
          Human
          Male
          Female
      ab: Background and Objective: Diagnosis of esophageal diseases is often hampered by sampling errors that are inherent in endoscopic biopsy, the standard of care. Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal endomicroscopy technology that has the potential to visualize cellular features from large regions of the esophagus, greatly decreasing the likelihood of sampling error. In this paper, we report results from a pilot clinical study imaging the human esophagus in vivo with a prototype SECM endoscopic probe.Materials and Methods: In this pilot clinical study, six patients undergoing esophagogastroduodenoscopy (EGD) for surveillance of Barrett's esophagus (BE) were imaged with the SECM endoscopic probe. The device had a diameter of 7 mm, a length of 2 m, and a rapid-exchange guide wire provision for esophageal placement. During EGD, the distal portion of the esophagus of each patient was sprayed with 2.5% acetic acid to enhance nuclear contrast. The SECM endoscopic probe was then introduced over the guide wire to the distal esophagus and large-area confocal images were obtained by helically scanning the optics within the SECM probe.Results: Large area confocal images of the distal esophagus (image length = 4.3-10 cm; image width = 2.2 cm) were rapidly acquired at a rate of ∼9 mm2 /second, resulting in short procedural times (1.8-4 minutes). SECM enabled the visualization of clinically relevant architectural and cellular features of the proximal stomach and normal and diseased esophagus, including squamous cell nuclei, BE glands, and goblet cells.Conclusions: This study demonstrates that comprehensive spectrally encoded confocal endomicroscopy is feasible and can be used to visualize architectural and cellular microscopic features from large segments of the distal esophagus at the gastroesophageal junction. By providing microscopic images that are less subject to sampling error, this technology may find utility in guiding biopsy and planning and assessing endoscopic therapy. Lasers Surg. Med. 49:233-239, 2017. © 2016 Wiley Periodicals, Inc.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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