Imaging of subsquamous Barrett's epithelium with ultrahigh-resolution optical coherence tomography: a histologic correlation study

• Published in: Gastrointestinal endoscopy 2010-02, Vol.71 (2), p.223-230
• Main Authors: Cobb, Michael J., PhD, Hwang, Joo Ha, MD, PhD, Upton, Melissa P., MD, Chen, Yuchuan, PhD, Oelschlager, Brant K., MD, Wood, Douglas E., MD, Kimmey, Michael B., MD, Li, Xingde, PhD
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Barrett Esophagus - pathology; Barrett Esophagus - surgery; Biological and medical sciences; Biopsy, Needle; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Diagnosis, Differential; Digestive system. Abdomen; Education, Medical, Continuing; Endoscopy; Epithelium - pathology; Epithelium - surgery; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophagectomy - methods; Esophagoscopy - methods; Esophagus; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hyperplasia - pathology; Immunohistochemistry; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Other diseases. Semiology; Precancerous Conditions - pathology; Sampling Studies; Sensitivity and Specificity; Tomography, Optical Coherence - methods
• ISSN: 0016-5107; 1097-6779; 1097-6779
• DOI: 10.1016/j.gie.2009.07.005

Background Optical coherence tomography (OCT) is being developed as a potentially valuable method for high-resolution cross-sectional imaging of the esophageal mucosal and submucosal layers. One potential application of OCT imaging is to identify subsquamous Barrett's epithelium in patients who have undergone ablative therapy, which is not visible on standard endoscopic examination. However, histologic correlation confirming the ability of OCT to image subsquamous Barrett's epithelium has yet to be performed. Design Histologic correlation study. Objective To perform histologic correlation of ultrahigh-resolution optical coherence tomography (UHR-OCT) imaging for identification of subsquamous Barrett's epithelium. Setting Academic Medical Center (University of Washington, Seattle, WA). Patients Fourteen patients with pathologic biopsy specimens, proven to be high-grade dysplasia or adenocarcinoma underwent esophagectomy. Interventions UHR-OCT imaging was performed on ex vivo esophagectomy specimens immediately after resection. Main Outcome Measurements Correlation of UHR-OCT images with histologic images. Results Subsquamous Barrett's epithelium was clearly identified by using UHR-OCT images and was confirmed by corresponding histology. Limitations Difficulty distinguishing some subsquamous Barrett's glands from blood vessels in ex vivo tissue (because of the lack of blood flow) in some cases. Imaging was performed with a bench-top system. Conclusions Results from this study demonstrate that UHR-OCT imaging is capable of identifying subsquamous Barrett's epithelium.