Background and study aims: Endoscopic ultrahigh resolution optical coherence tomography (UHR OCT) achieves
an axial image resolution of ~ 5 µm, which is 2 - 3 times finer than standard
endoscopic OCT imaging. This study investigated the capability of endoscopic UHR
OCT for imaging patients with Barrett’s esophagus.
Patients and methods: Fivty volunteers previously diagnosed with Barrett’s esophagus underwent UHR
OCT. Imaging was performed at 1.3 µm wavelengths with ~ 5 µm axial and ~ 15
µm transverse resolutions using a 1.8 mm/diameter linear-scanning catheter introduced
through the accessory channel of a standard endoscope. OCT images were compared
with endoscopic diagnosis and pinch biopsy histological appearances.
Results: UHR OCT images of normal esophagus, Barrett’s esophagus, high grade dysplasia
and esophageal adenocarcinoma were evaluated. UHR OCT images of the normal esophagus
exhibited characteristic layered architecture with uniform epithelium, while images
of Barrett’s esophagus corresponded to crypt-like glandular structures. High grade
dysplasia and esophageal adenocarcinoma images exhibited more heterogeneous structures
corresponding to irregular, heterogeneous tissue morphology from distorted and
cribriform or villiform glandular architecture. Fine features can be discerned
more clearly with endoscopic UHR OCT.
Conclusions: This study evaluated new endoscopic OCT technology and demonstrated the feasibility
of carrying out UHR OCT imaging in conjunction with standard endoscopy for in
vivo real-time imaging of Barrett’s esophagus, dysplasia, and esophageal adenocarcinoma.
A survey of normal and abnormal upper gastrointestinal tissues was performed
using a research prototype OCT system with the highest axial resolution to date,
and can serve as a baseline for future investigation.
References
hmashimo@hms.harvard.edu
