Clinical Translation of Tethered Confocal Microscopy Capsule for Unsedated Diagnosis of Eosinophilic Esophagitis

Tabatabaei, Nima; Kang, Do Kyun; Kim, Minkyu; Wu, Tao; Grant, Catriona N.; Rosenberg, Mireille; Nishioka, Norman S.; Hesterberg, Paul E.; Garber, John J.; Yuan, Qian; Katz, Aubrey J.; Tearney, Guillermo J.

doi:10.1038/s41598-018-20668-8

Cited by 24 publications

(29 citation statements)

References 32 publications

(44 reference statements)

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“…6a) covered a 20-cm length of the esophagus and stomach. 61.4% of the SECM imaging area had contact with the tissue, which was similar to the tissue contact proportion measured with the longer SECM capsule, 66.5% [15]. Imaging time was 30 seconds.…”

Section: Resultssupporting

confidence: 71%

“…Both images were normalized with the same intensity threshold. A magnified view of the Figure 8a Figure 8b shows a bi-lobed cell nucleus (arrow) without a surrounding dark background, suggestive of an eosinophil [15].…”

Section: Resultsmentioning

confidence: 99%

“…A magnified view of the Figure a (inset) clearly shows bright cell nuclei (arrows) surrounded by dark cytoplasm and bright cell borders (arrow heads), indicative of squamous epithelial cells. A magnified view of Figure b shows a bi‐lobed cell nucleus (arrow) without a surrounding dark background, suggestive of an eosinophil .…”

Section: Resultsmentioning

confidence: 99%

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A miniaturized, tethered, spectrally‐encoded confocal endomicroscopy capsule

Kang

Ryu

et al. 2019

Lasers Surg Med

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Background and Objective The tethered spectrally‐encoded confocal endomicroscopy (SECM) capsule is an imaging device that once swallowed by an unsedated patient can visualize cellular morphologic changes associated with gastrointestinal (GI) tract diseases in vivo. Recently, we demonstrated a tethered SECM capsule for counting esophageal eosinophils in patients with eosinophilic esophagitis (EoE) in vivo. Yet, the current tethered SECM capsule is far too long to be widely utilized for imaging pediatric patients, who constitute a major portion of the EoE patient population. In this paper, we present a new tethered SECM capsule that is 33% shorter, has an easier and repeatable fabrication process, and produces images with reduced speckle noise. Materials and Methods The smaller SECM capsule utilized a miniature condenser to increase the fiber numerical aperture and reduce the capsule length. A custom 3D‐printed holder was developed to enable easy and repeatable device fabrication. A dual‐clad fiber (DCF) was used to reduce speckle noise. Results The fabricated SECM capsule (length = 20 mm; diameter = 7 mm) had a similar size and shape to a pediatric dietary supplement pill. The new capsule achieved optical sectioning thickness of 13.2 μm with a small performance variation between devices of 1.7 μm. Confocal images of human esophagus obtained in vivo showed the capability of this new device to clearly resolve microstructural epithelial details with reduced speckle noise. Conclusions We expect that the smaller size and better image performance of this new SECM capsule will greatly facilitate the clinical adoption of this technology in pediatric patients and will enable more accurate assessment of EoE‐suspected tissues. Lasers Surg. Med. 51:452–458, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Resultssupporting

confidence: 71%

Section: Resultsmentioning

confidence: 99%

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A miniaturized, tethered, spectrally‐encoded confocal endomicroscopy capsule

Kang

Ryu

et al. 2019

Lasers Surg Med

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“…40,41,59,[61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] Swallowable, capsulebased OCT probes have also been developed for upper GI imaging without the need for sedation or traditional white light endoscopy. [76][77][78][79][80] Higher-resolution forms of OCT are also under development and have achieved resolutions of 1 lm in the ex vivo setting. [81][82][83][84] Confocal microscopy is an optical imaging technique that typically uses a pinpoint beam of light scanned across a tissue to create an en face, or transverse, image.…”

Section: Optical Imaging Modalitiesmentioning

confidence: 99%

In Vivo and Ex Vivo Microscopy: Moving Toward the Integration of Optical Imaging Technologies Into Pathology Practice

Wells

Thrall

Sorokina

et al. 2018

Archives of Pathology &Amp; Laboratory Medicine

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The traditional surgical pathology assessment requires tissue to be removed from the patient, then processed, sectioned, stained, and interpreted by a pathologist using a light microscope. Today, an array of alternate optical imaging technologies allow tissue to be viewed at high resolution, in real time, without the need for processing, fixation, freezing, or staining. Optical imaging can be done in living patients without tissue removal, termed in vivo microscopy, or also in freshly excised tissue, termed ex vivo microscopy. Both in vivo and ex vivo microscopy have tremendous potential for clinical impact in a wide variety of applications. However, in order for these technologies to enter mainstream clinical care, an expert will be required to assess and interpret the imaging data. The optical images generated from these imaging techniques are often similar to the light microscopic images that pathologists already have expertise in interpreting. Other clinical specialists do not have this same expertise in microscopy, therefore, pathologists are a logical choice to step into the developing role of microscopic imaging expert. Here, we review the emerging technologies of in vivo and ex vivo microscopy in terms of the technical aspects and potential clinical applications. We also discuss why pathologists are essential to the successful clinical adoption of such technologies and the educational resources available to help them step into this emerging role.

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“…and submucosal structures of the oesophagus in microscopic detail (axial resolution: ~10 µm, lateral resolution: 13 ~30µm) and has been successfully demonstrated in ex vivo and in vivo trials 91,98,170,171 . Various studies using OCT 14 with conventional endoscopy have demonstrated high-resolution volumetric images comparable to those obtained 15 from histology.…”

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confidence: 99%