Feasibility of optical coherence tomography for the evaluation of Barrett's mucosa buried underneath esophageal squamous epithelium

Hatta, Waku; Uno, Kaname; Koike, Tomoyuki; Ara, Nobuyuki; Asano, Naoki; Iijima, Katsunori; Imatani, Akira; Fujishima, Fumiyoshi; Shimosegawa, Tooru

doi:10.1111/den.12576

Cited by 16 publications

(20 citation statements)

References 26 publications

(63 reference statements)

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“…The overall accuracy, sensitivity, specificity, PPV, and NPV of the buried mucosa in the OCT imaging were 85.7% (12/14), 77.8% (7/9), 100% (5/5), 100% (7/7), and 71.4% (5/7), respectively. OCT, however, could not easily distinguish nondysplastic glands from dysplastic glands [11] .…”

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confidence: 83%

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Recent Updates in the Endoscopic Diagnosis of Barrett's Oesophagus

Sharma

2016

Gastrointest Tumors

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Background: Barrett's oesophagus (BO) is a premalignant condition associated with the development of oesophageal adenocarcinoma (OAC). Despite the low risk of progression per annum, OAC is associated with significant morbidity and mortality, with an estimated 5-year survival of 10%. Furthermore, the incidence of OAC continues to rise globally. Therefore, it is imperative to detect the premalignant phase of BO and follow up such patients accordingly. Summary: The mainstay diagnosis of BO is endoscopy and biopsy sampling. However, limitations with white light endoscopy (WLE) and undertaking biopsies have shifted the current focus towards real-time image analysis. Utilization of additional tools such as chromoendoscopy, narrow-band imaging (NBI), confocal laser endomicroscopy (CLE), and optical coherence tomography (OCT) are proving beneficial. Furthermore, it is also becoming more apparent that often these tools are utilized by experts in the field. Therefore, for the non-expert, training in these systems is key. Currently as yet, the methodologies used for training optimization require further inquiry. Key Message: (1) Real-time imaging can serve to minimize excess biopsies. (2) Tools such as chromoendoscopy, NBI, CLE, and OCT can help to compliment WLE. Practical Implications: WLE is associated with limited sensitivity. Biopsy sampling is cost-ineffective and associated with sampling error. Hence, from a practical perspective, endoscopists should aim to utilize additional tools to help in real-time image interpretation and minimize an overreliance on histology.

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confidence: 83%

“…A further study by Hatta et al [11] assessed the use of probe-type OCT imaging to evaluate Barrett's mucosa buried underneath oesophageal squamous epithelium. A single-centre prospective study was undertaken of patients with Barrett's adenocarcinoma from 2008 to 2014.…”

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confidence: 99%

Recent Updates in the Endoscopic Diagnosis of Barrett's Oesophagus

Sharma

2016

Gastrointest Tumors

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“…Furthermore, all of the 6 patients could be diagnosed with subsquamous carcinoma extension using such findings. Optical coherence tomography might be useful even for detecting subsquamous carcinoma extension [19]. Conversely, since most cases of subsquamous carcinoma extension were reported to be less than 1 cm in size, the oral safety margin that is placed 1 cm from the squamocolumnar junction is useful for ESD of EGJ adenocarcinoma resection with the negative oral side horizontal margin including the subsquamous carcinoma extension [11].…”

Section: Subsquamous Carcinoma Extensionmentioning

confidence: 99%

Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

et al. 2018

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Background: Adenocarcinoma of the esophagogastric junction (EGJ) is uncommon in Eastern countries, including Japan, but it is believed that the incidence of EGJ adenocarcinoma will increase in Asia in the future due to the decreasing incidence of Helicobacter pylori infection. Endoscopic submucosal dissection (ESD) is a minimally invasive and curative treatment that allows precise pathological assessment. Summary: Magnifying endoscopy with narrow-band imaging may be useful for differential diagnoses and for delineating the cancer margin of EGJ adenocarcinoma, but subsquamous carcinoma extension, which is the invasion of EGJ adenocarcinoma beneath the normal esophageal squamous epithelium, makes it difficult to detect cancer margins of the oral side in ESD for EGJ adenocarcinoma. Since subsquamous carcinoma extension was reported to be less than 1 cm in most cases, the oral safety margin that is placed 1 cm from the squamocolumnar junction is useful for negative cancerous horizontal margin. A multicenter retrospective study of esophageal adenocarcinoma including EGJ adenocarcinoma showed that mucosal and submucosal cancer within 500 μm from the muscularis mucosa without lymphovascular involvement, a poorly differentiated component, and lesion size over 3 cm were not associated with metastasis. Several retrospective studies about ESD for EGJ adenocarcinoma have suggested feasible short-term and long-term outcomes using curative criteria based on gastric cancer guidelines. Key Messages: ESD would be a good first-line treatment for superficial EGJ adenocarcinoma, including Barrett’s adenocarcinoma. Additional information about the incidence of metastasis would help confirm the indication of ESD for EGJ adenocarcinoma.

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“…Thus, the high‐resolution aspect of the OCT device can identify tiny submucosal structures that may not be depicted by endoscopic ultrasound. In fact, OCT may be applied for characterization of gastrointestinal tract tumors, including esophageal squamous cell carcinoma and EA related to BE, especially for subepithelial information. Some EA might extend no less than 1 cm proximal to the squamocolumnar junction (SCJ) through buried Barrett's glands underneath esophageal squamous epithelium beyond the oral side of the SCJ .…”

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confidence: 99%

“…In fact, OCT may be applied for characterization of gastrointestinal tract tumors, including esophageal squamous cell carcinoma and EA related to BE, especially for subepithelial information. Some EA might extend no less than 1 cm proximal to the squamocolumnar junction (SCJ) through buried Barrett's glands underneath esophageal squamous epithelium beyond the oral side of the SCJ . Then, precise preoperative evaluation of Barrett's mucosa is of clinical importance in clinical settings prior to endoscopic treatment against EA and premalignant lesions.…”

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confidence: 99%

Optical coherence tomography in Barrett's esophagus and the road to virtual optical pathology

Isomoto

2016

Digestive Endoscopy

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Feasibility of optical coherence tomography for the evaluation of Barrett's mucosa buried underneath esophageal squamous epithelium

Abstract: We demonstrated, for the first time, that pre-operative OCT imaging might be feasible for detecting the oral side extension of buried Barrett's mucosa to remove the entire area with malignant potential by ESD. This article is protected by copyright. All rights reserved.

Cited by 16 publications

References 26 publications

Recent Updates in the Endoscopic Diagnosis of Barrett's Oesophagus

Recent Updates in the Endoscopic Diagnosis of Barrett's Oesophagus

Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

Optical coherence tomography in Barrett's esophagus and the road to virtual optical pathology

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