Identifying intestinal metaplasia at the squamocolumnar junction by using optical coherence tomography

Evans, John A.; Bouma, Brett E.; Bressner, Jason; Shishkov, Milen; Lauwers, Gregory Y.; Mino‐Kenudson, Mari; Nishioka, Norman S.; Tearney, Guillermo J.

doi:10.1016/j.gie.2006.04.027

Cited by 111 publications

(92 citation statements)

References 22 publications

(17 reference statements)

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“…The overall average accuracy achieved by the readers was 82.6% (range, 73.7-94.7%), with good sensitivity (80.3-85.7%) and specificity (83.3-97.6%) for each of the carcinoma types over the two validation assessments. The sensitivities and specificities achieved in this study are comparable to those reported in prior studies validating OCT criteria in esophageal (23,24) and cardiovascular pathology (19).…”

Section: Discussionsupporting

confidence: 84%

“…OCT can be used to conduct large-volume in vivo microscopy of tissue with resolutions comparable to low-power microscopy (18). OCT has been used to accurately detect and diagnose pathology in vivo for a number of years (17)(18)(19)(20)(21)(22)(23)(24) and has been used to assess the fine microarchitectural features in both normal and pathologic lung (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43).…”

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confidence: 99%

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Diagnosing Lung Carcinomas with Optical Coherence Tomography

et al. 2015

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Rationale: Lung carcinoma diagnosis on tissue biopsy can be challenging because of insufficient tumor and lack of architectural information. Optical coherence tomography (OCT) is a high-resolution imaging modality that visualizes tissue microarchitecture in volumes orders of magnitude larger than biopsy. It has been proposed that OCT could potentially replace tissue biopsy.Objectives: We aim to determine whether OCT could replace histology in diagnosing lung carcinomas. We develop and validate OCT interpretation criteria for common primary lung carcinomas: adenocarcinoma, squamous cell carcinoma (SCC), and poorly differentiated carcinoma.Methods: A total of 82 ex vivo tumor samples were included in a blinded assessment with 3 independent readers. Readers were trained on the OCT criteria, and applied these criteria to diagnose adenocarcinoma, SCC, or poorly differentiated carcinoma in an OCT validation dataset. After a 7-month period, the readers repeated the training and validation dataset interpretation. An independent pathologist reviewed corresponding histology. Measurements and Main Results:The average accuracy achieved by the readers was 82.6% (range, 73.7-94.7%). The sensitivity and specificity for adenocarcinoma were 80.3% (65.7-91.4%) and 88.6% (80.5-97.6%), respectively. The sensitivity and specificity for SCC were 83.3% (70.0-100.0%) and 87.0% (75.0-96.5%), respectively. The sensitivity and specificity for poorly differentiated carcinoma were 85.7% (81.0-95.2%) and 97.6% (92.9-100.0%), respectively. Conclusions:Although these results are encouraging, they indicate that OCT cannot replace histology in the diagnosis of lung carcinomas. However, OCT has potential to aid in diagnosing lung carcinomas as a complement to tissue biopsy, particularly when insufficient tissue is available for pathology assessment.

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Section: Discussionsupporting

confidence: 84%

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confidence: 99%

Diagnosing Lung Carcinomas with Optical Coherence Tomography

et al. 2015

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“…Laser confocal micocroscopy in 63 patients had an accuracy of 94% for detection of neoplasia (70). Optical coherence tomography which functions in a manner more similar to ultrasonography but using light to create interference patterns also has promising results for the detection of intestinal metaplasia at the gastric junction although prior studies have not been very rewarding in detecting dysplasia (71). Spectroscopic devices can analyze the light coming from the mucosa and assess its components to determine the degree of dysplasia that is present.…”

Section: Imaging In Barrett's Esophagusmentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,278

893

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PREAMBLEThe guidelines for the diagnosis, surveillance and therapy of Barrett's esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002. These and other guidelines undergo periodic review. Significant advances have occurred in the area of Barrett's esophagus over the past four years leading to another revision of the prior guidelines. These advances include the potential use of esophageal capsule endoscopy for the diagnosis and screening of Barrett's esophagus, data regarding the outcome of low-grade dysplasia, the treatment of high-grade dysplasia using photodynamic therapy, and the development of new ablation techniques such as radiofrequency ablation. These guidelines are intended to be applied by physicians who see Barrett's esophagus patients and are intended to indicate a preferred, but certainly not the only, acceptable approach. Physicians need to choose the course best suited to the individual patient and to the variables that exist at the time of decision making. The guidelines are for adult patients with the diagnosis of Barrett's esophagus, as defined herein.Both these and the original guidelines were developed under auspices of the American College of Gastroenterology and the Practice Parameters Committee and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and once again reviewed using the National Library of Medicine database. Search terms used included Barrett's esophagus, esophageal neoplasm, esophagus, intestinal metaplasia, esophageal diseases, and adenocarcinoma, all appropriate studies and any additional ones found in reference to these papers were obtained and reviewed. Evidence was available from a hierarchy of trials and randomized controlled trials were given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations are based on expert opinion. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), Grade B indicates that the evidence would be level 2 or 3 which are cohort studies or case control studies. Grade C recommendations are based on level 4 studies meaning case series or poor quality cohort studies, and Grade D recommendations are based on level 5 evidence meaning expert opinion.

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“…[45][46][47][48][49][50][51][52][53] A novel ballooncentering OCT catheter was developed to conduct volumetric imaging of the entire distal esophagus (6 cm) ( Figure 1, B). 53 Squamous mucosa is characterized by the presence of layering without epithelial glands.…”

Section: Oct In Esophageal Imagingmentioning

confidence: 99%

“…53 The potential of OCT to diagnose SIM has been demonstrated in prospective studies, with sensitivities of 81% to 97% and specificities of 57% to 92%. [45][46][47][48][49][50][51][52][53] Additionally, studies have demonstrated successful grading of dysplasia with OCT. Reported sensitivities and specificities for detecting high-grade dysplasia/intramucosal carcinoma range from 54% to 83% and 72% to 75%, respectively. [45][46][47][48][49][50][51][52][53] Currently, studies are being conducted to evaluate real-time endoscopic OCT-guided biopsy with laser marking in patients.…”

Section: Oct In Esophageal Imagingmentioning

confidence: 99%

In Vivo Optical Coherence Tomography: The Role of the Pathologist

Hariri

Mino‐Kenudson

Mark

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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Optical coherence tomography (OCT) is a nondestructive, high-resolution imaging modality, providing cross-sectional, architectural images at near histologic resolutions, with penetration depths up to a few millimeters. Optical frequency domain imaging is a second-generation OCT technology that has equally high resolution with significantly increased image acquisition speeds and allows for large area, high-resolution tissue assessments. These features make OCT and optical frequency domain imaging ideal imaging techniques for surface and endoscopic imaging, specifically when tissue is unsafe to obtain and/or suffers from biopsy sampling error. This review focuses on the clinical impact of OCT in coronary, esophageal, and pulmonary imaging and the role of the pathologist in interpreting high-resolution OCT images as a complement to standard tissue pathology.

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Identifying intestinal metaplasia at the squamocolumnar junction by using optical coherence tomography

Abstract: Background-Optical coherence tomography (OCT) is an optical imaging method that produces high-resolution cross-sectional images of the esophagus. The accuracy of OCT for differentiating tissue types at the squamocolumnar junction (SCJ) has not been established.

Cited by 111 publications

References 22 publications

Diagnosing Lung Carcinomas with Optical Coherence Tomography

Diagnosing Lung Carcinomas with Optical Coherence Tomography

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

In Vivo Optical Coherence Tomography: The Role of the Pathologist

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