Tethered capsule en face optical coherence tomography for imaging Barrett’s oesophagus in unsedated patients

Liang, Kaicheng; Ahsen, Osman O.; Murphy, Annalee; Zhang, Jason; Nguyen, Tuan Hung; Potsaid, Benjamin; Figueiredo, Marisa; Huang, Qin; Mashimo, Hiroshi; Fujimoto, James G.

doi:10.1136/bmjgast-2020-000444

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…Moreover, challenges such as limitation in field of view, resolution ( 29 ) or feasibility for in vivo use ( 30 , 31 ) have been addressed by multiple studies, providing solutions and opportunities for further research. For example, techniques as hyperspectral laparoscopes ( 32 ), confocal laser endomicroscopy ( 33 ) and tethered capsules ( 34 ) have indicated the potential of optical imaging in endoscopic use. Despite these advances, a commercially available optical imaging device is not yet available for tumor response assessment in rectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Size and depth of residual tumor after neoadjuvant chemoradiotherapy in rectal cancer – implications for the development of new imaging modalities for response assessment

van der Stel,

van den Berg,

Snaebjornsson

et al. 2023

Front. Oncol.

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With the shift towards organ preserving treatment strategies in rectal cancer it has become increasingly important to accurately discriminate between a complete and good clinical response after neoadjuvant chemoradiotherapy (CRT). Standard of care imaging techniques such as CT and MRI are well equipped for initial staging of rectal tumors, but discrimination between a good clinical and complete response remains difficult due to their limited ability to detect small residual vital tumor fragments. To identify new promising imaging techniques that could fill this gap, it is crucial to know the size and invasion depth of residual vital tumor tissue since this determines the requirements with regard to the resolution and imaging depth of potential new optical imaging techniques. We analyzed 198 pathology slides from 30 rectal cancer patients with a Mandard tumor regression grade 2 or 3 after CRT that underwent surgery. For each patient we determined response pattern, size of the largest vital tumor fragment or bulk and the shortest distance from the vital tumor to the luminal surface. The response pattern was shrinkage in 14 patients and fragmentation in 16 patients. For both groups combined, the largest vital tumor fragment per patient was smaller than 1mm for 38% of patients, below 0.2mm for 12% of patients and for one patient as small as 0.06mm. For 29% of patients the vital tumor remnant was present within the first 0.01mm from the luminal surface and for 87% within 0.5mm. Our results explain why it is difficult to differentiate between a good clinical and complete response in rectal cancer patients using endoscopy and MRI, since in many patients submillimeter tumor fragments remain below the luminal surface. To detect residual vital tumor tissue in all patients included in this study a technique with a spatial resolution of 0.06mm and an imaging depth of 8.9mm would have been required. Optical imaging techniques offer the possibility of detecting majority of these cases due to the potential of both high-resolution imaging and enhanced contrast between tissue types. These techniques could thus serve as a complimentary tool to conventional methods for rectal cancer response assessment.

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Section: Discussionmentioning

confidence: 99%

Size and depth of residual tumor after neoadjuvant chemoradiotherapy in rectal cancer – implications for the development of new imaging modalities for response assessment

van der Stel,

van den Berg,

Snaebjornsson

et al. 2023

Front. Oncol.

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“…For this reason, large-scale clinical deployment of OCT has largely been limited to ophthalmology, dermatology, and cardiology, but creative advances in OCT probe and capsule technology will allow for continued in situ exploration of hemoglobin-related biomarkers from OCT in disease pathology throughout the body. 256 , 260 – 262 …”

Section: Depth-resolved Imagingmentioning

confidence: 99%

Noninvasive hemoglobin sensing and imaging: optical tools for disease diagnosis

et al. 2022

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. Significance: Measurement and imaging of hemoglobin oxygenation are used extensively in the detection and diagnosis of disease; however, the applied instruments vary widely in their depth of imaging, spatiotemporal resolution, sensitivity, accuracy, complexity, physical size, and cost. The wide variation in available instrumentation can make it challenging for end users to select the appropriate tools for their application and to understand the relative limitations of different methods. Aim: We aim to provide a systematic overview of the field of hemoglobin imaging and sensing. Approach: We reviewed the sensing and imaging methods used to analyze hemoglobin oxygenation, including pulse oximetry, spectral reflectance imaging, diffuse optical imaging, spectroscopic optical coherence tomography, photoacoustic imaging, and diffuse correlation spectroscopy. Results: We compared and contrasted the ability of different methods to determine hemoglobin biomarkers such as oxygenation while considering factors that influence their practical application. Conclusions: We highlight key limitations in the current state-of-the-art and make suggestions for routes to advance the clinical use and interpretation of hemoglobin oxygenation information.

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“…A non-endoscopic test, Cytosponge-trefoil factor 3 (TFF3), has demonstrated improved detection of Barrett esophagus compared with standard screening in a primary care setting [ 13 ]. Tethered capsule optical coherence tomography (OCT) is a non-endoscopic technique that has been developed and can volumetrically image esophageal mucosa and detect BE in unsedated patients in the outpatient setting [ 190 ].…”

Section: Future Directions In Diagnosis Of Esophageal and Gastric mentioning

confidence: 99%

Epidemiology, Diagnosis, Staging and Multimodal Therapy of Esophageal and Gastric Tumors

Cummings

Wong

Palm

et al. 2021

Cancers

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Gastric and esophageal tumors are diverse neoplasms that involve mucosal and submucosal tissue layers and include squamous cell carcinomas, adenocarcinomas, spindle cell neoplasms, neuroendocrine tumors, marginal B cell lymphomas, along with less common tumors. The worldwide burden of esophageal and gastric malignancies is significant, with esophageal and gastric cancer representing the ninth and fifth most common cancers, respectively. The approach to diagnosis and staging of these lesions is multimodal and includes a combination of gastrointestinal endoscopy, endoscopic ultrasound, and cross-sectional imaging. Likewise, therapy is multidisciplinary and combines therapeutic endoscopy, surgery, radiotherapy, and systemic chemotherapeutic tools. Future directions for diagnosis of esophageal and gastric malignancies are evolving rapidly and will involve advances in endoscopic and endosonographic techniques including tethered capsules, optical coherence tomography, along with targeted cytologic and serological analyses.

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Tethered capsule en face optical coherence tomography for imaging Barrett’s oesophagus in unsedated patients

Cited by 12 publications

References 28 publications

Size and depth of residual tumor after neoadjuvant chemoradiotherapy in rectal cancer – implications for the development of new imaging modalities for response assessment

Size and depth of residual tumor after neoadjuvant chemoradiotherapy in rectal cancer – implications for the development of new imaging modalities for response assessment

Noninvasive hemoglobin sensing and imaging: optical tools for disease diagnosis

Epidemiology, Diagnosis, Staging and Multimodal Therapy of Esophageal and Gastric Tumors

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