Tethered capsule endomicroscopy for microscopic imaging of the esophagus, stomach, and duodenum without sedation in humans (with video)

Gora, Michalina J.; Quénéhervé, Lucille; Carruth, Robert W.; Lu, Weina; Rosenberg, Mireille; Sauk, Jenny; Fasano, Alessio; Lauwers, Gregory Y.; Nishioka, Norman S.; Tearney, Guillermo J.

doi:10.1016/j.gie.2018.07.009

Cited by 38 publications

(34 citation statements)

References 37 publications

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“…Similar with the urinary tract, the OCT is applied in the digestive tract in vivo with the assistance of endoscope or during operation. The capsule endomicroscopy is also used in OCT detection recently, whose coverage of upper GI wall, esophagus and duodenum is 85.4%, 90.3% and 84.8% [38].…”

Section: Oct In Gastroenterologymentioning

confidence: 99%

Application of optical coherence tomography in clinical diagnosis

Wang

Liu

Lou

et al. 2020

XST

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BACKGROUND: Optical coherence tomography (OCT) is a non-invasive diagnosing tool used in clinics. Due to its high resolution (<10um), it is appropriate for the early detection of tiny infections. It has been widely used in diagnosis and treatment of diseases, evaluation of therapeutic efficacy, and monitoring of various physiological and pathological processes. OBJECTIVE: To systemically review literature to summarize the clinic application of OCT in recent years. METHODS: For clinic applications that OCT has been applied, we selected studies that describe the most relevant works. The discussion included: 1) which tissue could be used in the OCT detection, 2) which character of different tissue could be used as diagnosing criteria, 3) which diseases and pathological process have been diagnosed or monitored using OCT imaging, and 4) the recent development of clinic OCT diagnosing. RESULTS: The literature showed that the OCT had been listed as a routine test choice for ophthalmic diseases, while the first commercial product for cardiovascular OCT detection had gotten clearance. Meanwhile, as the development of commercial benchtop OCT equipment and tiny fiber probe, the commercial application of OCT in dermatology, dentistry, gastroenterology and urology also had great potential in the near future. CONCLUSIONS: The analysis and discussions showed that OCT, as an optical diagnosing method, has been used successfully in many clinical fields, and has the potential to be a standard inspection method in several clinic fields, such as dermatology, dentistry and cardiovascular.

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Section: Oct In Gastroenterologymentioning

confidence: 99%

Application of optical coherence tomography in clinical diagnosis

Wang

Liu

Lou

et al. 2020

XST

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“…OCT capsule studies demonstrated cross-sectional images, reported excellent patient toleration 17 and showed correlations with endoscopic Prague measurements. 18 However, there are limited investigations of capsule contact with the oesophagus and longitudinal pullback non-uniformity, which reduce image coverage and cause sampling errors. Procedural details for tethered OCT capsule imaging in unsedated patients have also been limited.…”

Section: What Are the New Findings?mentioning

confidence: 99%

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

Liang

Ahsen

Murphy

et al. 2020

BMJ Open Gastroenterol

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ObjectiveBarrett’s oesophagus (BE) screening outside the endoscopy suite can identify patients for surveillance and reduce mortality. Tethered capsule optical coherence tomography (OCT) can volumetrically image oesophageal mucosa in unsedated patients and detect features of BE. We investigated ultrahigh-speed tethered capsule swept-source OCT (SS-OCT), improved device design, developed procedural techniques and measured capsule contact, longitudinal pullback non-uniformity and patient toleration.DesignOCT was performed in 16 patients prior to endoscopic surveillance/treatment. Unsedated patients swallowed the capsule with sips of water and the tether was pulled back to image the oesophagus. SS-OCT at 1 000 000 A-scans/s enabled imaging 10 cm oesophageal lengths in 10 s with 30 µm transverse and 8 µm axial resolution. Capsule contact, longitudinal image coverage and patient toleration were assessed.ResultsNine patients had non-dysplastic BE, three had ablative treatment-naïve neoplasia and four had prior ablation for dysplasia. Dry swallows facilitated capsule transit through the lower oesophageal sphincter (LES), and waiting 10 s before pullback reduced swallow induced LES relaxation. Slow nasal inhalation facilitated capsule retrieval and minimised gag reflex. The procedure was well tolerated. Ultrahigh-speed SS-OCT generated cross-sectional and subsurface en face images showing BE features, while subsurface en face images were required to assess the gastro-oesophageal junction. Candidate features of dysplasia were also identified which could inform follow-up endoscopy/biopsy. BE features were seen in all patients with histologically confirmed BE. Mean capsule contact over BE was 75%±27% for all patients and better in short segment BE. Mean longitudinal image coverage over BE was 59%±34% and better for long segment BE.ConclusionsUltrahigh-speed tethered capsule SS-OCT can image en face and cross-sectional mucosal features over wide areas. Device and procedure optimisation improved performance. BE features could be identified in all patients, but limited capsule contact and longitudinal coverage could cause sampling errors for focal pathologies.

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“…5,6 This swallowable OCT-based capsule could discriminate efficiently between squamous esophagus and BE with or without dysplasia in a well-tolerated manner. 7 An automated segmentation and characterization algorithm 8 and the upcoming tethered capsule laser marking device 9 may further push this technique to achieve clinical adoption.…”

Section: Screening For Esophageal Squamous Cell Carcinoma: Insight Frmentioning

confidence: 99%

“…Theoretically, TCE might be helpful in reducing interobserver variability and sampling error of patchy multifocal lesions. 7 In addition, accurate staging of superficial ESCC, 10 and subsequently appropriate triage could be incorporated into the initial TCE examination. Whether TCE would be a valuable complement to endoscopy or a successful independent ESCC screening strategy requires further validation in both high-risk and lowrisk populations.…”

Section: Screening For Esophageal Squamous Cell Carcinoma: Insight Frmentioning

confidence: 99%

Screening for esophageal squamous cell carcinoma: insight from experience with Barrett's esophagus

Yang

2019

Gastrointestinal Endoscopy

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Tethered capsule endomicroscopy for microscopic imaging of the esophagus, stomach, and duodenum without sedation in humans (with video)

Abstract: TCE is a safe and feasible procedure for obtaining high-resolution microscopic images of the upper GI tract without endoscopic assistance or sedation.

Cited by 38 publications

References 37 publications

Application of optical coherence tomography in clinical diagnosis

Application of optical coherence tomography in clinical diagnosis

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

Screening for esophageal squamous cell carcinoma: insight from experience with Barrett's esophagus

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