Characterization of buried glands before and after radiofrequency ablation by using 3-dimensional optical coherence tomography (with videos)
Author(s)
Zhou, Chao; Tsai, Tsung-Han; Lee, Hsiang-Chieh; Kirtane, Tejas; Figueiredo, Marisa; Tao, Yuankai K.; Adler, Desmond C.; Schmitt, Joseph M.; Huang, Qin; Fujimoto, James G.; Mashimo, Hiroshi; Ahsen, Osman Oguz; ... Show more Show less![Thumbnail](/bitstream/handle/1721.1/100206/Fujimoto_Characterization%20of%20buried.pdf.jpg?sequence=4&isAllowed=y)
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Background
Radiofrequency ablation (RFA) is an endoscopic technique used to eradicate Barrett's esophagus (BE). However, such ablation can commonly lead to neosquamous epithelium overlying residual BE glands not visible by conventional endoscopy and may evade detection on random biopsy samples.
Objective
To demonstrate the capability of endoscopic 3-dimensional optical coherence tomography (3D-OCT) for the identification and characterization of buried glands before and after RFA therapy.
Design
Cross-sectional study.
Setting
Single teaching hospital.
Patients
Twenty-six male and 1 female white patients with BE undergoing RFA treatment.
Interventions
3D-OCT was performed at the gastroesophageal junction in 18 patients before attaining complete eradication of intestinal metaplasia (pre–CE-IM group) and in 16 patients after CE-IM (post–CE-IM group).
Main Outcome Measurements
Prevalence, size, and location of buried glands relative to the squamocolumnar junction.
Results
3D-OCT provided an approximately 30 to 60 times larger field of view compared with jumbo and standard biopsy and sufficient imaging depth for detecting buried glands. Based on 3D-OCT results, buried glands were found in 72% of patients (13/18) in the pre–CE-IM group and 63% of patients (10/16) in the post–CE-IM group. The number (mean [standard deviation]) of buried glands per patient in the post–CE-IM group (7.1 [9.3]) was significantly lower compared with the pre–CE-IM group (34.4 [44.6]; P = .02). The buried gland size (P = .69) and distribution (P = .54) were not significantly different before and after CE-IM.
Limitations
A single-center, cross-sectional study comparing patients at different time points in treatment. Lack of 1-to-1 coregistered histology for all OCT data sets obtained in vivo.
Conclusion
Buried glands were frequently detected with 3D-OCT near the gastroesophageal junction before and after radiofrequency ablation.
Date issued
2012-04Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science; Massachusetts Institute of Technology. Research Laboratory of ElectronicsJournal
Gastrointestinal Endoscopy
Publisher
Elsevier
Citation
Zhou, Chao, Tsung-Han Tsai, Hsiang-Chieh Lee, Tejas Kirtane, Marisa Figueiredo, Yuankai K. Tao, Osman O. Ahsen, et al. “Characterization of Buried Glands before and after Radiofrequency Ablation by Using 3-Dimensional Optical Coherence Tomography (with Videos).” Gastrointestinal Endoscopy 76, no. 1 (July 2012): 32–40.
Version: Author's final manuscript
ISSN
00165107