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Proceedings Paper

Natural history of Barrett’s esophagus using tethered capsule OCT endomicroscopy and portable OCT imaging system: initial experience (Conference Presentation)
Author(s): Jing Dong; Barry Vuong; Timothy Ford; Matthew Beatty; Seyed Hamid H. Hosseiny; Emilie Beaulieu-Ouellet; Rohith Reddy; Kanwarpal Singh; Hany Osman; Catriona Grant; Anna Huizi Gao; Samantha Leeds; Norman Nishioka; John Poneros; Julian Abrams; Charles Lightdale; Prateek Sharma; Michael Wallace; Herbert Wolfsen; Kenneth Wang; Cadman Leggett; Mireille Rosenberg; Guillermo Tearney

Paper Abstract

While the most common method used to evaluate and survey patients with Barrett’s Esophagus (BE) is endoscopic biopsy, this procedure is invasive, time-consuming, and suffers from sampling errors. Moreover, it requires patient sedation that increases cost and mandates its operation in specialized settings. Our lab has developed a new imaging tool termed tethered capsule endomicroscopy (TCE) that involves swallowing a tethered capsule which utilizes optical coherence tomography (OCT) to obtain three-dimensional microscopic (10µm) images of the entire esophageal wall as it traverses the luminal organ via peristalsis or is retrieved by pulling up tether. As opposed to endoscopy, TCE procedure is non-invasive, doesn’t require patient sedation and mitigates sampling error by evaluating the microscopic structure of the entire esophagus. The merits of TCE make it a suitable device to investigate the microscopic natural history of BE in a longitudinal manner. Here, we present our initial experience of a multicenter (5-site) clinical trial to study the microscopic natural history of BE. The TCE device used for the study is the new generation capsule with the ball lens optical configuration and a distal scan stepper motor, which provides 30µm (lateral) resolution and 40Hz imaging rate. The portable OCT imaging system is a custom in-house built swept source system and provides 7µm (axial) at a 100 kHz A-line rate with a center wavelength of ~1310 nm. To date, we have successfully enrolled 69 subjects at all sites (MGH: 33, Columbia University: 11, Kansas City VA: 10, Mayo Jacksonville: 8, Mayo Rochester: 7) and 59 have swallowed the capsule (85.5%). There have been no reported adverse events associated with TCE procedure. High-quality OCT images were reliably obtained from patients who swallowed the device, and BE tissues were identified by expert readers. Our initial experience with TCE in a multicenter study demonstrates that this technology is easy to use and efficient in multiple clinical settings. Completion of this longitudinal study is likely to provide new insights on the temporal progression of BE that may impact management strategies.

Paper Details

Date Published: 4 March 2019
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Proc. SPIE 10867, Optical Coherence Tomography and Coherence Domain Optical Methods in Biomedicine XXIII, 108670T (4 March 2019); doi: 10.1117/12.2511523
Show Author Affiliations
Jing Dong, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Barry Vuong, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Timothy Ford, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Matthew Beatty, Wellman Ctr. for Photomedicine (United States)
Seyed Hamid H. Hosseiny, Wellman Ctr. for Photomedicine (United States)
Emilie Beaulieu-Ouellet, Wellman Ctr. for Photomedicine (United States)
Rohith Reddy, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Kanwarpal Singh, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Hany Osman, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Catriona Grant, Wellman Ctr. for Photomedicine (United States)
Anna Huizi Gao, Wellman Ctr. for Photomedicine (United States)
Samantha Leeds, Columbia Univ. Medical Ctr. (United States)
Norman Nishioka, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
John Poneros, Columbia Univ. Medical Ctr. (United States)
Julian Abrams, Columbia Univ. Medical Ctr. (United States)
Charles Lightdale, Columbia Univ. Medical Ctr. (United States)
Prateek Sharma, Kansas City VA Medical Ctr. (United States)
The Univ. of Kansas School of Medicine (United States)
Michael Wallace, Mayo Clinic (United States)
Herbert Wolfsen, Mayo Clinic (United States)
Kenneth Wang, Mayo Clinic (United States)
Cadman Leggett, Mayo Clinic (United States)
Mireille Rosenberg, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Guillermo Tearney, Wellman Ctr. for Photomedicine (United States)
Harvard Medical School (United States)
Massachusetts General Hospital (United States)


Published in SPIE Proceedings Vol. 10867:
Optical Coherence Tomography and Coherence Domain Optical Methods in Biomedicine XXIII
James G. Fujimoto; Joseph A. Izatt, Editor(s)

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