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Assessment of Barrett’s esophagus and dysplasia with ultrahigh-speed volumetric en face and cross-sectional optical coherence tomography

2018; Thieme Medical Publishers (Germany); Volume: 51; Issue: 04 Linguagem: Inglês

10.1055/a-0725-7995

1438-8812

Osman O. Ahsen, Kaicheng Liang, Hsiang‐Chieh Lee, Michael G. Giacomelli, Zhao Wang, Benjamin Potsaid, Marisa Figueiredo, Qin Huang, Vijaysekhar Jayaraman, James G. Fujimoto, Hiroshi Mashimo,

Coronary Interventions and Diagnostics

Background This study aimed to evaluate the use of ultrahigh-speed volumetric en face and cross-sectional optical coherence tomography (OCT) with micromotor catheters for the in vivo assessment of Barrett’s esophagus and dysplasia. Methods 74 OCT datasets with correlated biopsy/endoscopic mucosal resection histology (49 nondysplastic Barrett’s esophagus [NDBE], 25 neoplasia) were obtained from 14 patients with Barrett’s esophagus and a history of dysplasia and 30 with NDBE. The associations between irregular mucosal patterns on en face OCT, absence of mucosal layering, surface signal > subsurface, and > 5 atypical glands on cross-sectional OCT vs. histology and treatment history were assessed by three blinded readers. Results Atypical glands under irregular mucosal patterns occurred in 75 % of neoplasia (96 % of treatment-naïve neoplasia) vs. 30 % of NDBE datasets (43 % of short- and 18 % of long-segment NDBE). Mucosal layering was absent in 35 % of neoplasia and 50 % of NDBE datasets, and surface signal > subsurface occurred in 29 % of neoplasia and 30 % of NDBE datasets. Conclusions Atypical glands under irregular mucosal patterns are strongly associated with neoplasia, suggesting potential markers for dysplasia and a role in pathogenesis.