TY - JOUR
T1 - High-resolution imaging in Barrett's esophagus
T2 - a novel, low-cost endoscopic microscope
AU - Muldoon, Timothy J.
AU - Anandasabapathy, Sharmila
AU - Maru, Dipen
AU - Richards-Kortum, Rebecca
N1 - Funding Information:
The following authors report that they have no disclosures relevant to this publication: T. J. Muldoon, S. Anandasabapathy, D. Maru. The following author has disclosed an actual or potential conflict: R. Richards-Kortum has a small ownership interest in Remicalm, Inc, which has licensed related technology from the University of Texas at Austin and Rice University. Supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases Center grant No. P30 DK56338, the Texas Digestive Disease Center (S. Anandasabapathy), and National Institutes of Health grants No. RO1 EB002179 and BRP CA103830 (R. Richards-Kortum) .
PY - 2008/10
Y1 - 2008/10
N2 - Background: This report describes the clinical evaluation of a novel, low-cost, high-resolution endoscopic microscope for obtaining fluorescent images of the cellular morphology of the epithelium of regions of the esophagus with Barrett's metaplasia. This noninvasive point imaging system offers a method for obtaining real-time histologic information during endoscopy. Objective: The objective of this study was to compare images taken with the fiberoptic endoscopic microscope with standard histopathologic examination. Design: Feasibility study. Setting: The University of Texas M.D. Anderson Cancer Center Department of Gastroenterology. Patients, Interventions, and Main Outcome Measurements: The tissue samples studied in this report were obtained by endoscopic resection from patients with previous diagnoses of either high-grade dysplasia or esophageal adenocarcinoma. Results: Three distinct tissue types were observed ex vivo with the endoscopic microscope: normal squamous mucosa, Barrett's metaplasia, and high-grade dysplasia. Squamous tissue was identified by bright nuclei surrounded by dark cytoplasm in an ordered pattern. Barrett's metaplasia could be identified by large glandular structures with intact nuclear polarity. High-grade dysplasia was visualized as plentiful, irregular glandular structures and loss of nuclear polarity. Standard histopathologic examination of study samples confirmed the results obtained by the endoscopic microscope. Limitations: The endoscopic microscope probe had to be placed into direct contact with tissue. Conclusions: It was feasible to obtain high-resolution histopathologic information using the endoscopic microscope device. Future improvement and integration with widefield endoscopic techniques will aid in improving the sensitivity of detection of dysplasia and early cancer development in the esophagus.
AB - Background: This report describes the clinical evaluation of a novel, low-cost, high-resolution endoscopic microscope for obtaining fluorescent images of the cellular morphology of the epithelium of regions of the esophagus with Barrett's metaplasia. This noninvasive point imaging system offers a method for obtaining real-time histologic information during endoscopy. Objective: The objective of this study was to compare images taken with the fiberoptic endoscopic microscope with standard histopathologic examination. Design: Feasibility study. Setting: The University of Texas M.D. Anderson Cancer Center Department of Gastroenterology. Patients, Interventions, and Main Outcome Measurements: The tissue samples studied in this report were obtained by endoscopic resection from patients with previous diagnoses of either high-grade dysplasia or esophageal adenocarcinoma. Results: Three distinct tissue types were observed ex vivo with the endoscopic microscope: normal squamous mucosa, Barrett's metaplasia, and high-grade dysplasia. Squamous tissue was identified by bright nuclei surrounded by dark cytoplasm in an ordered pattern. Barrett's metaplasia could be identified by large glandular structures with intact nuclear polarity. High-grade dysplasia was visualized as plentiful, irregular glandular structures and loss of nuclear polarity. Standard histopathologic examination of study samples confirmed the results obtained by the endoscopic microscope. Limitations: The endoscopic microscope probe had to be placed into direct contact with tissue. Conclusions: It was feasible to obtain high-resolution histopathologic information using the endoscopic microscope device. Future improvement and integration with widefield endoscopic techniques will aid in improving the sensitivity of detection of dysplasia and early cancer development in the esophagus.
UR - http://www.scopus.com/inward/record.url?scp=53249123345&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2008.05.018
DO - 10.1016/j.gie.2008.05.018
M3 - Article
C2 - 18926182
AN - SCOPUS:53249123345
SN - 0016-5107
VL - 68
SP - 737
EP - 744
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 4
ER -