New methodClinical endoscopyHigh-resolution imaging in Barrett's esophagus: a novel, low-cost endoscopic microscope
Section snippets
Patients
Patients who participated in this study had been previously diagnosed with either HGD or intramucosal adenocarcinoma and were scheduled for upper endoscopy with either jumbo biopsies or EMR of the affected areas. The study protocols were approved by both the Rice University Institutional Review Board and the University of Texas M.D. Anderson Cancer Center Institutional Review Board, and informed consent was obtained from each patient before the procedure. Eleven sequential patients with a
Results
Images obtained with the endoscopic microscope were compared with histopathologic interpretation of the same areas. Fluorescence images were evaluated qualitatively, noting nuclear size and density, nuclear-to-cytoplasmic ratio, glandular structure and organization, and intensity of fluorescence. Distinct patterns of fluorescence images were observed for tissues with different histopathologic diagnoses: (1) normal squamous epithelium, (2) Barrett's metaplasia/low-grade dysplasia, and (3)
Discussion
This study demonstrates the ability of an inexpensive (<$2500) system with a reusable probe to produce high-resolution images of a variety of esophageal tissue types. Such a device can easily be integrated into any standard endoscope to noninvasively yield subcellular-resolution images of the surface histologic features of a suspected lesion with the use of an appropriate fluorescent dye. Coupled with widefield imaging devices, this endoscopic microscope system should further enhance
Acknowledgments
Special appreciation is extended to Rachna Khare and Carolyn Paraguya for their expertise and assistance.
References (22)
- et al.
Narrow band imaging directed EMR for Barrett's esophagus with high-grade dysplasia
Gastrointest Endosc
(2007) - et al.
Autofluorescence endoscopy for detection of high-grade dysplasia in short-segment Barrett's esophagus
Gastrointest Endosc
(2003) - et al.
Optical biopsy of GI lesions by reflectance-type laser-scanning confocal microscopy
Gastrointest Endosc
(2007) - et al.
In vivo histology of Barrett's esophagus and associated neoplasia by confocal laser endomicroscopy
Clin Gastroenterol Hepatol
(2006) - et al.
A fluorescence confocal endomicroscope for in vivo microscopy of the upper- and the lower-GI tract
Gastrointest Endosc
(2005) - et al.
Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo
Gastroenterology
(2004) The failure of HAART to cure the HIV-1/AIDS complex: suggestions to add integrase inhibitors as complementary virostatics, and to replace their continuous long combination applications by short sequences differing by drug rotations
Biomed Pharmacother
(2001)- et al.
Barrett's esophagus: prevalence and incidence of adenocarcinoma
Arch Intern Med
(1991) Epidemiology and significance of Barrett's esophagus
Dig Dis
(2000)Epidemiology of Barrett's esophagus and adenocarcinoma
Dis Esophagus
(2002)