Li X D, Boppart S A, Van Dam J, Mashimo H, Mutinga M, Drexler W, Klein M, Pitris C, Krinsky M L, Brezinski M E, Fujimoto J G
Dept. of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, USA.
Endoscopy. 2000 Dec;32(12):921-30. doi: 10.1055/s-2000-9626.
Endoscopic optical coherence tomography (OCT) is an emerging medical technology capable of generating high-resolution cross-sectional imaging of tissue microstructure in situ and in real time. We assess the use and feasibility of OCT for real-time screening and diagnosis of Barrett's esophagus, and also review state-of-the-art OCT technology for endoscopic imaging.
OCT imaging was performed as an adjunct to endoscopic imaging of the human esophagus. Real-time OCT (13-microm resolution) was used to perform image-guided evaluation of normal esophagus and Barrett's esophagus. Beam delivery was accomplished with a 1-mm diameter OCT catheter-probe that can be introduced into the accessory channel of a standard endoscope. Different catheter-probe imaging designs which performed linear and radial scanning were assessed. Novel ultrahigh-resolution (1.1-microm resolution) and spectroscopic OCT techniques were used to image in vitro specimens of Barrett's esophagus.
Endoscopic OCT images revealed distinct layers of normal human esophagus extending from the epithelium to the muscularis propria. In contrast, the presence of gland- and crypt-like morphologies and the absence of layered structures were observed in Barrett's esophagus. All OCT images showed strong correlations with architectural morphology in histological findings. Ultrahigh-resolution OCT techniques achieved 1.1-microm image resolution in in vitro specimens and showed enhanced resolution of architectural features. Spectroscopic OCT identified localized regions of wavelength-dependent optical scattering, enhancing the differentiation of Barrett's esophagus.
OCT technology with compact fiberoptic imaging probes can be used as an adjunct to endoscopy for real-time image-guided evaluation of Barrett's esophagus. Linear and radial scan patterns have different advantages and limitations depending upon the application. Ultrahigh-resolution and spectroscopic OCT techniques improve structural tissue recognition and suggest future potential for resolution and contrast enhancements in clinical studies. A new balloon catheter-probe delivery device is proposed for systematic imaging and screening of the esophagus.
内镜光学相干断层扫描（OCT）是一项新兴的医学技术，能够对组织微观结构进行原位实时高分辨率横断面成像。我们评估了OCT用于巴雷特食管实时筛查和诊断的应用及可行性，并回顾了用于内镜成像的最新OCT技术。
OCT成像作为人体食管内镜成像的辅助手段进行。使用实时OCT（13微米分辨率）对正常食管和巴雷特食管进行图像引导评估。通过直径1毫米的OCT导管探头实现光束传输，该探头可插入标准内镜的附件通道。评估了执行线性和径向扫描的不同导管探头成像设计。使用新型超高分辨率（1.1微米分辨率）和光谱OCT技术对巴雷特食管的体外标本进行成像。
内镜OCT图像显示正常人体食管从上皮延伸至固有肌层的不同层次。相比之下，在巴雷特食管中观察到腺样和隐窝样形态，且无分层结构。所有OCT图像在组织学结果中均与结构形态有很强的相关性。超高分辨率OCT技术在体外标本中实现了1.1微米的图像分辨率，并显示出结构特征分辨率的提高。光谱OCT识别出波长依赖性光散射的局部区域，增强了巴雷特食管的鉴别能力。
具有紧凑型光纤成像探头的OCT技术可作为内镜检查的辅助手段，用于巴雷特食管的实时图像引导评估。线性和径向扫描模式根据应用具有不同的优缺点。超高分辨率和光谱OCT技术改善了组织结构识别，并提示了未来临床研究中分辨率和对比度增强的潜力。提出了一种新的球囊导管探头输送装置用于食管的系统成像和筛查。
