Department of Gastroenterology, Mayo Clinic, Jacksonville, Florida.
Gastroenterology, Hepatology, and Motility, Kansas City Veterans Administration Medical Center, Kansas City, Missouri.
Gastrointest Endosc. 2015 Oct;82(4):631-40. doi: 10.1016/j.gie.2015.03.1968. Epub 2015 May 6.
Volumetric laser endomicroscopy (VLE) produces high-resolution, cross-sectional surface, and subsurface images for detecting neoplasia, targeting biopsies, and guiding real-time treatment.
To evaluate the safety and feasibility of the Nvision VLE system.
Prospective, multicenter study.
Tertiary-care medical centers.
One hundred patients with suspected Barrett's esophagus, including 52 patients with prior endotherapy.
The first-generation Nvision VLE Imaging System, a balloon-centered, rotating optical probe provided images of the mucosa and submucosa through a 6-cm segment length and 360° scan of the distal esophagus.
Acquisition of a complete, 6-cm scan from the distal esophagus, demographic and procedural data, and final histologic diagnosis.
VLE imaging was successfully performed in 87 cases. After VLE imaging, biopsy specimens were obtained in 77 patients and mucosal resection was performed in 20 patients. The final pathologic diagnoses of the patients studied were adenocarcinoma (4 patients), high-grade dysplasia (10 patients), low-grade dysplasia (11 patients), indefinite (5 patients), intestinal metaplasia (29 patients), and normal squamous cells (18 patients). VLE was not completed in 13 of 100 (13%) because of optical probe and console issues. There were 2 minor adverse events (mucosal lacerations not requiring therapy).
This was a feasibility study with a first-generation device. There was no direct histopathologic correlation with the VLE images or any comparative analysis with white-light endoscopy or narrow-band imaging findings.
VLE is a safe procedure for patients with suspected or confirmed Barrett's esophagus. Real-time VLE images enabled visualization of the mucosa and submucosa in 87% of cases. Further studies are needed to evaluate the in vivo diagnostic accuracy and clinical utility of VLE.
容积激光内窥技术（VLE）可产生高分辨率的横截面、表面和次表面图像，用于检测肿瘤、靶向活检并指导实时治疗。
评估 Nvision VLE 系统的安全性和可行性。
前瞻性、多中心研究。
三级医疗中心。
100 例疑似 Barrett 食管患者，其中 52 例患者曾接受过内镜治疗。
第一代 Nvision VLE 成像系统，一个以球囊为中心、旋转的光学探头，通过对远端食管 360°扫描和 6cm 段长度，提供黏膜和黏膜下层的图像。
从远端食管采集完整的 6cm 扫描、人口统计学和程序数据以及最终组织学诊断。
87 例患者成功进行了 VLE 成像。VLE 成像后，77 例患者获得了活检标本，20 例患者进行了黏膜切除术。研究患者的最终病理诊断为腺癌（4 例）、高级别异型增生（10 例）、低级别异型增生（11 例）、不确定（5 例）、肠上皮化生（29 例）和正常鳞状细胞（18 例）。由于光学探头和控制台问题，100 例患者中有 13 例（13%）未能完成 VLE。有 2 例轻微不良事件（无需治疗的黏膜撕裂）。
这是一项使用第一代设备的可行性研究，VLE 图像与组织病理学结果之间没有直接的相关性，也没有与白光内镜或窄带成像结果进行任何比较分析。
VLE 是疑似或确诊 Barrett 食管患者的安全操作。实时 VLE 图像可使 87%的病例可视化黏膜和黏膜下层。需要进一步研究来评估 VLE 的体内诊断准确性和临床应用价值。
