Endoscopic OCT
An early cancer detection method for imaging the gastrointestinal (GI) tract may reduce morbidity and mortality.
Three-dimensional OCT endomicroscopy can potentially be a powerful analysis and assessment tool for real time and in vivo GI cancer diagnosis and treatment.
Gastrointestinal (GI) cancer is one of the most common cancers in the United States and is newly diagnosed in more than 270,000 patients annually. When detected and treated early, the survival rate for GI cancers can greatly increases. However, many early-stage lesions are missed during standard endoscopic examination due to sampling errors associated with standard excisional pinch biopsies. In addition, there are new treatments, such as ablation which can remove pre-cancerous tissue or dysplastic tissue in order to reduce cancer progression. Therefore, development of imaging techniques which can be used to direct excisional biopsy to reduce sampling errors or to assess the outcomes of therapies.
Our group has developed an ultra-high speed three dimensional (3D) OCT endomicroscopy system for in vivo imaging of GI tract. OCT is well suited for detecting the changes in tissue microstructure associated with early GI cancers which often begin as small lesions and are difficult to identified using conventional endoscopy. 3D OCT endomicroscopy is capable of acquiring large volume 3D data at unprecedented speeds and high 3D resolution compared to standard endoscopic examination, enabling the detection of GI pathology linked to diseases such as Barrett’s esophagus (BE) and colon cancers. 3D acquisition also enables a variety of powerful visualization techniques such as frame averaging to increase image contrast and en face image generation for comparison to microscopy or endoscopy.
In collaboration with Dr. Hiroshi Mashimo, M.D., Ph.D. at the VA Boston Health System, our group performs several clinical studies using 3D-OCT endomicroscopy. Ongoing studies include the assessment of radiofrequency ablation (RFA) of BE and radiation proctitis (RP), comparison of structural features among different esophageal cancers, investigation of sub-epithelial glandular structures in the GI tract after endoscopic mucosal ablation, comparison of tissue architectural changes between RFA and cryospray ablation (CSA) in BE, and other pathology studies in GI tracts. While 3D-OCT endomicroscopy does not possess the same magnification or contrast as conventional biopsy and histopathologic analysis, it is capable of visualizing larger and deeper tissue volumes in vivo with greatly reduced sampling errors compared to excisional biopsy. High imaging speed and 3D resolution also can assist clinicians to diagnose diseases in real time, assess the efficacy of treatment, and perform guided biopsies or therapies. 3D-OCT endomicroscopy can potentially be a powerful analysis and assessment tool for real time and in vivo GI cancer diagnosis and treatment.
