TY - JOUR
T1 - Safety and feasibility of volumetric laser endomicroscopy in patients with Barrett's esophagus (with videos)
AU - Wolfsen, Herbert C.
AU - Sharma, Prateek
AU - Wallace, Michael B.
AU - Leggett, Cadman
AU - Tearney, Guillermo
AU - Wang, Kenneth K.
N1 - Publisher Copyright:
© 2015 American Society for Gastrointestinal Endoscopy.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background Volumetric laser endomicroscopy (VLE) produces high-resolution, cross-sectional surface, and subsurface images for detecting neoplasia, targeting biopsies, and guiding real-time treatment. Objective To evaluate the safety and feasibility of the Nvision VLE system. Design Prospective, multicenter study. Setting Tertiary-care medical centers. Patients One hundred patients with suspected Barrett's esophagus, including 52 patients with prior endotherapy. Interventions 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. Main Outcome Measurements Acquisition of a complete, 6-cm scan from the distal esophagus, demographic and procedural data, and final histologic diagnosis. Results 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). Limitations 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. Conclusion 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.
AB - Background Volumetric laser endomicroscopy (VLE) produces high-resolution, cross-sectional surface, and subsurface images for detecting neoplasia, targeting biopsies, and guiding real-time treatment. Objective To evaluate the safety and feasibility of the Nvision VLE system. Design Prospective, multicenter study. Setting Tertiary-care medical centers. Patients One hundred patients with suspected Barrett's esophagus, including 52 patients with prior endotherapy. Interventions 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. Main Outcome Measurements Acquisition of a complete, 6-cm scan from the distal esophagus, demographic and procedural data, and final histologic diagnosis. Results 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). Limitations 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. Conclusion 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.
KW - BE Barrett's esophagus
KW - CLE confocal laser endomicroscopy
KW - OCT optical coherence tomography
KW - OFDI optical frequency domain imaging
KW - VLE volumetric laser endomicroscopy
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U2 - 10.1016/j.gie.2015.03.1968
DO - 10.1016/j.gie.2015.03.1968
M3 - Article
C2 - 25956472
AN - SCOPUS:84942079531
SN - 0016-5107
VL - 82
SP - 631
EP - 640
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 4
ER -