Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response
Background Radiofrequency ablation (RFA) is effective for treating Barrett's esophagus (BE) but often involves multiple endoscopy sessions over several months to achieve complete response. Objective Identify structural markers that correlate with treatment response by using 3-dimensional (3-...
| Main Authors: | , , , , , , , , , , , |
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| 格式: | 文件 |
| 语言: | en_US |
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Elsevier
2015
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| 在线阅读: | http://hdl.handle.net/1721.1/100211 https://orcid.org/0000-0003-4811-3429 https://orcid.org/0000-0002-0828-4357 https://orcid.org/0000-0002-2976-6195 |
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| author | Tsai, Tsung-Han Zhou, Chao Tao, Yuankai K. Lee, Hsiang-Chieh Figueiredo, Marisa Kirtane, Tejas Adler, Desmond C. Schmitt, Joseph M. Huang, Qin Fujimoto, James G. Mashimo, Hiroshi Ahsen, Osman Oguz |
| author2 | Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science |
| author_facet | Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science Tsai, Tsung-Han Zhou, Chao Tao, Yuankai K. Lee, Hsiang-Chieh Figueiredo, Marisa Kirtane, Tejas Adler, Desmond C. Schmitt, Joseph M. Huang, Qin Fujimoto, James G. Mashimo, Hiroshi Ahsen, Osman Oguz |
| author_sort | Tsai, Tsung-Han |
| collection | MIT |
| description | Background
Radiofrequency ablation (RFA) is effective for treating Barrett's esophagus (BE) but often involves multiple endoscopy sessions over several months to achieve complete response.
Objective
Identify structural markers that correlate with treatment response by using 3-dimensional (3-D) optical coherence tomography (OCT; 3-D OCT).
Design
Cross-sectional.
Setting
Single teaching hospital.
Patients
Thirty-three patients, 32 male and 1 female, with short-segment (<3 cm) BE undergoing RFA treatment.
Intervention
Patients were treated with focal RFA, and 3-D OCT was performed at the gastroesophageal junction before and immediately after the RFA treatment. Patients were re-examined with standard endoscopy 6 to 8 weeks later and had biopsies to rule out BE if not visibly evident.
Main Outcome Measurements
The thickness of BE epithelium before RFA and the presence of residual gland-like structures immediately after RFA were determined by using 3-D OCT. The presence of BE at follow-up was assessed endoscopically.
Results
BE mucosa was significantly thinner in patients who achieved complete eradication of intestinal metaplasia than in patients who did not achieve complete eradication of intestinal metaplasia at follow-up (257 ± 60 μm vs 403 ± 86 μm; P < .0001). A threshold thickness of 333 μm derived from receiver operating characteristic curves corresponded to a 92.3% sensitivity, 85% specificity, and 87.9% accuracy in predicting the presence of BE at follow-up. The presence of OCT-visible glands immediately after RFA also correlated with the presence of residual BE at follow-up (83.3% sensitivity, 95% specificity, 90.6% accuracy).
Limitations
Single center, cross-sectional study in which only patients with short-segment BE were examined.
Conclusion
Three-dimensional OCT assessment of BE thickness and residual glands during RFA sessions correlated with treatment response. Three-dimensional OCT may predict responses to RFA or aid in making real-time RFA retreatment decisions in the future. |
| first_indexed | 2024-09-23T15:05:29Z |
| format | Article |
| id | mit-1721.1/100211 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T15:05:29Z |
| publishDate | 2015 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | mit-1721.1/1002112022-10-02T00:32:30Z Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response Tsai, Tsung-Han Zhou, Chao Tao, Yuankai K. Lee, Hsiang-Chieh Figueiredo, Marisa Kirtane, Tejas Adler, Desmond C. Schmitt, Joseph M. Huang, Qin Fujimoto, James G. Mashimo, Hiroshi Ahsen, Osman Oguz Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science Massachusetts Institute of Technology. Research Laboratory of Electronics Tsai, Tsung-Han Zhou, Chao Tao, Yuankai K. Lee, Hsiang-Chieh Ahsen, Osman Oguz Fujimoto, James G. Background Radiofrequency ablation (RFA) is effective for treating Barrett's esophagus (BE) but often involves multiple endoscopy sessions over several months to achieve complete response. Objective Identify structural markers that correlate with treatment response by using 3-dimensional (3-D) optical coherence tomography (OCT; 3-D OCT). Design Cross-sectional. Setting Single teaching hospital. Patients Thirty-three patients, 32 male and 1 female, with short-segment (<3 cm) BE undergoing RFA treatment. Intervention Patients were treated with focal RFA, and 3-D OCT was performed at the gastroesophageal junction before and immediately after the RFA treatment. Patients were re-examined with standard endoscopy 6 to 8 weeks later and had biopsies to rule out BE if not visibly evident. Main Outcome Measurements The thickness of BE epithelium before RFA and the presence of residual gland-like structures immediately after RFA were determined by using 3-D OCT. The presence of BE at follow-up was assessed endoscopically. Results BE mucosa was significantly thinner in patients who achieved complete eradication of intestinal metaplasia than in patients who did not achieve complete eradication of intestinal metaplasia at follow-up (257 ± 60 μm vs 403 ± 86 μm; P < .0001). A threshold thickness of 333 μm derived from receiver operating characteristic curves corresponded to a 92.3% sensitivity, 85% specificity, and 87.9% accuracy in predicting the presence of BE at follow-up. The presence of OCT-visible glands immediately after RFA also correlated with the presence of residual BE at follow-up (83.3% sensitivity, 95% specificity, 90.6% accuracy). Limitations Single center, cross-sectional study in which only patients with short-segment BE were examined. Conclusion Three-dimensional OCT assessment of BE thickness and residual glands during RFA sessions correlated with treatment response. Three-dimensional OCT may predict responses to RFA or aid in making real-time RFA retreatment decisions in the future. Center for Integration of Medicine and Innovative Technology (Medical Engineering Fellowship) United States. Dept. of Veterans Affairs. Boston Healthcare System National Institutes of Health (U.S.) (Grant R01-CA75289-15) National Institutes of Health (U.S.) (Grant R44CA101067-06) National Institutes of Health (U.S.) (Grant K99-EB010071-01A1) United States. Air Force Office of Scientific Research (Grant FA9550-10-1-0063) United States. Air Force Office of Scientific Research. Medical Free Electron Laser Program (Grant FA9550-10-1-0551) 2015-12-13T03:11:10Z 2015-12-13T03:11:10Z 2012-12 Article http://purl.org/eprint/type/JournalArticle 00165107 http://hdl.handle.net/1721.1/100211 Tsai, Tsung-Han, Chao Zhou, Yuankai K. Tao, Hsiang-Chieh Lee, Osman O. Ahsen, Marisa Figueiredo, Tejas Kirtane, et al. “Structural Markers Observed with Endoscopic 3-Dimensional Optical Coherence Tomography Correlating with Barrett’s Esophagus Radiofrequency Ablation Treatment Response (with Videos).” Gastrointestinal Endoscopy 76, no. 6 (December 2012): 1104–1112. https://orcid.org/0000-0003-4811-3429 https://orcid.org/0000-0002-0828-4357 https://orcid.org/0000-0002-2976-6195 en_US http://dx.doi.org/10.1016/j.gie.2012.05.024 Gastrointestinal Endoscopy Creative Commons Attribution http://creativecommons.org/licenses/by-nc-nd/4.0/ application/pdf Elsevier PMC |
| spellingShingle | Tsai, Tsung-Han Zhou, Chao Tao, Yuankai K. Lee, Hsiang-Chieh Figueiredo, Marisa Kirtane, Tejas Adler, Desmond C. Schmitt, Joseph M. Huang, Qin Fujimoto, James G. Mashimo, Hiroshi Ahsen, Osman Oguz Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response |
| title | Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response |
| title_full | Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response |
| title_fullStr | Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response |
| title_full_unstemmed | Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response |
| title_short | Structural markers observed with endoscopic 3-dimensional optical coherence tomography correlating with Barrett's esophagus radiofrequency ablation treatment response |
| title_sort | structural markers observed with endoscopic 3 dimensional optical coherence tomography correlating with barrett s esophagus radiofrequency ablation treatment response |
| url | http://hdl.handle.net/1721.1/100211 https://orcid.org/0000-0003-4811-3429 https://orcid.org/0000-0002-0828-4357 https://orcid.org/0000-0002-2976-6195 |
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