1. Articles from Gregory Y. Lauwers

    1-7 of 7
    1. A new step for volumetric laser endomicroscopy: entering the therapeutic realm of endoscopic mucosal resection

      A new step for volumetric laser endomicroscopy: entering the therapeutic realm of endoscopic mucosal resection

      The incidence of esophageal adenocarcinoma (EAC) is rising despite a better understanding of the natural history of Barrett’s esophagus (BE) as a precursor lesion for EAC. 1 Surveillance is recommended once the diagnosis of BE is established, and endoscopic eradication therapy is reserved for treatment of dysplasia or early neoplasia. 2 In recent years, significant clinical and technologic advances have been made in endoscopic methods for the diagnosis and treatment of early esophageal adenocarcinomas arising in Barrett’s esophagus. 3 , 4 , 5 In the current issue of Gastrointestinal Endoscopy , Kamboj et al 6 show that using a synergistic combination ...

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    2. Esophageal-guided biopsy with volumetric laser endomicroscopy and laser cautery marking: a pilot clinical study

      Esophageal-guided biopsy with volumetric laser endomicroscopy and laser cautery marking: a pilot clinical study

      Background Biopsy surveillance protocols for the assessment of Barrett's esophagus can be subject to sampling errors, resulting in diagnostic uncertainty. Optical coherence tomography is a cross-sectional imaging technique that can be used to conduct volumetric laser endomicroscopy (VLE) of the entire distal esophagus. We have developed a biopsy guidance platform that places endoscopically visible marks at VLE-determined biopsy sites. Objective The objective of this study was to demonstrate in human participants the safety and feasibility of VLE-guided biopsy in vivo. Design A pilot feasibility study. Setting Massachusetts General Hospital. Patients A total of 22 participants were enrolled from January ...

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    3. Barrett's Esophagus Screening Using Balloon-Based Optical Frequency Domain Imaging: A Comparison With Endoscopy

      Abstracts submitted to ASGE 2010. Optical coherence tomography (OCT) is a high-resolution cross-sectional imaging modality that has been shown to accurately differentiate esophageal pathology relevant to screening and surveillance in Barrett's patients. We have previously demonstrated that optical frequency domain imaging (OFDI), a high speed 2nd generation embodiment of OCT, may be used to perform volumetric microscopy of the distal esophagus in patients. In this present study we compare the sensitivity of OFDI to endoscopy for the diagnosis of specialized intestinal metaplasia (SIM), using histopathology as the gold standard.

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    4. Image-guided biopsy in the esophagus through comprehensive optical frequency domain imaging and laser marking: a study in living swine

      Image-guided biopsy in the esophagus through comprehensive optical frequency domain imaging and laser marking: a study in living swine
      Background: Random biopsy esophageal surveillance can be subject to sampling errors, resulting in diagnostic uncertainty. Optical frequency domain imaging (OFDI) is a high-speed, 3-dimensional endoscopic microscopy technique. When deployed through a balloon-centering catheter, OFDI can automatically image the entire distal esophagus (6.0 cm length) in approximately 2 minutes. Objective: To test a new platform for guided biopsy that allows the operator to select target regions of interest on an OFDI dataset, and then use a laser to mark the esophagus at corresponding locations. The specific goals include determining the optimal laser parameters, testing the accuracy of the laser marking ...
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    5. Combined Reflection Confocal Microscopy and Optical Coherence Tomography Imaging of Esophageal Biopsy

      Reflection confocal microscopy (RCM) and optical coherence tomography (OCT) are two non-contact optical imaging technologies that provide images of tissue cellular and architectural morphology, which are both used for histopathologic diagnosis. We have developed a combined RCM and OCT system to compare the accuracy of these imaging techniques for diagnosing esophageal pathology and to evaluate the potential utility of merging the two modalities into a single imaging system. Clinical study was conducted on 32 human esophageal biopsy samples from 23 patients with various histories. Esophageal mucosa was differentiated from gastric mucosa, Barrett's esophagus with intestinal metaplasia was distinguished from ...
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    6. Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging

      Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging
      Background: Optical coherence tomography (OCT) is a cross-sectional, high-resolution imaging modality that has been shown to accurately differentiate esophageal specialized intestinal metaplasia (SIM) from gastric cardia at the squamocolumnar junction (SCJ) and diagnose high-grade dysplasia and intramucosal carcinoma in patients with SIM. The clinical utility of OCT has been limited, however, by its inability to acquire images over large areas.Objective: The aim of this study was to use recently developed high-speed OCT technology, termed optical frequency domain imaging (OFDI), and a new balloon-centering catheter (2.5 cm diameter) to demonstrate the feasibility of large area, comprehensive optical microscopy of ...
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    7. Optical Coherence Tomography to Identify Intramucosal Carcinoma and High-Grade Dysplasia in Barrett’s Esophagus

      Optical Coherence Tomography to Identify Intramucosal Carcinoma and High-Grade Dysplasia in Barrett’s Esophagus
      Background & Aims: Optical coherence tomography (OCT) is an optical technique that produces high-resolution images of the esophagus during endoscopy. OCT can distinguish specialized intestinal metaplasia (SIM) from squamous mucosa, but image criteria for differentiating intramucosal carcinoma (IMC) and high-grade dysplasia (HGD) from low-grade dysplasia (LGD), indeterminate-grade dysplasia (IGD), and SIM without dysplasia have not been validated. The purpose of this study was to establish OCT image characteristics of IMC and HGD in Barrett’s esophagus. Methods: Biopsy-correlated OCT images were acquired from patients with Barrett’s esophagus undergoing endoscopic surveillance. Two pathologists rendered consensus diagnoses of the biopsy specimens. A ...
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    1-7 of 7
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    1. (6 articles) Massachusetts General Hospital
    2. (6 articles) Harvard University
    3. (6 articles) Guillermo J. Tearney
    4. (6 articles) Brett E. Bouma
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    Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging Optical Coherence Tomography to Identify Intramucosal Carcinoma and High-Grade Dysplasia in Barrett’s Esophagus Image-guided biopsy in the esophagus through comprehensive optical frequency domain imaging and laser marking: a study in living swine Esophageal-guided biopsy with volumetric laser endomicroscopy and laser cautery marking: a pilot clinical study A new step for volumetric laser endomicroscopy: entering the therapeutic realm of endoscopic mucosal resection Fantom Encore Sirolimus-eluting Bioresorbable Scaffold for Treatment of De-novo CAD: the ENCORE-I Study Assessment of Microcirculatory Dysfunction in Septic Shock Patients by OCTA OCT system used at home demonstrates potential for daily monitoring of AMD Optical Coherence Tomography Biomarkers of the Outer Blood—Retina Barrier in Patients with Diabetic Macular Oedema Retinal Boundary Segmentation in Stargardt Disease Optical Coherence Tomography Images Using Automated Multi-channel swept source optical coherence tomography concept based on photonic integrated circuits Assessment of Retinal Vessel Density in Adult-Onset Foveomacular Vitelliform Dystrophy by Optical Coherence Tomography Angiography