1. Articles in category: Gastroenterology

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    1. Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users

      Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users

      Abstract Background and Aims Targeting neoplasia in Barrett’s esophagus (BE) is challenging. Volumetric laser endomicroscopy (VLE) is a new imaging technique that allows for real time cross-sectional microstructure imaging that can detect BE neoplasia. The interobserver agreement among users in practice is unknown. Methods Eight high-volume users of VLE from different academic centers in the United States evaluated 120-stored VLE images blinded to the endoscopic and clinical findings. There were 30 images for each tissue type: gastric cardia, esophageal squamous mucosa, non-neoplastic BE, and neoplastic BE. Each image with BE had corresponding histology confirming the tissue diagnosis. Each normal ...

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    2. NinePoint Medical Announces Substantial Hospital Reimbursement Increase for Procedures Using the NvisionVLE Imaging System with Real-time Targeting

      NinePoint Medical Announces Substantial Hospital Reimbursement Increase for Procedures Using the NvisionVLE Imaging System with Real-time Targeting

      NinePoint Medical, Inc., a transformative medical device company pioneering the use of an advanced imaging platform for gastrointestinal applications, announced today that the U.S. Centers for Medicare & Medicaid Services (CMS) has published its 2017 final fee schedule. The annual update includes a material increase to the reimbursement rate for CPT Code 43252 1 ( upper GI endoscopy with optical endomicroscopy ), used for esophageal procedures using the NvisionVLE Imaging System with Real-time Targeting. According to the final 2017 CMS fee schedule, starting January 1, 2017, the reimbursement rate for CPT code 43252 in the hospital out-patient setting increases 131% from $1 ...

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    3. Volumetric Mapping of Barrett’s Esophagus and Dysplasia With en face Optical Coherence Tomography Tethered Capsule

      Volumetric Mapping of Barrett’s Esophagus and Dysplasia With en face Optical Coherence Tomography Tethered Capsule

      To the Editor: Dysplasia in Barrett’s Esophagus (BE) is patchy ( 1 ) and sometimes missed by random biopsies. Optical coherence tomography (OCT) can image large areas of the esophagus; however, slow imaging speeds in earlier studies limited visualization to cross-sections. Cross-sectional OCT detected high-grade dysplasia with sensitivity / specificity of ~80 % ( 2 , 3 ). Tethered OCT capsules were demonstrated for cross-sectional imaging in unsedated screening to detect BE ( 4 , 5 ). Our group recently developed ultrahigh-speed OCT for en face and angiographic imaging, using micromotor probes in patients ( 6 , 7 ) and large field-of-view tethered capsule devices in swine ( 8 ). Narrow-band imaging (NBI) visualizes ...

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    4. Endoscopic optical coherence tomography using compressive sensing

      Endoscopic optical coherence tomography using compressive sensing

      Conventionally endoscopic OCT images are reconstructed by uniform sampling in both axial and transverse direction of the image. To shorten the scanning time and reduce the acquisition data, we propose to sparsely sample the axial scans and use compressive sensing (CS) to reconstruct the full endoscopic OCT image with randomly chosen axial scans that are much less than conventional Nyquist criteria requirement. And we study the ratio of sparse sampling numerically and experimentally that are required to reconstruct acceptable OCT images. We demonstrate that the OCT image acquisition time can be significantly reduced because of much less acquired data.

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    5. Miniaturization of plastic lens by injection molding for disposable endoscopie optical coherence tomography system

      Miniaturization of plastic lens by injection molding for disposable endoscopie optical coherence tomography system

      Minimally invasive robotic surgery required disposable endoscopie optical coherence tomography (OCT) for high-resolution deep tissue imaging and cross-contamination prevention. Here, we developed a miniaturized plastic lens by injection molding for developing a disposable endoscopie optical coherence tomography system for the first time. Injection molding provided low-cost and high-production rate to produce a disposable plastic lens and enabled the miniaturization of plastic lens. Transmittance and curvature of the plastic lens was measured. The plastic lens was integrated with an endoscopie OCT system, and the images of human-skin and microspheres embedded in agarose gel were captured. We are currently trying to integrate ...

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      Mentions: Ki Hean Kim
    6. Identification of Volumetric Laser Endomicroscopy features predictive for early neoplasia in Barrett’s esophagus using high-quality histological correlation

      Identification of Volumetric Laser Endomicroscopy features predictive for early neoplasia in Barrett’s esophagus using high-quality histological correlation

      Background and aims volumetric laser endomicroscopy (VLE) provides a circumferential scan that enables the visualization of subsurface layers of the esophageal wall at 7 μm resolution. The aims of this study were to identify VLE features ofBarrett’s esophagus (BE) neoplasia and to develop a VLE prediction score. Methods A database of VLE images from endoscopic resection specimens, precisely correlated with histology, from BE patients +/- neoplasia was used. Features potentially predictive for early BE neoplasia were identified by unblinded evaluation of 25 VLE-histology images. In a learning phase, 20 VLE images with or without BE neoplasia were scored by 2 ...

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    7. Common-path optical coherence tomography using a microelectromechanical-system-based endoscopic probe

      Common-path optical coherence tomography using a microelectromechanical-system-based endoscopic probe

      This paper presents a common-path (CP) swept-source optical coherence tomography (SSOCT) system based on a special endoscopic probe design with an in-line internal reflection as the reference and a two-axis electrothermal microelectromechanical system mirror for image scanning. The rear surface of a gradient reflective index (GRIN) lens inside the probe is set as the reference reflection plane. The length of the GRIN lens is optimized to eliminate the artifacts in SSOCT images successfully. Doppler OCT is also demonstrated based on the CP endoscopic probe. The diameter of the probe is only 2.5 mm, so it can be easily inserted ...

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    8. In vivo endoscopic Doppler optical coherence tomography imaging of the colon

      In vivo endoscopic Doppler optical coherence tomography imaging of the colon

      Background and Objective Colorectal cancer (CRC) remains the second deadliest cancer in the United States. Several screening methods exist; however, detection of small polyps remains a challenge. Optical coherence tomography (OCT) has been demonstrated to be capable of detecting lesions as small as 1 mm in the mouse colon, but detection is based on measuring a doubling of the mucosa thickness. The colon microvasculature may be an attractive biomarker of early tumor development because tumor vessels are characterized by irregular structure and dysfunction. Our goal was to develop an endoscopic method of detecting and segmenting colon vessels using Doppler OCT ...

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    9. Optical Coherence Tomography: Clinical Applications in Gastrointestinal Endoscopy (Book Chapter)

      Optical Coherence Tomography: Clinical Applications in Gastrointestinal Endoscopy (Book Chapter)

      Optical coherence tomography (OCT) is a high-resolution imaging modality that uses principles of light interferometry. It has achieved clinical application in several other specialties such as ophthalmology and cardiology where its high resolution and deeper penetration into the surface permits much more detailed examination of the mucosa. In the field of gastroenterology, the technology has evolved through several iterations beginning with a focal magnifying imaging technique and evolving into currently a widefield imaging modality that can scan a relatively large area of mucosa with high resolution. OCT has been used to detect dysplasia in Barrett’s esophagus, differentiate between inflammatory ...

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    10. University of Washington Receives NIH Grant for Needle Biopsy Preservation and Preparation for Rapid 2D Pathology of Pancreas

      University of Washington Receives NIH Grant for Needle Biopsy Preservation and Preparation for Rapid 2D Pathology of Pancreas

      University of Washington Receives a 2016 NIH Grant for $235,226 for Needle Biopsy Preservation and Preparation for Rapid 2D Pathology of Pancreas. The principal investigator is Eric Seibel. The program began in 2014 and ends in 2017. Below is a summary of the proposed work. There are over three million needle biopsies performed every year in the USA, typically for the diagnosis of breast, prostate, thyroid, lung, liver, and pancreatic cancers. Because needle biopsies are less invasive than surgical biopsies, they are much more cost-effective. However, a major limitation for all needle biopsies are that the pathologist or cytologist ...

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    11. The new kid on the block for advanced imaging in Barrett’s esophagus: a review of volumetric laser endomicroscopy

      The new kid on the block for advanced imaging in Barrett’s esophagus: a review of volumetric laser endomicroscopy

      Advanced imaging techniques used in the management of Barrett’s esophagus include electronic imaging enhancement (e.g. narrow band imaging, flexible spectral imaging color enhancement, and i-Scan), chromoendoscopy, and confocal laser endomicroscopy. Electronic imaging enhancement is used frequently in daily practice, but use of the other advanced technologies is not routine. High-definition white light endoscopy and random four quadrant biopsy remain the standard of care for evaluation of Barrett’s esophagus; this is largely due to the value of advanced imaging technologies not having been validated in large studies or in everyday practice. A new advanced imaging technology called volumetric ...

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    12. Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus

      Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus

      Methods and study aims: The incidence of esophageal cancer is rising despite increased surveillance efforts. Volumetric laser endomicroscopy (VLE) is a new endoscopic imaging tool that can allow for targeted biopsy of neoplasia in Barrett’s esophagus. We report a series of 6 patients with long-segment Barrett’s esophagus ( > 3 cm), who underwent a session of endoscopy with volumetric laser endomicroscopy, after a separate prior session of standard high-definition endoscopy with narrow band imaging (NBI) and random biopsies that did not reveal neoplasia. In all six patients, the first endoscopy was the index endoscopy diagnosing the Barrett’s esophagus. All ...

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    13. Toward High-Speed Imaging of Cellular Structures in Rat Colon Using Micro-optical Coherence Tomography

      Toward High-Speed Imaging of Cellular Structures in Rat Colon Using Micro-optical Coherence Tomography

      The mucosal microanatomy of the large intestine is characterized by the presence of crypts of Lieberkühn, which is associated predominantly with goblet cells. Such cellular-level intestinal microstructures undergo morphological changes during the progression of bowel diseases, such as colon cancer or ulcerative colitis. As an indicator of gastric cancers, intestinal metaplasia in the large intestine is characterized by the appearance of goblet cells in gastric epithelium, and therefore, visualization of intestinal microstructure changes in cross-sectional view, particularly in vivo, in a highspeed fashion would assist early disease diagnosis and its treatment. In this paper, we investigated the capability of ...

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    14. Massachusetts General Hospital Receives a 2016 NIH Grant for Celiac Disease Diagnosis Using Tethered Capsule Endomicroscopy

      Massachusetts General Hospital Receives a 2016 NIH Grant for Celiac Disease Diagnosis Using Tethered Capsule Endomicroscopy

      Massachusetts General Hospital Receives a 2016 NIH Grant for $573,805 for Celiac Disease Diagnosis Using Tethered Capsule Endomicroscopy. The principal investigator is Guillermo Tearney. The program began in $2014 and ends in 2019. Below is a summary of the proposed work. Celiac disease (CD) is an autoimmune response to gluten proteins that affects 3M people in the US and 50M worldwide. These proteins incite an inflammatory reaction that eventually destroys the absorptive villi in the duodenum, resulting in gastrointestinal symptoms, malabsorption, malnutrition, and an increased incidence of other autoimmune diseases, diabetes, and cancer. A definitive diagnosis of CD is ...

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    15. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter

      Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter

      We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec ...

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    16. Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

      Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

      Purpose . To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG). Methods . A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40) who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT), total macular volume (TMV), and retinal ganglion cell layer (RGCL) were measured by spectral-domain optical coherence tomography (SD-OCT). Subfoveal choroidal thickness (SFCT) was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT). Results . The mean CMT was   μ m,   μ m, and   μ m preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively ( ). The ...

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    17. Label-Free Imaging of Eosinophilic Esophagitis Mouse Models Using Optical Coherence Tomography

      Label-Free Imaging of Eosinophilic Esophagitis Mouse Models Using Optical Coherence Tomography

      Eosinophilic esophagitis (EoE) is an immune-mediated disorder characterized by esophageal inflammation and related structural changes causing symptoms such as feeding difficulties and food impaction. The pathophysiological mechanisms underlying EoE remain poorly understood. Preclinical studies using mouse models have been critical in comprehending human disease mechanisms and associated pathways. In this chapter, we describe an experimental method using a noninvasive label-free optical imaging technique, optical coherence tomography, to characterize the pathophysiological changes in the esophagus of mice with EoE-like disease ex vivo.

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    18. NinePoint Medical Announces Completion of Clinical Registry and Publication of Results at DDW 2016

      NinePoint Medical Announces Completion of Clinical Registry and Publication of Results at DDW 2016

      NinePoint Medical, Inc., a transformative medical device company pioneering the use of an advanced imaging platform for gastrointestinal applications, announced today that it has completed the primary phase of its Registry for High Resolution Optical Imaging of the Esophagus Using the NvisionVLE ® Imaging System. Results from the registry’s interim analysis will be presented in 11 scientific abstracts accepted to Digestive Disease Week ® (DDW) 2016, to be held May 21-24 in San Diego, California.

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    19. Bimodal endoscopic probe combining white-light microscopy and optical coherence tomography

      Bimodal endoscopic probe combining white-light microscopy and optical coherence tomography

      We present a novel bimodal endoscopic imaging probe that can simultaneously provide full-field white-light video microscopy and confocal optical coherence tomography (OCT) depth scans. The two modalities rely on spectrally separated optical paths that run partially in parallel through a micro-optical bench system, which has a cross-section of only 2    mm × 2.76    mm and is realized via standard silicon micromachining techniques. With a numerical aperture of 0.061, the video modality has a resolution and field of view of 9.3 and 1240    μm × 1080    μm , respectively. The resolution is limited by the pixel spacing of the coherent fiber ...

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    20. Massachusetts Institute of Technology Receives Grant for Optical Biopsy Using Optical Coherence Tomography

      Massachusetts Institute of Technology Receives Grant for Optical Biopsy Using Optical Coherence Tomography

      Massachusetts Institute of Technology Receives a 2016 NIH Grant for $288,576 for Optical Biopsy Using Optical Coherence Tomography. The principal investigator is James Fujimoto. The program began in 1997 and ends in 2019. Below is a summary of the proposed work. This is a multidisciplinary collaboration between investigators at the Massachusetts Institute of Technology and the VA Boston Healthcare System integrating imaging technology research, clinical imaging studies, medical device development and animal imaging studies. Esophageal cancer is a lethal malignancy, with a five-year survival rate of 16%. Barrett's esophagus (BE) and dysplasia are precursors to esophageal adenocarcinoma (EAC ...

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    21. NinePoint Medical Announces FDA 510(k) Clearance of a Real-Time Targeting Feature for the NvisionVLE® Imaging System and the First Clinical Cases in the U.S.

      NinePoint Medical Announces FDA 510(k) Clearance of a Real-Time Targeting Feature for the NvisionVLE® Imaging System and the First Clinical Cases in the U.S.

      NinePoint Medical, Inc., a transformative medical device company pioneering the use of a real-time imaging platform for gastrointestinal applications, announced today that it has received U.S. Food and Drug Administration (FDA) 510(k) clearance to market its Real-time Targeting™ feature for its flagship product, the NvisionVLE ® Imaging System. In addition, the first procedures with this new system were performed at Beth Israel Deaconess Medical Center in Boston, Massachusetts. The NvisionVLE Imaging System employs proprietary Optical Coherence Tomography (OCT) technology allowing physicians to perform a Volumetric Laser Endomicroscopy (VLE) procedure that produces real-time, high-resolution cross-sectional images. This system enables gastroenterologists ...

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    22. NinePoint Medical Strengthens Sales Leadership by appointing John Temple as Vice President of Sales

      NinePoint Medical Strengthens Sales Leadership by appointing John Temple as Vice President of Sales

      NinePoint Medical, Inc., a transformative medical device company that is pioneering the clinical use of a real-time imaging platform based upon a proprietary optical coherence tomography (OCT) technology, announced today the appointment of John Temple as Vice President of Sales. Mr. Temple reports directly to NinePoint Medical’s President and CEO, Christopher R. von Jako, Ph.D. “We are delighted to welcome such an accomplished sales executive to the NinePoint Medical team. Not only does John bring tremendous commercial leadership experience, but also in-depth gastroenterology industry knowledge and relationships,” said Dr. von Jako. “John’s exceptional track record will be ...

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    23. Optical coherence tomography (OCT) prior to peroral endoscopic myotomy (POEM) reduces procedural time and bleeding: a multicenter international collaborative study

      Optical coherence tomography (OCT) prior to peroral endoscopic myotomy (POEM) reduces procedural time and bleeding: a multicenter international collaborative study

      Background Per-oral endoscopic myotomy (POEM) has emerged as an endoscopic treatment of achalasia. There are no pre-procedural imaging modalities to predict the safest and the most efficacious approach. Aim To evaluate the use of optimal coherence tomography (OCT) in providing a pre-procedural esophageal assessment. Methods Patients undergoing POEM from July 2013 to November 2015 were captured in a multicenter, international registry. Patients who underwent OCT pre-POEM (“OCT arm”) were compared to patients without pre-POEM OCT (“control arm”). OCT images were assessed for the degree of vascularity and the thickness of the circular muscular layer, and an approach was determined. Results ...

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    24. Spectrally encoded miniature endoscopic imaging probe

      Spectrally encoded miniature endoscopic imaging probe

      A spectrally encoded endoscopic probe having high resolution and small diameter comprising at least one flexible optical fiber; an energy source; a grating through which said energy is transmitted such that the energy spectrum is dispersed; a lens for focusing the dispersed energy spectrum onto a sample such that the impingement spot for each wavelength is a separate position on the sample, the wavelength spectrum defining a wavelength encoded axis; means for mechanically scanning the sample with focused energy in a direction perpendicular to the wavelength encoded axis; a means for receiving energy reflected from the sample; and, a means ...

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