1. Articles in category: Gastroenterology

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    1. NinePoint Medical Appoints Eman Namati, Ph.D., to Chief Executive Officer

      NinePoint Medical Appoints Eman Namati, Ph.D., to Chief Executive Officer

      NinePoint Medical, Inc, a transformative medical device company pioneering the use of Optical Coherence Tomography (OCT) for gastrointestinal applications, is pleased to announce the appointment of Eman Namati, Ph.D., to President and Chief Executive Officer. Dr. Namati succeeds Christopher von Jako, Ph.D., who will continue to serve on the Board of Directors as an independent member. Dr. Namati will assume day-to-day leadership at NinePoint Medical while working in collaboration with Merit Medical Systems Inc. (NASDAQ:MMSI), who now manages the sales distribution and customer service for the NvisionVLE®Imaging System. "With the recent strategic partnership NinePoint entered into ...

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    2. Optical Coherence Tomography for Barrett Esophagus

      Optical Coherence Tomography for Barrett Esophagus

      G&H Can you provide a brief overview of optical coherence tomography? VK Optical coherence tomography (OCT) is an advanced imaging technology that was developed in the 1990s. Its application in the endoscopic realm began in the late 1990s. Approximately 5 years ago, a second-generation, advanced OCT technology known as volumetric laser endomicroscopy (VLE; NvisionVLE Imaging System, NinePoint Medical) became available in the US market. Since then, VLE has been the main commercially available OCT-platform product approved by the US Food and Drug Administration for the purpose of advanced endoscopic imaging. The mechanism by which OCT technology works is by ...

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    3. Innovative Endoscopies to Be Clinically Used in the Near Future

      Innovative Endoscopies to Be Clinically Used in the Near Future

      In contrast to traditional single-lens endoscopies, recently introduced full-spectrum endoscopy (FUSE) scopes include multiple lenses providing a much wider field of view. In many studies, FUSE was shown to be feasible, effective, and safe, and FUSE colonoscopy yielded higher polyp (PDR), adenoma (ADR), and diverticular (DDR) detection rates than did traditional colonoscopy, without therapeutic failure or complications. Moreover, using FUSE gastroscopy, the prevalence of duodenal peri-ampullary diverticula (DPAD) in the general population could be analyzed without using ERCP. In the future, the next generation of modified FUSE system is expected to be useful in direct peroral cholangioscopy and in simultaneous ...

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    4. Gastrointestinal Endoscopy Editorial Board top 10 topics: advances in GI endoscopy in 2017

      Gastrointestinal Endoscopy Editorial Board top 10 topics: advances in GI endoscopy in 2017

      Much effort during the past 2 decades has focused on developing novel imaging techniques to enable real-time “optical biopsy” during endoscopy. The ASGE’s Preservation and Incorporation of Valuable Endoscopic Innovations initiative recommends appropriate thresholds for application of novel imaging, particularly narrow-band imaging, when trained endoscopists evaluate BE and small colon polyps.40,41 Although narrow-band imaging has been available in most endoscopy units for many years, its application for management of BE in routine practice is still unclear. In 2017, a retrospective analysis of BE detection before and after the institution of a novel imaging– directed biopsy program did ...

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    5. Multimodality endoscopic optical coherence tomography and fluorescence imaging technology for visualization of layered architecture and subsurface microvasculature

      Multimodality endoscopic optical coherence tomography and fluorescence imaging technology for visualization of layered architecture and subsurface microvasculature

      Endoscopic imaging technologies, such as endoscopic optical coherence tomography (OCT) and near-infrared fluorescence, have been used to investigate vascular and morphological changes as hallmarks of early cancer in the gastrointestinal tract. Here we developed a high-speed multimodality endoscopic OCT and fluorescence imaging system. Using this system, the architectural morphology and vasculature of the rectum wall were obtained simultaneously from a Sprague Dawley rat in vivo . This multimodality imaging strategy in a single imaging system permits the use of a single imaging probe, thereby improving prognosis by early detection and reducing costs.

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    6. NinePoint Medical, Inc. Enters Into A Strategic Partnership and Worldwide Distribution with Merit Medical Systems, Inc.

      NinePoint Medical, Inc. Enters Into A Strategic Partnership and Worldwide Distribution with Merit Medical Systems, Inc.

      NinePoint Medical, Inc., a transformative medical device company pioneering the use of Optical Coherence Tomography (OCT) for gastrointestinal applications, today announced a long-term strategic partnership with Merit Medical Systems, Inc. (NASDAQ: MMSI ). This partnership includes a strategic investment and a worldwide distribution agreement with Merit Medical’s endoscopic division, Merit Medical Endotek® (Endotek), for NinePoint Medical’s NvisionVLE® Imaging System with Real-time Targeting™. This partnership combines the world-class Gastrointestinal (GI) and Pulmonary medical devices from Endotek with the ground-breaking Advanced OCT platform from NinePoint Medical. This OCT platform has, in a short period of time, become a primary imaging device ...

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    7. Feasibility of Optical Coherence Tomography (OCT) for Intra-Operative Detection of Blood Flow during Gastric Tube Reconstruction

      Feasibility of Optical Coherence Tomography (OCT) for Intra-Operative Detection of Blood Flow during Gastric Tube Reconstruction

      In this study; an OCT-based intra-operative imaging method for blood flow detection during esophagectomy with gastric tube reconstruction is investigated. Change in perfusion of the gastric tube tissue can lead to ischemia; with a high morbidity and mortality as a result. Anastomotic leakage (incidence 5–20%) is one of the most severe complications after esophagectomy with gastric tube reconstruction. Optical imaging techniques provide for minimal-invasive and real-time visualization tools that can be used in intraoperative settings. By implementing an optical technique for blood flow detection during surgery; perfusion can be imaged and quantified and; if needed; perfusion can be improved ...

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    8. Feasibility of using optical coherence tomography to detect acute radiation-induced esophageal damage in small animal models

      Feasibility of using optical coherence tomography to detect acute radiation-induced esophageal damage in small animal models

      Lung cancer survival is poor, and radiation therapy patients often suffer serious treatment side effects. The esophagus is particularly sensitive leading to acute radiation-induced esophageal damage (ARIED). We investigated the feasibility of optical coherence tomography (OCT) for minimally invasive imaging of the esophagus with high resolution (10  μm) to detect ARIED in mice. Thirty mice underwent cone-beam computed tomography imaging for initial setup assessment and dose planning followed by a single-dose delivery of 4.0, 10.0, 16.0, and 20.0 Gy on 5.0-mm spots, spaced 10.0 mm apart in the esophagus. They were repeatedly imaged using ...

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    9. Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol

      Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol

      Background and Aims Volumetric laser endomicroscopy (VLE) is a new wide-field advanced imaging technology for Barrett’s esophagus (BE). No data exist on incremental yield of dysplasia detection. Our aim is to report the incremental yield of dysplasia detection in BE using VLE. Methods This is a retrospective study from a prospectively maintained database from 2011 to 2017 comparing the dysplasia yield of 4 different surveillance strategies in an academic BE tertiary care referral center. The groups were (1) random biopsies (RB), (2) Seattle protocol random biopsies (SP), (3) VLE without laser marking (VLE), and (4) VLE with laser marking ...

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    10. Optical coherence tomography-guided laser marking with tethered capsule endomicroscopy

      Optical coherence tomography-guided laser marking with tethered capsule endomicroscopy

      Tethered capsule endomicroscopy (TCE) is a new method for performing comprehensive microstructural OCT imaging of gastrointestinal (GI) tract in unsedated patients in a well-tolerated and cost-effective manner. These features of TCE bestow it with significant potential to improve the screening, surveillance and management of various upper gastrointestinal diseases. To achieve clinical adoption of this imaging technique, it is important to validate it with co-registered histology, the current diagnostic gold standard. One such method for co-registering OCT images with histology is laser cautery marking, previously demonstrated using a balloon-centering OCT catheter that operates in conjunction with sedated endoscopy. With laser marking ...

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    11. Quantifying optical properties with visible and near-infrared optical coherence tomography to visualize esophageal microwave ablation zones

      Quantifying optical properties with visible and near-infrared optical coherence tomography to visualize esophageal microwave ablation zones

      Microwave ablation is a minimally invasive image guided thermal therapy for cancer that can be adapted to endoscope use in the gastrointestinal (GI) tract. Microwave ablation in the GI tract requires precise control over the ablation zone that could be guided by high resolution imaging with quantitative contrast. Optical coherence tomography (OCT) provides ideal imaging resolution and allows for the quantification of tissue scattering properties to characterize ablated tissue. Visible and near-infrared OCT image analysis demonstrated increased scattering coefficients ( μ s ) in ablated versus normal tissues (Vis: 347.8%, NIR: 415.0%) and shows the potential for both wavelength ranges to ...

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    12. Automated detection of esophageal dysplasia in in vivo optical coherence tomography images of the human esophagus

      Automated detection of esophageal dysplasia in in vivo optical coherence tomography images of the human esophagus

      Catheter-based Optical Coherence Tomography (OCT) devices allow real-time and comprehensive imaging of the human esophagus. Hence, they provide the potential to overcome some of the limitations of endoscopy and biopsy, allowing earlier diagnosis and better prognosis for esophageal adenocarcinoma patients. However, the large number of images produced during every scan makes manual evaluation of the data exceedingly difficult. In this study, we propose a fully automated tissue characterization algorithm, capable of discriminating normal tissue from Barrett’s Esophagus (BE) and dysplasia through entire three-dimensional (3D) data sets, acquired in vivo. The method is based on both the estimation of the ...

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    13. Full depth measurement of tenofovir transport in rectal mucosa using confocal Raman spectroscopy and optical coherence tomography

      Full depth measurement of tenofovir transport in rectal mucosa using confocal Raman spectroscopy and optical coherence tomography

      The prophylactic activity of antiretroviral drugs applied as microbicides against sexually transmitted HIV is dependent upon their concentrations in infectable host cells. Within mucosal sites of infection (e.g., vaginal and rectal mucosa), those cells exist primarily in the stromal layer of the tissue. Traditional pharmacokinetic studies of these drugs have been challenged by poor temporal and spatial specificity. Newer techniques to measure drug concentrations, involving Raman spectroscopy, have been limited by laser penetration depth into tissue. Utilizing confocal Raman spectroscopy (RS) in conjunction with optical coherence tomography (OCT), a new lateral imaging assay enabled concentration distributions to be imaged ...

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    14. Clinical Translation of Tethered Confocal Microscopy Capsule for Unsedated Diagnosis of Eosinophilic Esophagitis

      Clinical Translation of Tethered Confocal Microscopy Capsule for Unsedated Diagnosis of Eosinophilic Esophagitis

      Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level. To demonstrate imaging capabilities, we conducted a human pilot study (n = 17) on Eosinophilic Esophagitis (EoE) patients and healthy volunteers ...

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    15. Structural and functional optical coherence tomography imaging of the colon (Thesis)

      Structural and functional optical coherence tomography imaging of the colon  (Thesis)

      Colorectal cancer (CRC) remains the second deadliest cancer in the United States, despite steady reduction in mortality rate over the last three decades. Colonoscopy is the gold-standard screening modality with high sensitivity and specificity to mature polyps. However, the miss rate for small (< 5 mm) lesions is estimated to be as high as 26%. Because the five-year survival rate for CRC detected at the local stage is 90%, there is a clear need for a screening procedure that is sensitive to these small lesions. Optical coherence tomography (OCT) has become a major biomedical imaging modality since its invention in 1991 ...

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    16. Cycloid scanning for wide field optical coherence tomography endomicroscopy and angiography in vivo

      Cycloid scanning for wide field optical coherence tomography endomicroscopy and angiography in vivo

      Devices that perform wide field-of-view (FOV) precision optical scanning are important for endoscopic assessment and diagnosis of luminal organ disease such as in gastroenterology. Optical scanning for in vivo endoscopic imaging has traditionally relied on one or more proximal mechanical actuators, limiting scan accuracy and imaging speed. There is a need for rapid and precise two-dimensional (2D) microscanning technologies to enable the translation of benchtop scanning microscopies to in vivo endoscopic imaging. We demonstrate a new cycloid scanner in a tethered capsule for ultrahigh speed, side-viewing optical coherence tomography (OCT) endomicroscopy in vivo . The cycloid capsule incorporates two scanners: a ...

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    17. Optical coherence tomography in gastroenterology: a review and future outlook

      Optical coherence tomography in gastroenterology: a review and future outlook

      Optical coherence tomography (OCT) is an imaging technique optically analogous to ultrasound that can generate depth-resolved images with micrometer-scale resolution. Advances in fiber optics and miniaturized actuation technologies allow OCT imaging of the human body and further expand OCT utilization in applications including but not limited to cardiology and gastroenterology. This review article provides an overview of current OCT development and its clinical utility in the gastrointestinal tract, including disease detection/differentiation and endoscopic therapy guidance, as well as a discussion of its future applications.

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    18. Broadband rotary joint for high-speed ultrahigh-resolution endoscopic OCT imaging at 800  nm

      Broadband rotary joint for high-speed ultrahigh-resolution endoscopic OCT imaging at 800  nm

      We report the development of a broadband rotary joint for high-speed ultrahigh-resolution endoscopic optical coherence tomography (OCT) imaging in the 800 nm spectral range. This rotary joint features a pair of achromatic doublets in order to achieve broadband operation for a 3 dB bandwidth over 150 nm. The measured one-way throughput of the rotary joint is greater than 80%, while the fluctuation of the double-pass coupling efficiency during 360 deg rotation is less than ± 5 % ±5% at a near video-rate speed of 20 revolutions/s (rps). The rotary joint is used in conjunction with a diffractive-optics-based endoscope and 800 nm ...

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    19. Ultrahigh-speed endoscopic optical coherence tomography and angiography enables delineation of lateral margins of endoscopic mucosal resection: a case report

      Ultrahigh-speed endoscopic optical coherence tomography and angiography enables delineation of lateral margins of endoscopic mucosal resection: a case report

      Endoscopic mucosal resection (EMR) is a common technique for resecting dysplastic lesions in Barrett’s esophagus (BE), stomach, and colon, 1 but precise delineation of dysplastic margins before resection and verification of complete removal after resection remain challenging. 2 , 3 Endoscopic optical coherence tomography (OCT) enables three-dimensional visualization of tissue microstructure and is commercially available as Volumetric Laser Endomicroscopy (NinePoint Medical, Bedford, MA, USA). 4 , 5 We recently developed an ultrahigh-speed endoscopic OCT system which operates more than 10 times faster than commercial instruments, generating volumetric images with higher transverse resolution and voxel density. 6 , 7 This allows visualization of ...

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    20. Are we ready to move toward digital image interpretation in Barrett’s esophagus surveillance?

      Are we ready to move toward digital image interpretation in Barrett’s esophagus surveillance?

      In this issue of Gastrointestinal Endoscopy, Swager et al 1 deal with the issue of a novel technology for Barrett’s esophagus surveillance, reporting the performance of a computer-aided volumetric laser endomicroscopy (VLE) algorithm for early detection of high-grade dysplasia/esophageal adenocarcinoma (HGD/EAC) in Barrett’s esophagus (BE). The authors compared the performance of a computer-aided algorithm versus a clinical algorithm using VLE. Volumetric laser endomicroscopy is a novel advanced imaging technology able to capture esophageal wall images up to 3 mm below the mucosa with a 7-μ resolution in real time. The system consists of a disposable balloon ...

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    21. New Clinical Data Presented at the World Congress of Gastroenterology @ ACG 2017 Shows Increased Dysplasia Detection Using Volumetric Laser Endomicroscopy with Laser Marking

      New Clinical Data Presented at the World Congress of Gastroenterology @ ACG 2017 Shows Increased Dysplasia Detection Using Volumetric Laser Endomicroscopy with Laser Marking

      NinePoint Medical, Inc., a transformative medical device company pioneering the use of Optical Coherence Tomography (OCT) for gastrointestinal applications, today announced exciting new clinical data which was presented at the Plenary session at the World Congress of Gastroenterology @ the ACG 2017 in Orlando, FL. This data highlights clinical results achieved using the NvisionVLE ® Imaging System with Real-time Targeting™ - NinePoint Medical’s groundbreaking technology enabling Volumetric Laser Endomicroscopy (VLE) scanning of the esophagus and subsequent laser marking of concerning regions for pathological examination. Dr. Arvind Trindade and his colleagues from the Northwell Health System studied 369 consecutive patients that received endoscopic ...

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    22. Visibility of Fiducial Markers used for Image-Guided Radiation Therapy on Optical Coherence Tomography for Registration with CT: an Esophageal Phantom Study

      Visibility of Fiducial Markers used for Image-Guided Radiation Therapy on Optical Coherence Tomography for Registration with CT: an Esophageal Phantom Study

      Purpose Optical coherence tomography (OCT) is of interest to visualize microscopic esophageal tumor extensions to improve tumor delineation for radiation therapy (RT) planning. Fiducial marker placement is a common method to ensure target localization during planning and treatment. Visualization of these fiducial markers on OCT permits integrating OCT and computed tomography (CT) images used for RT planning via image registration. We studied the visibility of 13 (8 types) commercially available solid and liquid fiducial markers in OCT images at different depths using dedicated esophageal phantoms and evaluated marker placement depth in clinical practice. Materials and Methods We designed and fabricated ...

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    23. NinePoint Medical is featuring the NvisionVLE® Imaging System with Real-time Targeting™ at ACG 2017; Eight Scientific Abstracts to be Presented

      NinePoint Medical is featuring the NvisionVLE® Imaging System with Real-time Targeting™ at ACG 2017; Eight Scientific Abstracts to be Presented

      Visit us at ACG 2017! Booth #825 NinePoint Medical is featuring the NvisionVLE ® Imaging System with Real-time Targeting™ at ACG 2017; Eight Scientific Abstracts to be Presented NinePoint Medical, Inc., a transformative medical device company pioneering the use of an advanced imaging platform for gastrointestinal applications, today announced that new clinical data relating to its proprietary NvisionVLE ® Imaging System with Real-time Targeting™ will be presented at two upcoming major conferences. Seven clinical abstracts will be featured at the World Congress of Gastroenterology @ the ACG 2017 conference taking place October 13-18 in Orlando, FL, and one poster session will be presented ...

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