Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy

Dong Kyun Kang, Melissa J. Suter, Caroline Boudoux, Hongki Yoo, Patrick S. Yachimski, William P. Puricelli, Norman S. Nishioka, Mari Mino-Kenudson, Gregory Y. Lauwers, Brett E. Bouma, Guillermo J. Tearney

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Abstract

Background: Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique that has the potential to be used for acquiring comprehensive images of the entire distal esophagus endoscopically with subcellular resolution. Objective: The goal of this study was to demonstrate large-area SECM in upper GI tissues and to determine whether the images contain microstructural information that is useful for pathologic diagnosis. Design: A feasibility study. Setting: Gastrointestinal Unit, Massachusetts General Hospital. Patients: Fifty biopsy samples from 36 patients undergoing routine EGD were imaged by SECM, in their entirety, immediately after their removal. Results: The microstructure seen in the SECM images was similar to that seen by histopathology. Gastric cardia mucosa was clearly differentiated from squamous mucosa. Gastric fundic/body type mucosa showed more tightly packed glands than gastric cardia mucosa. Fundic gland polyps showed cystically dilated glands lined with cuboidal epithelium. The presence of intraepithelial eosinophils was detected with the cells demonstrating a characteristic bilobed nucleus. Specialized intestinal metaplasia was identified by columnar epithelium and the presence of goblet cells. Barrett's esophagus (BE) with dysplasia was differentiated from specialized intestinal metaplasia by the loss of nuclear polarity and disorganized glandular architecture. Limitations: Ex vivo, descriptive study. Conclusions: Large-area SECM images of gastroesophageal biopsy samples enabled the visualization of both subcellular and architectural features of various upper GI mucosal types and were similar to the corresponding histopathologic slides. These results suggest that the development of an endoscopic SECM probe is merited.

Original languageEnglish
Pages (from-to)35-43
Number of pages9
JournalGastrointestinal Endoscopy
Volume71
Issue number1
DOIs
StatePublished - 2010 Jan 1

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Confocal Microscopy
Biopsy
Cardia
Metaplasia
Gastric Mucosa
Mucous Membrane
Epithelium
Somatotypes
Goblet Cells
Barrett Esophagus
Feasibility Studies
Polyps
Eosinophils
General Hospitals
Esophagus
Stomach

Cite this

Kang, D. K., Suter, M. J., Boudoux, C., Yoo, H., Yachimski, P. S., Puricelli, W. P., ... Tearney, G. J. (2010). Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy. Gastrointestinal Endoscopy, 71(1), 35-43. https://doi.org/10.1016/j.gie.2009.08.026
Kang, Dong Kyun ; Suter, Melissa J. ; Boudoux, Caroline ; Yoo, Hongki ; Yachimski, Patrick S. ; Puricelli, William P. ; Nishioka, Norman S. ; Mino-Kenudson, Mari ; Lauwers, Gregory Y. ; Bouma, Brett E. ; Tearney, Guillermo J. / Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy. In: Gastrointestinal Endoscopy. 2010 ; Vol. 71, No. 1. pp. 35-43.
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abstract = "Background: Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique that has the potential to be used for acquiring comprehensive images of the entire distal esophagus endoscopically with subcellular resolution. Objective: The goal of this study was to demonstrate large-area SECM in upper GI tissues and to determine whether the images contain microstructural information that is useful for pathologic diagnosis. Design: A feasibility study. Setting: Gastrointestinal Unit, Massachusetts General Hospital. Patients: Fifty biopsy samples from 36 patients undergoing routine EGD were imaged by SECM, in their entirety, immediately after their removal. Results: The microstructure seen in the SECM images was similar to that seen by histopathology. Gastric cardia mucosa was clearly differentiated from squamous mucosa. Gastric fundic/body type mucosa showed more tightly packed glands than gastric cardia mucosa. Fundic gland polyps showed cystically dilated glands lined with cuboidal epithelium. The presence of intraepithelial eosinophils was detected with the cells demonstrating a characteristic bilobed nucleus. Specialized intestinal metaplasia was identified by columnar epithelium and the presence of goblet cells. Barrett's esophagus (BE) with dysplasia was differentiated from specialized intestinal metaplasia by the loss of nuclear polarity and disorganized glandular architecture. Limitations: Ex vivo, descriptive study. Conclusions: Large-area SECM images of gastroesophageal biopsy samples enabled the visualization of both subcellular and architectural features of various upper GI mucosal types and were similar to the corresponding histopathologic slides. These results suggest that the development of an endoscopic SECM probe is merited.",
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Kang, DK, Suter, MJ, Boudoux, C, Yoo, H, Yachimski, PS, Puricelli, WP, Nishioka, NS, Mino-Kenudson, M, Lauwers, GY, Bouma, BE & Tearney, GJ 2010, 'Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy', Gastrointestinal Endoscopy, vol. 71, no. 1, pp. 35-43. https://doi.org/10.1016/j.gie.2009.08.026

Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy. / Kang, Dong Kyun; Suter, Melissa J.; Boudoux, Caroline; Yoo, Hongki; Yachimski, Patrick S.; Puricelli, William P.; Nishioka, Norman S.; Mino-Kenudson, Mari; Lauwers, Gregory Y.; Bouma, Brett E.; Tearney, Guillermo J.

In: Gastrointestinal Endoscopy, Vol. 71, No. 1, 01.01.2010, p. 35-43.

Research output: Contribution to journalArticle

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T1 - Comprehensive imaging of gastroesophageal biopsy samples by spectrally encoded confocal microscopy

AU - Kang, Dong Kyun

AU - Suter, Melissa J.

AU - Boudoux, Caroline

AU - Yoo, Hongki

AU - Yachimski, Patrick S.

AU - Puricelli, William P.

AU - Nishioka, Norman S.

AU - Mino-Kenudson, Mari

AU - Lauwers, Gregory Y.

AU - Bouma, Brett E.

AU - Tearney, Guillermo J.

PY - 2010/1/1

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N2 - Background: Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique that has the potential to be used for acquiring comprehensive images of the entire distal esophagus endoscopically with subcellular resolution. Objective: The goal of this study was to demonstrate large-area SECM in upper GI tissues and to determine whether the images contain microstructural information that is useful for pathologic diagnosis. Design: A feasibility study. Setting: Gastrointestinal Unit, Massachusetts General Hospital. Patients: Fifty biopsy samples from 36 patients undergoing routine EGD were imaged by SECM, in their entirety, immediately after their removal. Results: The microstructure seen in the SECM images was similar to that seen by histopathology. Gastric cardia mucosa was clearly differentiated from squamous mucosa. Gastric fundic/body type mucosa showed more tightly packed glands than gastric cardia mucosa. Fundic gland polyps showed cystically dilated glands lined with cuboidal epithelium. The presence of intraepithelial eosinophils was detected with the cells demonstrating a characteristic bilobed nucleus. Specialized intestinal metaplasia was identified by columnar epithelium and the presence of goblet cells. Barrett's esophagus (BE) with dysplasia was differentiated from specialized intestinal metaplasia by the loss of nuclear polarity and disorganized glandular architecture. Limitations: Ex vivo, descriptive study. Conclusions: Large-area SECM images of gastroesophageal biopsy samples enabled the visualization of both subcellular and architectural features of various upper GI mucosal types and were similar to the corresponding histopathologic slides. These results suggest that the development of an endoscopic SECM probe is merited.

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