Optical coherence tomography: Advanced technology for the endoscopic imaging of Barrett's esophagus

X. D. Li, S. A. Boppart, J. Van Dam, H. Mashimo, M. Mutinga, W. Drexler, M. Klein, C. Pitris, M. L. Krinsky, M. E. Brezinski, J. G. Fujimoto

Research output: Contribution to journalArticlepeer-review

221 Scopus citations


Background and study aims: Endoscopic optical coherence tomography (OCT) is an emerging medical technology capable of generating high-resolution cross -sectional imaging of tissue microstructure in situ and in real time. We assess the use and feasibility of OCT for real-time screening and diagnosis of Barrett's esophagus, and also review state-of-the-art OCT technology for endoscopic imaging. Materials and methods: OCT imaging was performed as an adjunt to endoscopic imaging of the human esophagus. Real-time OCT (13-μm resolution) was used to perform image-guided evaluation of normal esophagus and Barrett's esophagus. Beam delivery was accomplished with a 1-mm diameter OCT catheter-probe that can be introduced into the accessory channel of a standard endoscope. Different catheter-probe imaging designs which performed linear and radial scanning were assessed. Novel ultrahigh-resolution (1.1-μm resolution) and spectroscopic OCT techniques were used to image in vitro specimens of Barrett's esophagus. Results: Endoscopic OCT images revealed distinct layers of normal human esophagus extending from the epithelium to the muscularis propria. In contrast, the presence of gland- and crypt-like morphologies and the absence of layered structures were observed in Barrett's esophagus. All OCT images showed strong correlations with architectural morphology in histological findings. Ultrahigh-resolution OCT techniques achieved 1.1-μm image resolution in in vitro specimens and showed enhanced resolution of architectural features. Spectroscopic OCT identified localized regions of wavelength-dependent optical scattering, enhancing the differentiation of Barrett's esophagus. Conclusions: OCT technology with compact fiberoptic imaging probes can be used as an adjunct to endoscopy for real-time image-guided evaluation of Barrett's esophagus. Linear and radial scan patterns have different advantages and limitations depending upon the application. Ultrahigh-resolution and spectroscopic OCT techniques improve structural tissue recognition and suggest future potential for resolution and contrast enhancements in clinical studies. A new balloon catheter-probe delivery device is proposed for systematic imaging and screening of the esophagus.

Original languageEnglish (US)
Pages (from-to)921-930
Number of pages10
Issue number12
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology


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