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Gora MJ, Simmons LH, Quénéhervé L, Grant CN, Carruth RW, Lu W, Tiernan A, Dong J, Walker-Corkery B, Soomro A, Rosenberg M, Metlay JP, Tearney GJ. Tethered capsule endomicroscopy: from bench to bedside at a primary care practice. J Biomed Opt 2016; 21:104001. [PMID: 27689919 PMCID: PMC5043371 DOI: 10.1117/1.jbo.21.10.104001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/12/2016] [Indexed: 05/23/2023]
Abstract
Due to the relatively high cost and inconvenience of upper endoscopic biopsy and the rising incidence of esophageal adenocarcinoma, there is currently a need for an improved method for screening for Barrett’s esophagus. Ideally, such a test would be applied in the primary care setting and patients referred to endoscopy if the result is suspicious for Barrett’s. Tethered capsule endomicroscopy (TCE) is a recently developed technology that rapidly acquires microscopic images of the entire esophagus in unsedated subjects. Here, we present our first experience with clinical translation and feasibility of TCE in a primary care practice. The acceptance of the TCE device by the primary care clinical staff and patients shows the potential of this device to be useful as a screening tool for a broader population.
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Affiliation(s)
- Michalina J. Gora
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115, United States
- Strasbourg University, CNRS, ICube Laboratory, 1 Place de l’Hopital, Strasbourg 67091, France
| | - Leigh H. Simmons
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115, United States
- Massachusetts General Hospital, Division of General Internal Medicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Lucille Quénéhervé
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Institut des Maladies de l’Appareil Digestif, CHU Nantes, Hôtel Dieu, place Alexis Ricordeau, Nantes 44000, France
| | - Catriona N. Grant
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Robert W. Carruth
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Weina Lu
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Aubrey Tiernan
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Jing Dong
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115, United States
| | - Beth Walker-Corkery
- Massachusetts General Hospital, Division of General Internal Medicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Amna Soomro
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Mireille Rosenberg
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115, United States
| | - Joshua P. Metlay
- Massachusetts General Hospital, Division of General Internal Medicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
| | - Guillermo J. Tearney
- Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115, United States
- Massachusetts General Hospital, Department of Pathology, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Harvard-MIT Division of Health Sciences Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, United States
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Ughi GJ, Gora MJ, Swager AF, Soomro A, Grant C, Tiernan A, Rosenberg M, Sauk JS, Nishioka NS, Tearney GJ. Automated segmentation and characterization of esophageal wall in vivo by tethered capsule optical coherence tomography endomicroscopy. Biomed Opt Express 2016; 7:409-19. [PMID: 26977350 PMCID: PMC4771459 DOI: 10.1364/boe.7.000409] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 05/18/2023]
Abstract
Optical coherence tomography (OCT) is an optical diagnostic modality that can acquire cross-sectional images of the microscopic structure of the esophagus, including Barrett's esophagus (BE) and associated dysplasia. We developed a swallowable tethered capsule OCT endomicroscopy (TCE) device that acquires high-resolution images of entire gastrointestinal (GI) tract luminal organs. This device has a potential to become a screening method that identifies patients with an abnormal esophagus that should be further referred for upper endoscopy. Currently, the characterization of the OCT-TCE esophageal wall data set is performed manually, which is time-consuming and inefficient. Additionally, since the capsule optics optimally focus light approximately 500 µm outside the capsule wall and the best quality images are obtained when the tissue is in full contact with the capsule, it is crucial to provide feedback for the operator about tissue contact during the imaging procedure. In this study, we developed a fully automated algorithm for the segmentation of in vivo OCT-TCE data sets and characterization of the esophageal wall. The algorithm provides a two-dimensional representation of both the contact map from the data collected in human clinical studies as well as a tissue map depicting areas of BE with or without dysplasia. Results suggest that these techniques can potentially improve the current TCE data acquisition procedure and provide an efficient characterization of the diseased esophageal wall.
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Affiliation(s)
- Giovanni J. Ughi
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Michalina J. Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- ICube, CNRS, Strasbourg University, France
| | - Anne-Fré Swager
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Amna Soomro
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Catriona Grant
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Aubrey Tiernan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Mireille Rosenberg
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Norman S. Nishioka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Harvard-MIT Division of Health Sciences Technology, Cambridge, MA, USA
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Gora MJ, Sauk JS, Carruth RW, Lu W, Carlton DT, Soomro A, Rosenberg M, Nishioka NS, Tearney GJ. Imaging the upper gastrointestinal tract in unsedated patients using tethered capsule endomicroscopy. Gastroenterology 2013; 145:723-5. [PMID: 23932950 PMCID: PMC3866798 DOI: 10.1053/j.gastro.2013.07.053] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Michalina J Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jenny S Sauk
- Department of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Robert W Carruth
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Weina Lu
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Drew T Carlton
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Amna Soomro
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Mireille Rosenberg
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Norman S Nishioka
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Harvard-MIT Health Sciences and Technology, Cambridge, Massachusetts, USA,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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