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Tethered capsule endomicroscopy for microscopic imaging of the esophagus, stomach, and duodenum without sedation in humans (with video)
- Source :
- Gastrointestinal Endoscopy, Gastrointestinal Endoscopy, Elsevier, 2018, 88 (5), pp.830-840.e3. ⟨10.1016/j.gie.2018.07.009⟩, Gastrointest Endosc
- Publication Year :
- 2018
- Publisher :
- HAL CCSD, 2018.
-
Abstract
- Patients with many different digestive diseases undergo repeated EGDs throughout their lives. Tethered capsule endomicroscopy (TCE) is a less-invasive method for obtaining high-resolution images of the GI mucosa for diagnosis and treatment planning of GI tract diseases. In this article, we present our results from a single-center study aimed at testing the safety and feasibility of TCE for imaging the esophagus, stomach, and duodenum.After being swallowed by a participant without sedation, the tethered capsule obtains cross-sectional, 10 μm-resolution, optical coherence tomography images as the device traverses the alimentary tract. After imaging, the device is withdrawn through the mouth, disinfected, and reused. Safety and feasibility of TCE were tested, focusing on imaging the esophagus of healthy volunteers and patients with Barrett's esophagus (BE) and the duodenum of healthy volunteers. Images were compared with endoscopy and histopathology findings when available.Thirty-eight patients were enrolled. No adverse effects were reported. The TCE device swallowing rate was 34 of 38 (89%). The appearance of a physiologic upper GI wall, including its microscopic pathology, was visualized with a tissue coverage of 85.4% ± 14.9% and 90.3% ± 6.8% in the esophagus of BE patients with and without endoscopic evidence of a hiatal hernia, respectively, as well as 84.8% ± 7.4% in the duodenum. A blinded comparison of TCE and endoscopic BE measurements showed a strong to very strong correlation (r = 0.7-0.83; P .05) for circumferential extent and a strong correlation (r = 0.77-0.78; P .01) for maximum extent (Prague classification). TCE interobserver correlation was very strong, at r = 0.92 and r = 0.84 (P .01), for Prague classification circumferential (C) and maximal (M) length measurements, respectively.TCE is a safe and feasible procedure for obtaining high-resolution microscopic images of the upper GI tract without endoscopic assistance or sedation.
- Subjects :
- Male
Pilot Projects
01 natural sciences
Capsule Endoscopy
Cohort Studies
Upper Gastrointestinal Tract
0302 clinical medicine
Endoscopy, Digestive System
Intestinal Mucosa
ComputingMilieux_MISCELLANEOUS
medicine.diagnostic_test
Stomach
Gastroenterology
Middle Aged
Healthy Volunteers
3. Good health
medicine.anatomical_structure
[PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph]
030211 gastroenterology & hepatology
Female
Radiology
Tomography, Optical Coherence
Adult
medicine.medical_specialty
Duodenum
Sensitivity and Specificity
Article
010309 optics
Hiatal hernia
03 medical and health sciences
Esophagus
Swallowing
0103 physical sciences
medicine
Endomicroscopy
[INFO.INFO-IM]Computer Science [cs]/Medical Imaging
Humans
Radiology, Nuclear Medicine and imaging
Chi-Square Distribution
business.industry
medicine.disease
Endoscopy
Gastric Mucosa
Barrett's esophagus
Linear Models
[SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic
Feasibility Studies
business
Subjects
Details
- Language :
- English
- ISSN :
- 00165107
- Database :
- OpenAIRE
- Journal :
- Gastrointestinal Endoscopy, Gastrointestinal Endoscopy, Elsevier, 2018, 88 (5), pp.830-840.e3. ⟨10.1016/j.gie.2018.07.009⟩, Gastrointest Endosc
- Accession number :
- edsair.doi.dedup.....c30dd26f96c7acd60fffc14ac9a55c18
- Full Text :
- https://doi.org/10.1016/j.gie.2018.07.009⟩