Endoscopic optical coherence tomography angiography microvascular features associated with dysplasia in Barrett's esophagus (with video) - 19/08/17
Abstract |
Background and Aims |
Angiogenesis is associated with neoplastic progression of Barrett’s esophagus (BE). Volumetric optical coherence tomography angiography (OCTA) visualizes subsurface microvasculature without exogenous contrast agents. We investigated the association of OCTA microvascular features with low-grade dysplasia (LGD) and high-grade dysplasia (HGD).
Methods |
Fifty-two patients undergoing BE surveillance or endoscopic eradication therapies for dysplasia were imaged using volumetric OCTA and corresponding histologic diagnoses wre obtained to yield 97 data sets (nondysplastic BE [NDBE], 74; LGD, 10; HGD, 13). After evaluating OCTA image quality, 54 datasets (NDBE, 35; LGD, 8; HGD, 11) from 32 patients were used to develop a training and reading protocol. The association of abnormal vessel branching and heterogeneous vessel size with LGD/HGD and a regular honeycomb vessel pattern with NDBE were investigated.
Results |
Blinded OCTA reading of 41 OCTA datasets (NDBE, 27; LGD, 7; HGD, 7) was performed by readers with various levels of OCT/OCTA experience including 3 OCT trainees, 1 gastroenterologist, and 2 gastroenterology fellows. Among the 6 readers, OCTA features of abnormal vessel branching and heterogeneous vessel size had an overall 94% sensitivity (95% CI, 89-99) and 69% specificity (95% CI, 62-76) for differentiating LGD/HGD versus NDBE with a mean reading time of 45 seconds per data set and moderate (kappa = .58) interobserver agreement.
Conclusions |
Volumetric en face OCTA imaging enables rapid examination of depth resolved microvascular features with near-microscopic resolution. OCTA can visualize microvascular features associated with LGD/HGD with high accuracy, which motivates new technologic advances and future studies investigating the diagnostic performance of OCTA.
Le texte complet de cet article est disponible en PDF.Abbreviations : BE, CI, CLE, EAC, EET, HGD, LGD, NBI, NDBE, NPV, OCT, OCTA, VLE
Plan
| DISCLOSURE: The following authors received research support for this study from the National Institutes of Health: J.G. Fujimoto (grants R01-CA075289-19, R44-CA101067-05, R01-CA178636-04, R01-EY011289-30), H. Mashimo (grant R01-CA075289-19), M.G. Giacomelli (grant F32-CA183400); from the Air Force Office of Scientific Research: J.G. Fujimoto (grants FA9550-15-1-0473, FA9550-12-1-0499); and from the Agency for Science, Technology and Research (Singapore): K. Liang (graduate fellowship). In addition, the following authors disclosed financial relationships relevant to this publication: B. Potsaid: Employee of Thorlabs, Inc. J. G. Fujimoto: Royalties recipient from LightLab Imaging Inc, St. Jude Medical. All other authors disclosed no financial relationships relevant to this publication. |
Vol 86 - N° 3
P. 476 - septembre 2017 Retour au numéro
Article précédent
- A new aim for targeted biopsies in Barrett’s esophagus
- Cadman L. Leggett, Herbert C. Wolfsen
- Comparison of endoscopic submucosal tunneling dissection and thoracoscopic enucleation for the treatment of esophageal submucosal tumors
- Qing-yuan Li, Yan Meng, Yu-yuan Xu, Qiang Zhang, Jian-qun Cai, Hao-xuan Zheng, Hai-tao Qing, Si-lin Huang, Ze-long Han, Ai-min Li, Ying Huang, Ya-li Zhang, Fa-chao Zhi, Rui-jun Cai, Yue Li, Wei Gong, Si-de Liu
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?