GI Tract Imaging

for cancer detection, guidance of biopsy and surgical intervention, and assessment of ablative therapy

Overview:

Esophageal adenocarcinoma is one of the deadliest cancers with a 5 year survival rate of only about 11% and its prognosis is poor due to the late presentation of the symptoms. Several diseases (e.g., Barrett's esophagus) can lead to high risk of developing esophageal adenocarcinoma. Current screening procedure of four-quadrant biopsy is invasive and prone to sampling error. OCT is emerging as an enabling technology for noninvasive detection of esophageal abnormalities, such as Barrett's epithelium an dneoplasia, including abnormalities hidden below a normal looking squamous epithelium such as subsquamous Barrett's glands and even neoplasia which are not visible under standard GI endoscopy. As the less-invasive and pre-emptive treatment methods (such as RF ablation) is becoming a standard of care for treating early-stage upper GI neoplasia and for eliminating Barrett's epithelium, 3D OCT imaging technology along with an innovative balloon imaging catheter offers a means (and probably the only means currently available) to systematically survey the entire esophagus and assess the ablative treatment outcome.

Figure 1. OCT-Histology correlation of normal human esophageal tissue. (Click to enlarge and view detailed caption)

Figure 2. OCT-Histology correlation for subsquamous Barrett's epithelial (SBE) glands. (Click to enlarge and view detailed caption)

Figure 3. OCT-Histology correlation for esophageal adenocarcinoma. (Click to enlarge and view detailed caption)

Our research interests include:

  1. Development of an OCT imaging catheter of a very small diameter (~1 mm) but a diffraction-limited high resolution (~20 μm) at a large working distance (~10-12 mm) for systematic surveillance of the esophagus;
  2. Development of a double-lumen balloon catheter that can be interfaced with the OCT imaging catheter and a standard upper GI endoscope for systematic imaging of the esophagus;
  3. Clinical evaluation of the potential of OCT technology for GI cancer detection, guidance of biopsy and interventions, improvement of diagnostic yields, and assessment of ablative treatment outcomes.
  4. 3D animation illustration of ballon catheter system

    Animation 1. 3D animation illustration of ballon catheter system. (Click to play and view detailed caption)

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Figure 4. Representitave OCT balloon catheter images. (Click to enlarge and view detailed caption)

3D Animations:

Animation of pig esophagus OCT image <em>in vivo</em> Animation of Human esophagectomy specimen OCT image <em>ex vivo</em>

Animation 2. Animation of 3D esophageal imaging. (Click to play and view detailed caption)



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