Abstract
(1) Background: Barrett’s esophagus (BE) is a complication of chronic gastroesophageal reflux disease and is a precursor to esophageal adenocarcinoma. The clinical implication of subsurface glandular structures of Barrett’s esophagus is not well understood. Optical coherence tomography (OCT), also known as volumetric laser endomicroscopy (VLE), can assess subsurface glandular structures, which appear as subsurface hyposcattering structures (SHSs). The aim of this study is to develop a computer-aided algorithm and apply it to investigate the characteristics of SHSs in BE using clinical VLE data; (2) Methods: SHSs were identified with an initial detection followed by machine learning. Comprehensive SHS characteristics including the number, volume, depth, size and shape were quantified. Clinical VLE datasets collected from 35 patients with a history of dysplasia undergoing BE surveillance were analyzed to study the general SHS distribution and characteristics in BE. A subset of radiofrequency ablation (RFA) patient data were further analyzed to investigate the pre-RFA SHS characteristics and post-RFA treatment response; (3) Results: SHSs in the BE region were significantly shallower, more vertical, less eccentric, and more regular, as compared with squamous SHSs. SHSs in the BE region which became neosquamous epithelium after RFA were shallower than those in the regions that remained BE. Pre-ablation squamous SHSs with higher eccentricity correlated strongly with larger reduction of post-ablation BE length for less elderly patients; (4) Conclusions: The computer algorithm is potentially a valuable tool for studying the roles of SHSs in BE.
Highlights
Barrett’s esophagus (BE), a complication of chronic gastroesophageal reflux disease, and in which the normal squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium, is associated with an increased risk of esophageal carcinoma [1,2,3]
The automatically detected subsurface hyposcattering structures (SHSs) can be visualized in 2D and 3D
We found that the eccentricity of pre-ablation SHSs in the squamous region was strongly correlated with the reduction of BE length at follow-up (Table 4), but only for less elderly patients
Summary
Barrett’s esophagus (BE), a complication of chronic gastroesophageal reflux disease, and in which the normal squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium, is associated with an increased risk of esophageal carcinoma [1,2,3]. Sci. 2018, 8, 2420 is a widely used method to treat BE [1,3,4]. Multicenter clinical studies have demonstrated that RFA safely and effectively eradicates intestinal metaplasia and dysplasia [5]. Repeated RFA over multiple treatment sessions is usually required to achieve complete remission of intestinal metaplasia (CRIM) and there is recurrence of BE even after achieving CRIM [3]. Standard white light endoscopy visualizes only the esophageal surface, and is unable to discern deeper gland-like structures
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have