Abstract
Microwave ablation is a minimally invasive image guided thermal therapy for cancer that can be adapted to endoscope use in the gastrointestinal (GI) tract. Microwave ablation in the GI tract requires precise control over the ablation zone that could be guided by high resolution imaging with quantitative contrast. Optical coherence tomography (OCT) provides ideal imaging resolution and allows for the quantification of tissue scattering properties to characterize ablated tissue. Visible and near-infrared OCT image analysis demonstrated increased scattering coefficients (μs ) in ablated versus normal tissues (Vis: 347.8%, NIR: 415.0%) and shows the potential for both wavelength ranges to provide quantitative contrast. These data suggest OCT could provide quantitative image guidance and valuable information about antenna performance in vivo.
Highlights
Barrett’s esophagus (BE) is a premalignant lesion strongly associated with the development of esophageal adenocarcinoma, a cancer with a 5-year survival rate of less than 15% [1]
The visible light Optical coherence tomography (OCT) signal was completely attenuated by 300 μm into tissue, restricting images to the epithelial layer due to the increase in scattering at shorter wavelengths [36]
While the imaging depth is reduced in the visible system, there appears to be more contrast, suggesting a greater sensitivity to scattering
Summary
Barrett’s esophagus (BE) is a premalignant lesion strongly associated with the development of esophageal adenocarcinoma, a cancer with a 5-year survival rate of less than 15% [1]. Suspected lesions are evaluated with both endoscopy and endoscopic biopsy to diagnose the abnormal region as no dysplasia, low-grade dysplasia, high-grade dysplasia, or intramucosal carcinoma. In the case of high-grade dysplasia and intramucosal carcinoma, endoscopic resection is used to remove lesions followed by endoscopic radiofrequency ablation (RFA) to ensure total destruction of malignant tissue [2]. There has been high variability in RFA success rates for treatment of intestinal metaplasia or BE [3]. The eradication rates of high-grade dysplasia and intestinal metaplasia are lower than the eradication rate of low-grade dysplasia. The presence of buried of glands may result in recurrence and have been observed in patients after RFA treatment [4,5,6]. Better treatment outcomes will require improved ablation methods as well as depth-resolved quantitative imaging of ablation zones
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