Oesophageal histology without a biopsy

and can be 97% sensitive and 92% specific for diagnosing specialised intestinal metaplasia.

By | February 7, 2001

Optical coherence tomography generates high-resolution images of tissue in vivo and can be 97% sensitive and 92% specific for diagnosing specialised intestinal metaplasia.

Patients with chronic gastroesophageal reflux disease can develop specialised intestinal metaplasia (SIM). This is a histological lesion that predisposes to adenocarcinoma of the oesophagus, and is currently diagnosed by endoscopy and biopsy. In the January Gastroenterology a team from Harvard Medical School suggest that a new method, optical coherence tomography (OCT), is a more reliable and sensitive technique for diagnosing SIM.

OCT can produce high-resolution (~10 μm) cross-sectional images of tissue in vivo without the need for a biopsy. The principle is analogous to ultrasonography, but OCT uses infrared light rather than acoustic energy and it can be performed through the instrument channel of a conventional endoscope.

John M. Poneros and colleagues studied 121 patients, acquiring a total of 288 biopsies that they then correlated with OCT images. Using these samples they have established the first OCT criteria for diagnosing SIM and demonstrate that these criteria are 100% sensitive and 93% specific when applied retrospectively and 97% sensitive and 92% specific when tested prospectively (Gastroenterology 2001, 120:7-12).


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