Oesophageal histology without a biopsy

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 ...