Gone Fishing For Barrett’s Oesophagus

In short

A new pill-sized device provides rapid, detailed imaging of the oesophageal lining, outperforming endoscopy as a diagnostic tool in spotting Barrett’s Oesophagus.

Background 

We’ve covered these so-called “pill-cams” quite extensively, notably the eponymous offering from Israeli company Given Imaging. Now researchers at the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH) have developed a system specific to the Oesophagus which promises to not only provide extremely accurate imaging, but is also quicker than a traditional endocopy and preferred by patients.

The technology is called Optical Frequency Domain Imaging (OFDI) and utilises a rapidly rotating laser tip emitting a beam of near-infrared light and sensors that record light reflected back from the oesophageal lining. Unlike some other invesigators into “pill-cam” devices, the effort here has gone into the imaging rather than the navigation, the capsule being tethered for retraction and retrieval rather than steerable or otherwise powered. That of course limits its use to the Oesophagus, but if the results are as good as the publication in Nature Medicine suggest, it’s doing it’s job.

The study involved 13 unsedated participants, six known to have Barrett’s Oesophagus and seven healthy volunteers. The physicians operating the system were able to image the entire oesophagus in less than a minute with a procedure involving four passes being completed in around six minutes, significantly less than the 90 minutes a traditional endoscopy can typically take.

Unlike the superficial view gained by a visual endoscopy, the detailed microscopic images produced by the OFDI system revealed subsurface structures and clearly distinguished the cellular changes that signify Barrett’s Oesophagus.

Study participants who had previously undergone endoscopy indicated they preferred the new procedure.

Physician comments

“This system gives us a convenient way to screen for Barrett’s that doesn’t require patient sedation, a specialized setting and equipment, or a physician who has been trained in endoscopy,” says Gary Tearney, MD, PhD, of the Wellman Center and the MGH Pathology Department, corresponding author of the report receiving online publication in Nature Medicine. “By showing the three-dimensional, microscopic structure of the esophageal lining, it reveals much more detail than can be seen with even high-resolution endoscopy.”

Source: Fierce Medical Devices, Nature Medicine

 

 

 

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