Screening of Barrett’s Esophagus (BE) for progression to esophageal adenocarcinoma with standard endoscopic biopsy is expensive, invasive, and imprecise due to sampling error and the limited value of histomorphology for predicting cancer risk. We have developed a technology called in vivo laser capture microdissection (IVLCM) that overcomes these issues by using OCT tethered capsule endomicroscopy (OCT-TCE) to image the entire esophagus at the microscopic level. Pilot clinical study results show that IVLCM samples provide sufficient DNA material for genetic sequencing. The comparison of sequencing quality and gene mapping of IVLCM samples and conventional FFPE biopsy samples will be analyzed in the ongoing clinical study.
In our first clinical experience, we have found that Retrograde Tethered Capsule Endomicroscopy (R-TCE) was able to be advanced ~ 30 cm in 3 minutes in the colon of an unsedated study subject. R-TCE imaging enabled full circumferential OCT visualization of 96.60 ± 0.22 (95% CI) of the human colon wall. 3D rendered flythroughs of R-TCE OCT images demonstrate comprehensive visualization behind colonic folds where pre-neoplastic lesions may be missed by colonoscopy. The R-TCE procedure was well-tolerated, there were no complications, and a sigmoidoscopy conducted after the procedure did not show any R-TCE-related mucosal damage.
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