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Optical coherence tomography for the staging of tumor infiltration in superficial esophageal squamous cell carcinoma

Published:March 22, 2010DOI:https://doi.org/10.1016/j.gie.2009.11.052

      Background

      Optical coherence tomography (OCT) is a noninvasive technology that can produce high-resolution cross-sectional images in real-time without acoustic coupling, enabling precise assessment of tumor invasion in superficial esophageal squamous cell carcinomas (SESCCs).

      Objective

      To elucidate the usefulness of in vivo OCT for the staging of SESCCs.

      Design

      A single-center, prospective study in 2 phases: phase I to establish the OCT criteria classified into 3 categories (epithelium or lamina propria mucosa [EP/LPM], muscularis mucosa [MM], submucosa [SM]) and phase II to evaluate these criteria.

      Setting

      An academic medical center.

      Patients

      Sixty-two patients with a histological diagnosis of SESCC by routine endoscopy. In the phase I study, 35 images from 16 patients were used. In the phase II study, 109 images from 46 subsequent consecutive patients enrolled from January 2007 to May 2009 were used.

      Interventions

      We performed OCT for preoperative staging followed by endoscopic submucosal dissection or a surgical procedure and compared precisely the visualized OCT sites with the corresponding tissue sections.

      Main Outcome Measurements

      The accuracy of OCT for the staging.

      Results

      The overall accuracy rate was 92.7% (EP/LPM, 94.9%; MM, 85.0%; SM, 90.9%). The OCT signal penetration depth was sufficient to depict the boundary of the deepest region of cancer, the thickness of which was less than 1.5 mm.

      Limitations

      The small number of patients.

      Conclusions

      To our knowledge, this is the first study demonstrating that OCT might be useful for the preoperative staging of SESCCs with a high degree of accuracy.

      Abbreviations:

      EP (confined to epithelium), ER (endoscopic resection), LPM (invading lamina propria mucosa), MM (invading muscularis mucosa), OCT (optical coherence tomography), SESCC (superficial esophageal squamous cell carcinoma), SM (invading submucosa)
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