Background
Volumetric laser endomicroscopy (VLE) produces high-resolution, cross-sectional surface,
and subsurface images for detecting neoplasia, targeting biopsies, and guiding real-time
treatment.
Objective
To evaluate the safety and feasibility of the Nvision VLE system.
Design
Prospective, multicenter study.
Setting
Tertiary-care medical centers.
Patients
One hundred patients with suspected Barrett’s esophagus, including 52 patients with
prior endotherapy.
Interventions
The first-generation Nvision VLE Imaging System, a balloon-centered, rotating optical
probe provided images of the mucosa and submucosa through a 6-cm segment length and
360° scan of the distal esophagus.
Main Outcome Measurements
Acquisition of a complete, 6-cm scan from the distal esophagus, demographic and procedural
data, and final histologic diagnosis.
Results
VLE imaging was successfully performed in 87 cases. After VLE imaging, biopsy specimens
were obtained in 77 patients and mucosal resection was performed in 20 patients. The
final pathologic diagnoses of the patients studied were adenocarcinoma (4 patients),
high-grade dysplasia (10 patients), low-grade dysplasia (11 patients), indefinite
(5 patients), intestinal metaplasia (29 patients), and normal squamous cells (18 patients).
VLE was not completed in 13 of 100 (13%) because of optical probe and console issues.
There were 2 minor adverse events (mucosal lacerations not requiring therapy).
Limitations
This was a feasibility study with a first-generation device. There was no direct histopathologic
correlation with the VLE images or any comparative analysis with white-light endoscopy
or narrow-band imaging findings.
Conclusion
VLE is a safe procedure for patients with suspected or confirmed Barrett’s esophagus.
Real-time VLE images enabled visualization of the mucosa and submucosa in 87% of cases.
Further studies are needed to evaluate the in vivo diagnostic accuracy and clinical
utility of VLE.
Abbreviations:
BE (Barrett's esophagus), CLE (confocal laser endomicroscopy), OCT (optical coherence tomography), OFDI (optical frequency domain imaging), VLE (volumetric laser endomicroscopy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 05, 2015
Accepted:
March 18,
2015
Received:
June 27,
2014
Footnotes
DISCLOSURE: Study funding, including volumetric laser endomicroscopy imaging consoles and optical probes, was provided by NinePoint Medical (Cambridge, Mass). H. Wolfsen receives research support fromOlympus IncandNinePoint Medical. He is a consultant for CSA Medical, Mauna Kea Technologies, Covidien, and Fuji Film. P. Sharma receives grant funding fromCook Medical,CDx Laboratories,NinePoint Medical, andOlympus Inc. G. Tearney receives research support fromiLumen MedicalandNinePoint Medical. He is a consultant for NinePoint Medical and Samsung. Massachusetts General Hospital has a licensing arrangement with NinePoint Medical. G. Tearney has the rights to receive royalties from this licensing arrangement. M. Wallace receives research funding fromOlympus,Boston Scientific, andNinePoint Medical. K. Wang receives research support fromNinePoint Medical,CSA Medical,Fujinon, andCDx Diagnosticsand is on the advisory boards for NinePoint Medical and CDx Diagnostics. K. Wangreceived research support fromCovidien(Barrx) completed within the past 12 months. Mayo Clinic does not endorse any specific products, advertisers, or services included in this material.
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
