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Gastroenterology Research and Practice
Volume 2012, Article ID 684832, 8 pages
http://dx.doi.org/10.1155/2012/684832
Clinical Study

Comparison of Tissue Architectural Changes between Radiofrequency Ablation and Cryospray Ablation in Barrett’s Esophagus Using Endoscopic Three-Dimensional Optical Coherence Tomography

1Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
2Gastroenterology Section, VA Boston Healthcare System, Boston, MA 02130, USA
3Harvard Medical School, Boston, MA 02115, USA
4LightLab Imaging Inc.-St. Jude Medical Inc., Westford, MA 01886, USA

Received 10 March 2012; Revised 8 May 2012; Accepted 8 May 2012

Academic Editor: Mohammad Ahmad Al-Shatouri

Copyright © 2012 Tsung-Han Tsai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Two main nonsurgical endoscopic approaches for ablating dysplastic and early cancer lesions in the esophagus have gained popularity, namely, radiofrequency ablation (RFA) and cryospray ablation (CSA). We report a uniquely suited endoscopic and near-microscopic imaging modality, three-dimensional (3D) optical coherence tomography (OCT), to assess and compare the esophagus immediately after RFA and CSA. The maximum depths of architectural changes were measured and compared between the two treatment groups. RFA was observed to induce 230~260 μm depth of architectural changes after each set of ablations over a particular region, while CSA was observed to induce edema-like spongiform changes to ~640 μm depth within the ablated field. The ability to obtain micron-scale depth-resolved images of tissue structural changes following different ablation therapies makes 3D-OCT an ideal tool to assess treatment efficacy. Such information could be potentially used to provide real-time feedback for treatment dosing and to identify regions that need further retreatment.