In the esophagus, repeated exposure to stomach acid caused by gastric reflux can transform a portion of esophageal tissue into stomach-like cells. This condition, known as Barrett’s esophagus, carries an elevated risk for the development of esophageal adenocarcinoma. Optical coherence tomography (OCT) can produce high-resolution cross-sectional images of the esophagus, revealing the presence and location of any BE. To image the esophagus, a fiber optic probe must be deployed. We have recently developed a 3D-printed probe that attaches to an endoscope to allow an endoscopist to obtain OCT images from any areas of interest seen during a typical endoscopic imaging procedure.
While a map of BE is useful information on its own, the key to surveillance of BE is detecting dysplasia, a precancerous transformation. Dysplastic tissue is typically characterized by enlarged nuclei and is thus scatter light at different angles compared to normal-sized nuclei. Our lab has developed another coherence-domain (depth-sensitive) optical method for measuring nuclear size using the angular profile of light scattering known as angle-resolved Low-Coherence Interformetry (a/LCI). In the past, we have shown that a/LCI can detect esophageal dysplasia in a standalone probe. We are now integrating a/LCI technology with our recently developed 3D printed paddle probes to provide a reading on dysplasia, as well as OCT images of Barrett’s esophagus, during a single procedure. And because the current standard therapy for dysplasia is radiofrequency ablation using a different paddle-shaped endoscopic attachment, our imaging and detection probe could one day be combined with a therapeutic modality as well.