TY - JOUR
T1 - Clinical translation of tethered confocal microscopy capsule for unsedated diagnosis of eosinophilic esophagitis
AU - Tabatabaei, Nima
AU - Kang, Dongkyun
AU - Kim, Minkyu
AU - Wu, Tao
AU - Grant, Catriona N.
AU - Rosenberg, Mireille
AU - Nishioka, Norman S.
AU - Hesterberg, Paul E.
AU - Garber, John
AU - Yuan, Qian
AU - Katz, Aubrey J.
AU - Tearney, Guillermo J.
N1 - Funding Information:
This research was supported by the NIH National Institute of Diabetes and Digestive and Kidney Diseases grant (5R01DK091923, PI: G.J.T.) and NinePoint Medical (technology development). N.T. is thankful to the Natural Sciences and Engineering Research Council of Canada (NSERC) for award of a post-doctoral fellowship scholarship as well as Discovery Grant (RGPIN-2015-03666). M.K. is currently with Koyoung technology in South Korea. T.W. is currently with Amazon.
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level. To demonstrate imaging capabilities, we conducted a human pilot study (n = 17) on Eosinophilic Esophagitis (EoE) patients and healthy volunteers from which representative cases are presented and discussed. Results indicate that, compared to endoscopic biopsy, unsedated tethered capsule endomicroscopy obtains orders of magnitude more cellular information while successfully resolving characteristic tissue microscopic features such as stratified squamous epithelium, lamina propria papillae, intraepithelial eosinophils, and gastric cardia and body/fundic mucosa epithelia. Based on the major import of whole organ, cellular-level microscopy to obviate sampling error and the clear cost and convenience advantages of unsedated procedure, we believe that this tool has the potential to become a simpler and more effective device for diagnosing and monitoring the therapeutic response of EoE and other esophageal diseases.
AB - Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level. To demonstrate imaging capabilities, we conducted a human pilot study (n = 17) on Eosinophilic Esophagitis (EoE) patients and healthy volunteers from which representative cases are presented and discussed. Results indicate that, compared to endoscopic biopsy, unsedated tethered capsule endomicroscopy obtains orders of magnitude more cellular information while successfully resolving characteristic tissue microscopic features such as stratified squamous epithelium, lamina propria papillae, intraepithelial eosinophils, and gastric cardia and body/fundic mucosa epithelia. Based on the major import of whole organ, cellular-level microscopy to obviate sampling error and the clear cost and convenience advantages of unsedated procedure, we believe that this tool has the potential to become a simpler and more effective device for diagnosing and monitoring the therapeutic response of EoE and other esophageal diseases.
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U2 - 10.1038/s41598-018-20668-8
DO - 10.1038/s41598-018-20668-8
M3 - Article
C2 - 29422678
AN - SCOPUS:85041930423
SN - 2045-2322
VL - 8
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 2631
ER -