High-resolution imaging of the human esophagus and stomach in vivo using optical coherence tomography

Background: Optical coherence tomography is a new, high spatial-resolution, cross-sectional imaging technique. We investigated the ability of optical coherence tomography to provide detailed images of subsurface structures in the upper gastrointestinal (GI) tract. Methods: Optical coherence tomography was performed during routine upper GI endoscopy on 32 patients including 20 patients with Barrett's esophagus. A n endoscopic mucosal biopsy was obtained immediately after imaging and was used for histopathologic correlation. Results: Optical coherence tomography provided clear delineation of layers of the normal human esophagus extending from the epithelium to the longitud inal muscularis propria. Gastric mucosa was differentiated from esophageal mucosa, Barrett's esophagus was differentiated from normal esophageal mucos a, and esophageal adenocarcinoma was distinguished from normal esophagus an d Barrett's esophagus. Conclusions: Optical coherence tomography allows visualization of the subsu rface architectural morphology of the upper GI tract. The diagnostic inform ation provided by this new imaging modality suggests that it may be a usefu l adjunct to endoscopy.