The team assessed the sensitivity and specificity of optical coherence tomography (OCT), an imaging technique that produces high-resolution cross-sectional in vivo images, for diagnosing specialized intestinal metaplasia (SIM).
They have reported their findings in this month's issue of Gastroenterology.
OCT was used to image the stomach and esophagus of 121 patients. A total of 288 biopsy-correlated OCT images were acquired.
The researchers formulated OCT criteria for SIM by analyzing 75 images of SIM. Applying them to images of gastric, squamous, SIM, and cardiac epithelium retrospectively tested the SIM image criteria. The criteria were subsequently tested prospectively to determine the sensitivity and specificity of OCT for diagnosing SIM.
The OCT images of SIM were characterized by the following:
(1) Absence of the layered structure of normal squamous epithelium and the vertical "pit and crypt" morphology of gastric mucosa.
(2) Disorganized architecture with inhomogeneous tissue contrast and an irregular mucosal surface.
(3) Presence of submucosal glands.
OCT criteria for specialized intestinal metaplasia:
- Retrospectively 100% sensitive, 93% specific
- Prospectively 97% sensitive, 92% specific
When applied retrospectively, these criteria were found to be 100% sensitive and 93% specific for SIM. When tested prospectively they were 97% sensitive and 92% specific.
Dr John Poneros concluded on behalf of the group that, "OCT is highly sensitive and specific for SIM and may aid in the diagnosis and surveillance of this preneoplastic lesion."