Imaging Pod Highlights Details of Esophageal Lining

The capsule is attached to a tether that connects to the imaging console, allowing health professionals to control the system. After the capsule is swallowed by a patient, it is carried down the esophagus by normal contraction of the surrounding muscles. When the capsule reaches the entrance to the stomach, it can be pulled back up by the tether.

OFDI images are taken throughout the capsule's transit down and up the esophagus by manipulating a plastic ball attached to the flexible tether, which controls the position of the endomicroscopy capsule in the patient's esophagus. The detailed microscopic images produced by the system reveal subsurface structures not easily seen with endoscopy, and clearly distinguish the cellular changes that signify Barrett's esophagus (BE). Current recommendations for use of the device are in screening of BE in patients with chronic, frequent heartburn or other symptoms of gastroesophageal reflux disease (GERD).

The researchers have tested the system in 13 unsedated participants, 6 known to have BE and 7 healthy volunteers. The physicians operating the system were able to image the entire esophagus in less than a minute, and a procedure involving four passes—two down the esophagus and two up—could be completed in around six minutes. Study participants who had previously undergone endoscopy indicated they preferred the new procedure. The study describing the OFDI endomicroscopy capsule was published online on January 14, 2013, in Nature Medicine.

“This system gives us a convenient way to screen for Barrett's that doesn't require patient sedation, a specialized setting and equipment, or a physician who has been trained in endoscopy,” said corresponding author Gary Tearney, MD, PhD, of the MGH Wellman Center for Photomedicine. “By showing the three-dimensional, microscopic structure of the esophageal lining, it reveals much more detail than can be seen with even high-resolution endoscopy.”

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