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Feasibility and safety of tethered capsule endomicroscopy in patients with Barrett’s esophagus in a multi-center study

Jing Dong, Catriona N Grant, B. Vuong, N. Nishioka, A. Gao, M. Beatty, Grace Baldwin, Aaron Bailargeon et al.

Clinical Gastroenterology and Hepatology, 2021

147 participants · 33 citations

Abstract

Background & Aims Tethered capsule endomicroscopy (TCE) involves swallowing small tethered pill that implements optical coherence tomography (OCT) imaging, procuring high resolution images of the whole esophagus. Here, we demonstrate and evaluate the feasibility and safety of TCE and a portable OCT imaging system in patients with Barrett’s esophagus (BE) in a multi-center (5-site) clinical study. Methods Untreated patients with BE as per endoscopic biopsy diagnosis were eligible to participate in the study. TCE procedures were performed in unsedated patients by either doctors or nurses. After the capsule was swallowed, the device continuously obtained 10-μm-resolution cross-sectional images as it traversed the esophagus. Following imaging, the device was withdrawn through mouth, and disinfected for subsequent reuse. BE lengths were compared to endoscopy findings when available. OCT-TCE images were compared to volumetric laser endomicroscopy (VLE) images from a patient who had undergone VLE on the same day as TCE. Results 147 patients with BE were enrolled across all sites. 116 swallowed the capsule (79%), 95/114 (83.3%) men and 21/33 (63.6%) women (p=0.01). High-quality OCT images were obtained in 104/111 swallowers (93.7%) who completed the procedure. The average imaging duration was 5.55±1.92 minutes. A blinded comparison of maximum extent of BE measured by OCT-TCE and EGD showed a strong correlation (r=0.77–0.79). OCT-TCE images were of similar quality to those obtained…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 147 participants or records.

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