Evaluation of a novel forward-looking optical coherence tomography probe for endoscopic applications: an ex vivo...

As a result of recent advances in the development of small microelectromechanical system mirrors, a novel forward-looking optical coherence tomography (OCT) probe with a uniquely large field of view is being commercially developed. The aim of this study is to prospectively assess the feasibility of this advanced OCT probe in interpreting ex vivo images of colorectal polyp tissue and to identify necessary steps for further development.

A total of 13 colorectal lesions from 9 patients, removed during endoscopic resection, were imaged ex vivo with the OCT device and compared with histopathological images that served as the gold standard for diagnostics. Normal tissue from one patient, removed during the endoscopic procedure, was imaged as a negative control. We assessed the presence of features indicative for polyp type and degree of dysplasia, by comparing OCT images to histopathological images and by evaluating the presence of OCT-specific features identified by previous studies, such as effacement (loss of layered tissue structure), a hyperreflective epithelial layer, and irregularity of the surface.

As verified by corresponding histological images, tissue structures such as blood vessels and tissue layers could be distinguished in OCT images of the normal tissue sample. Detailed structures on histological images such as crypts and cell nuclei could not be identified in the OCT images. However, we did identify OCT features specific for colorectal lesions, such as effacement and a hyperreflective epithelial layer. In general, the imaging depth was about 1 mm.

Some relevant tissue structures could be observed in OCT images of the novel device. However, some adaptations, such as increasing imaging depth using a laser with a longer central wavelength, are required to improve its clinical value for the imaging of colorectal lesions.