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Artif Intell Gastrointest Endosc. Aug 28, 2021; 2(4): 149-156
Published online Aug 28, 2021. doi: 10.37126/aige.v2.i4.149
Role of optical coherence tomography in Barrett’s esophagus
Nikhil Gupta, Raghav Yelamanchi, Himanshu Agrawal, Nitin Agarwal
Nikhil Gupta, Raghav Yelamanchi, Himanshu Agrawal, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
Nitin Agarwal, Department of Surgical Disciploines, Postgraduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
Author contributions: Gupta N performed the literature review and critically reviewed the manuscript; Yelamanchi R performed the literature review and drafted the manuscript; Agrawal H and Agarwal N reviewed the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: None of the authors has any conflict of interest or financial ties to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikhil Gupta, FACS, FRCS (Gen Surg), Professor, Surgeon, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India. nikhil_ms26@yahoo.co.in
Received: May 9, 2021
Peer-review started: May 9, 2021
First decision: May 19, 2021
Revised: May 20, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: August 28, 2021
Abstract

Traditional endoscopic techniques for Barrett’s esophagus (BE) surveillance relied on factor of probability as endoscopists performed cumbersome random biopsies of low yield. Optical coherence tomography (OCT) is a novel technique based on tissue light interference and is set to break conventional barriers. OCT was initially introduced in ophthalmology but was soon adopted by other areas of medicine. When applied to endoscopy, OCT can render images of the superficial layers of the gastrointestinal tract and is highly sensitive in detecting dysplasia in BE. Volumetric laser endomicroscopy is a second generation OCT endoscope device which is able to identify buried glands after ablation. Addition of artificial intelligence to OCT has rendered it more productive. The newer additions to OCT such as angiogram and laser marking will increase the accuracy of investigation. In spite of the few inevitable drawbacks associated with the technology, it presently outperforms all newer endoscopic techniques for the surveillance of BE.

Keywords: Optical coherence tomography, Volume laser endomicroscopy, Esophageal adenocarcinoma, Endoscopy, Gastroesophageal reflux disease

Core Tip: Surveillance of Barrett’s esophagus for dysplasia is a long-debated and intensively researched topic. Optical coherence tomography (OCT) is a breakthrough technology in the medical field that enables the visualization of the layers of a structure in an office setting. The application of artificial intelligence (AI) to OCT endoscopy is the latest addition to the armamentarium of endoscopists. AI-based diagnostic algorithm scores are proven to be better than clinical scores. The accuracy of AI-based system is enhanced further by using color coding software and convolutional neural networks. Multi-center randomized control trials validating these technologies is the need of the hour.