Interpretation of volumetric laser endomicroscopy in Barrett's esophagus using image enhancement software

Dis Esophagus. 2019 Dec 30;32(11):doz037. doi: 10.1093/dote/doz037.


Image interpretation of Barrett's esophagus (BE) with volumetric laser endomicroscopy (VLE) can be enhanced by image processing software that highlights established features using a color-graded scale (intelligent real-time image segmentation, IRIS). This study aims to provide a description of IRIS features of various gastroesophageal tissue types using histologic correlation. A database of 80 VLE laser-marked targets with histologic correlation was reviewed for various tissue types. IRIS was applied off-line to the VLE scans, laser-marked targets were identified, and feature review was performed. Squamous epithelium targets (N = 7) showed IRIS layered architecture with lack of surface hyper-reflectivity and epithelial glands. Gastric cardia targets (N = 10) showed absent layering (100%) and surface hyper-reflectivity with epithelial glands (40%). Nondysplastic BE targets (N = 39) showed surface hyper-reflectivity (64%), epithelial glands (51%), and lack of layering (74%). Targets of BE with early neoplasia (N = 24), showed surface hyper-reflectivity (96%), epithelial glands (67%), and lack of layering (96%). IRIS features that characterize each tissue type appear to mirror the nonenhanced VLE counterparts that define them.

Keywords: Barrett's esophagus; intelligent real-time image segmentation; volumetric laser endomicroscopy.

MeSH terms

  • Barrett Esophagus / diagnostic imaging*
  • Barrett Esophagus / pathology*
  • Cardia
  • Esophageal Mucosa / diagnostic imaging
  • Esophageal Mucosa / pathology
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / pathology*
  • Esophagoscopy
  • Gastric Mucosa / diagnostic imaging
  • Gastric Mucosa / pathology
  • Humans
  • Image Processing, Computer-Assisted*
  • Intravital Microscopy
  • Microscopy, Confocal / methods
  • Software