In vivo optical endomicroscopy: two decades of translational research towards next generation diagnosis of eosinophilic esophagitis

Abstract

Histopathologic analysis of biopsy specimens obtained via white light endoscopy (WLE) is the gold standard for the diagnosis of several mucosal diseases in the upper gastrointestinal (GI) tract. However, this standard of care entails a series of critical shortcomings such as missing depth information, high costs, time inefficiency, low-resolution imaging in vivo, high sampling variability, missing intrinsic tissue-specific contrast, and anesthesia related risk. In the quest for a diagnostic technology to replace the current standard of care, in vivo optical endomicroscopy has emerged as a promising alternative. This paper tells the story of a cluster of optical microscopy-based modalities invented, further developed, or first-validated in the laboratory of Dr. Guillermo J. Tearney (Tearney Lab) at the Wellman Center for Photomedicine of Massachusetts General Hospital over the past two decades, that combined lead to a novel method for diagnosis of eosinophilic esophagitis (EoE). Rather than being a comprehensive literature review, this paper aims to describe the translational journey towards a disease specific diagnostic and research tool for this increasingly recognized yet poorly understood immune-mediated disorder of the esophagus.

Optical Coherence Tomography Imaging by a Fully Integrated MOEMS Endomicroscopy Probe With Mirau Microinterferometer and Two-Axis Electrothermal Microscanner Using Lissajous Trajectory Scanning

“…Thus, to achieve the best result, the measured sample has to be placed in the focus of the probe. The axial resolution of the probe depends on the parameters of the applied swept source, and it is determined by equation 1 [29,30]: (1) where: λc = 1060 nm, central wavelength; ∆λ = 100 nm, tuning range of the swept source.…”

“…key issue of modern technique is the development of noninvasive, fast, accurate, and reliable diagnostic methods for imaging the sample into hard-to-reach places such as holes and cavities [1,2,3]. One of the most attractive method for 2D and 3D imaging investigated structure into hard-to-reach places is the optical coherency tomography (OCT) technique combined with endomicroscopic device [4,5,6,7,8].…”

PharmaChk: a decade of research and development towards the first quantitative, field-based medicine quality screening instrument

“…This paper describes the scientific and engineering work over the first ten years towards the development of the PharmaChk instrument; it is part of an original education series with the goal of illustrating, through concrete examples from academic research laboratories, what it really takes to translate discoveries and new technologies into new therapeutics, diagnostics, or medical devices. [1][2][3][4] First, we explain the global health need that launched our efforts and define the instrument's specifications. Second, we detail the scientific and engineering goals, challenges, and achievements that drove the development of the instrument.…”