Celiac disease (CD) affects around 1% of the global population and can cause serious long-term symptoms including malnutrition, fatigue, and diarrhea, amongst others. Despite this, it is often left undiagnosed. Currently, a tissue diagnosis of CD is made by random endoscopic biopsy of the duodenum to confirm the existence of microscopic morphologic alterations in the intestinal mucosa. However, duodenal endoscopic biopsy is problematic because the morphological changes can be focal and endoscopic biopsy is plagued by sampling error. Additionally, tissue artifacts can also an issue because cuts in the transverse plane can make duodenal villi appear artifactually shortened and can bias the assessment of intraepithelial inflammation. Moreover, endoscopic biopsy is costly and poorly tolerated as the patient needs to be sedated to perform the procedure.
Our lab has previously developed technology termed tethered capsule OCT endomicroscopy (TCE) to overcome these diagnostic limitations of endoscopy. TCE involves swallowing an optomechanically-engineered pill that generates 3D images of the GI tract as it traverses the lumen of the organ via peristalsis, assisted by gravity. In several patients we have demonstrated TCE imaging of duodenal villi, however the current TCE device design is not optimal for CD diagnosis as the villi compress when in contact with the smooth capsule’s wall. In this work, we present methods for structuring the outer surface of the capsule to improve the visualization of the villi height and crypt depth. Preliminary results in humans suggest that new TCE capsule enables better visualization of villous architecture, making it possibly to comprehensively scan the entire duodenum to obtain a more accurate tissue diagnosis of CD.
Jing Dong, Michalina J. Gora, Emilie Beaulieu-Ouellet, Lucille H. Queneherve, Catriona N. Grant, Mireille Rosenberg, Norman S. Nishioka, Alessio Fasano, and Guillermo J. Tearney, "Optimizing the villi visualization by tethered capsule OCT endomicroscopy for comprehensive imaging of human duodenum (Conference Presentation)," Proc. SPIE 10040, Endoscopic Microscopy XII, 100400D (Presented at SPIE BiOS: January 29, 2017; Published: 19 April 2017); https://doi.org/10.1117/12.2255772.5369883822001.
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Study of self-shadowing effect as a simple means to realize nanostructured thin films and layers with special attentions to birefringent obliquely deposited thin films and photo-luminescent porous silicon