Digestive Diseases and Sciences

, Volume 58, Issue 8, pp 2261–2265

Interobserver Agreement for the Detection of Barrett’s Esophagus with Optical Frequency Domain Imaging

  • Jenny Sauk
  • Emmanuel Coron
  • Lauren Kava
  • Melissa Suter
  • Michalina Gora
  • Kevin Gallagher
  • Mireille Rosenberg
  • Ashwin Ananthakrishnan
  • Norman Nishioka
  • Gregory Lauwers
  • Kevin Woods
  • William Brugge
  • David Forcione
  • Brett E. Bouma
  • Guillermo Tearney
Original Article

DOI: 10.1007/s10620-013-2625-x

Cite this article as:
Sauk, J., Coron, E., Kava, L. et al. Dig Dis Sci (2013) 58: 2261. doi:10.1007/s10620-013-2625-x

Abstract

Background

Optical frequency domain imaging (OFDI) is a second-generation form of optical coherence tomography (OCT) providing comprehensive cross-sectional views of the distal esophagus at a resolution of ~7 μm.

Aim

Using validated OCT criteria for squamous mucosa, gastric cardia mucosa, and Barrett’s esophagus (BE), the objective of this study was to determine the inter- and intra-observer agreements by a large number of OFDI readers for differentiating these tissues.

Methods

OFDI images were obtained from nine subjects undergoing screening and surveillance for BE. Sixty-four OFDI image regions of interest were randomly selected for review. A training set of 19 images was compiled distinguishing squamous mucosa from gastric cardia and BE using previously validated OCT criteria. The ten readers then interpreted images in a test set of 45 different images of squamous mucosa (n = 15), gastric cardia (n = 15), or BE (n = 15). Interobserver agreement differentiating the three tissue types and BE versus non-BE mucosa was determined using multi-rater Fleiss’s κ value. The images were later randomized again and four readers repeated the test 3 weeks later to assess intraobserver reliability.

Results

All ten readers showed excellent agreement for the differentiation of BE versus non-BE mucosa (κ = 0.811 p < 0.0001) and for differentiating BE versus gastric cardia versus squamous mucosa (κ = 0.866, p < 0.0001). For the four readers who repeated the test, the median intraobserver agreement (BE vs. non-BE) was high (κ = 0.975, IQR: 0.94, 1.0).

Conclusions

Trained readers have a high interobserver agreement for differentiating BE, squamous, and gastric cardia mucosa using OFDI.

Keywords

Barrett’s esophagusOptical coherence tomographyImaging/innovationUpper endoscopy GI tract

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jenny Sauk
    • 1
    • 2
  • Emmanuel Coron
    • 3
  • Lauren Kava
    • 1
  • Melissa Suter
    • 1
  • Michalina Gora
    • 1
  • Kevin Gallagher
    • 1
  • Mireille Rosenberg
    • 1
  • Ashwin Ananthakrishnan
    • 2
  • Norman Nishioka
    • 2
  • Gregory Lauwers
    • 4
  • Kevin Woods
    • 1
    • 2
    • 5
  • William Brugge
    • 2
  • David Forcione
    • 2
  • Brett E. Bouma
    • 1
  • Guillermo Tearney
    • 1
    • 4
  1. 1.Wellman Center for Photomedicine, Harvard Medical SchoolMassachusetts General HospitalBostonUSA
  2. 2.Gastroenterology DivisionMassachusetts General HospitalBostonUSA
  3. 3.Department of Gastroenterology and Hepatology, Digestive Diseases InstituteUniversity HospitalNantes CedexFrance
  4. 4.Department of PathologyMassachusetts General HospitalBostonUSA
  5. 5.Digestive Diseases, Interventional Endoscopy, Emory University School of MedicineThe Emory Clinic, Inc.AtlantaUSA