Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Lagergren J, Bergstrom R, Lindgren A, et al. Barrett’s esophagus. A prevalent, occult complication of gastroesophageal reflux disease. Gastroenterology. 1987;92:118–124.

    Google Scholar 

  2. Pohl H, Sirovich B, Welch HG. Esophageal adenocarcinoma incidence: are we reaching the peak? Cancer Epidemiol Biomarkers Prev. 2010;19:1468–1470.

    Article  PubMed  Google Scholar 

  3. Cook MB, Chow WH, Devesa SS. Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977–2005. Br J Cancer. 2009;101:855–859.

    Article  PubMed  CAS  Google Scholar 

  4. Siegel R, Niashadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29.

    Article  PubMed  Google Scholar 

  5. Fitzgerald RC, Lascar R, Triadafilopoulos G. Review article: Barrett’s oesophagus, dysplasia and pharmacologic acid suppression. Aliment Pharmacol Ther. 2001;15:269–276.

    Article  PubMed  CAS  Google Scholar 

  6. Konda VJ, Dalal K. Optimal management of Barrett’s esophagus: pharmacologic, endoscopic and surgical interventions. Ther Clin Risk Manag. 2011;7:447–458.

    Article  PubMed  Google Scholar 

  7. Falk GW. Barrett’s esophagus. Gastroenterology. 2002;122:1569–1591.

    Article  PubMed  Google Scholar 

  8. Hvid-Jensen F, Pedersen L, Drewes AM, et al. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Eng J Med. 2011;365:1375–1383.

    Article  CAS  Google Scholar 

  9. Bytzer P, Christensen PB, Damkier P, et al. Adenocarcinoma of the esophagus and Barrett’s esophagus: a population based study. Am J Gastroenterol. 1998;94:86–91.

    Article  Google Scholar 

  10. Cameron AJ, Zinsmeister AR, Ballard DJ, et al. Prevalence of columnar-lined (Barrett’s) esophagus. Comparison of population-based clinical and autopsy based findings. Gastroenterology. 1990;99:918–922.

    PubMed  CAS  Google Scholar 

  11. Sikkema M, De Jonge PJ, Steyerberg EW, et al. Risk of esophageal adenocarcinoma and mortality with Barrett’s esophagus: a systemic review and meta-analysis. Clinical Gastroenterol Hepatol. 2010;8:235–244.

    Article  Google Scholar 

  12. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C and M criteria. Gastroenterology. 2006;131:1392–1399.

    Article  PubMed  Google Scholar 

  13. Harrison R, Perry I, Haddadin W, et al. Detection of intestinal metaplasia in Barrett’s esophagus: an observational comparator study suggests the need for a minimum of eight biopsies. Am J Gastroenterol. 2007;102:1154–1161.

    Article  PubMed  Google Scholar 

  14. Hanna S, Rastogi A, Weston AP, et al. Detection of Barrett’s esophagus after endoscopic healing of erosive esophagitis. Am J Gastroenterol. 2006;101:1416–1420.

    Article  PubMed  Google Scholar 

  15. Ishimura N, Amano Y, Appelman HD, et al. Barrett’s esophagus: endoscopic diagnosis. Ann NY Acad Sci. 2011;1232:53–75.

    Article  PubMed  Google Scholar 

  16. Yun SH, Tearney GH, de Boer JF, et al. High speed optical frequency domain imaging. Opt Express. 2003;11:2953–2963.

    Article  PubMed  CAS  Google Scholar 

  17. Yun SH, Tearney GJ, Vakoc BJ, et al. Comprehensive volumetric optical microscopy in vivo. Nat Med. 2006;12:1429–1433.

    Article  PubMed  CAS  Google Scholar 

  18. Suter MJ, Vakoc BJ, Shishkov YP, et al. Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging. Gastrointest Endosc. 2008;68:745–753.

    Article  PubMed  Google Scholar 

  19. Vakoc BJ, Shishkov M, Yun SH, et al. Comprehensive esophageal microscopy by using optical frequency domain imaging. Gastrointest Endosc. 2007;65:898–905.

    Article  PubMed  Google Scholar 

  20. Bouma BE, Tearney GJ, Compton CC, et al. High resolution imaging of the human esophagus and stomach in vivo using optical coherence tomography. Gastrointest Endosc. 2000;51:467–474.

    Article  PubMed  CAS  Google Scholar 

  21. Poneros JM, Brand S, Bouma BE, et al. Diagnosis of specialized intestinal metaplasia by optical coherence tomography. Gastroenterology. 2001;120:7–12.

    Article  PubMed  CAS  Google Scholar 

  22. Evans JA, Bouma BE, Bressner J, et al. Identifying intestinal metaplasia at the squamocolumnar junction by using optical coherence tomography. Gastrointest Endosc. 2007;65:50–56.

    Article  PubMed  Google Scholar 

  23. Suter MJ, Jillela PA, Vakoc BJ, et al. Image guided biopsy in the esophagus through comprehensive optical frequency domain imaging and laser marking: a study in living swine. Gastrointest Endosc. 2010;71:346–353.

    Article  PubMed  Google Scholar 

  24. Conio M, Cameron AJ, Romero Y, et al. Secular trends in the epidemiology and outcome of Barrett’s esophagus in Olmsted County, Minnesota. Gut. 2001;48:304–309.

    Article  PubMed  CAS  Google Scholar 

  25. Sharma P, Hawes RH, Bansal A, et al. Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett’s esophagus: a prospective, international, randomized controlled trial. Gut. 2013;62:15–21.

    Google Scholar 

  26. Jayasekera C, Taylor AC, Desmond PV, et al. Added value of narrow band imaging and confocal laser endomicroscopy in detecting Barrett’s esophagus neoplasia. Endoscopy. 2012;44:1089–1095.

    Article  PubMed  CAS  Google Scholar 

  27. Gora MJ, Sauk JS, Carruth RW. Tethered capsule endomicroscopy enables less invasive imaging of gastrointestinal microstructure. Nat Med. 2013;19:238–240.

    Google Scholar 

  28. Evans JA, Poneros JM, Bouma BE, et al. Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4:38–43.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This work is supported by grants from the National Institutes of Health (R01 CA103769).

Conflict of interest

Drs. Tearney, Bouma, Suter, and Nishioka have the rights to receive royalties from OFDI technology licensed to Ninepoint Medical. Drs. Tearney, Bouma, and Suter receive sponsored research funding from Ninepoint Medical. Drs. Bouma and Tearney consult for Ninepoint Medical.

Author information

Authors and Affiliations

  1. Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, 40 Blossom Street, Boston, MA, 02114, USA

    Jenny Sauk, Lauren Kava, Melissa Suter, Michalina Gora, Kevin Gallagher, Mireille Rosenberg, Kevin Woods, Brett E. Bouma & Guillermo Tearney

  2. Gastroenterology Division, Massachusetts General Hospital, Boston, MA, USA

    Jenny Sauk, Ashwin Ananthakrishnan, Norman Nishioka, Kevin Woods, William Brugge & David Forcione

  3. Department of Gastroenterology and Hepatology, Digestive Diseases Institute, University Hospital, Nantes Cedex, France

    Emmanuel Coron

  4. Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, WRN 2, Boston, MA, 02114-2696, USA

    Gregory Lauwers & Guillermo Tearney

  5. Digestive Diseases, Interventional Endoscopy, Emory University School of Medicine, The Emory Clinic, Inc., 1365 Clifton Road NE, Clinic B, Suite 1200, Atlanta, GA, 30322, USA

    Kevin Woods

Authors
  1. Jenny Sauk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emmanuel Coron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lauren Kava
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Melissa Suter
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michalina Gora
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kevin Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mireille Rosenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ashwin Ananthakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Norman Nishioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gregory Lauwers
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Kevin Woods
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. William Brugge
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. David Forcione
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Brett E. Bouma
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Guillermo Tearney
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guillermo Tearney.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sauk, J., Coron, E., Kava, L. et al. Interobserver Agreement for the Detection of Barrett’s Esophagus with Optical Frequency Domain Imaging. Dig Dis Sci 58, 2261–2265 (2013). https://doi.org/10.1007/s10620-013-2625-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-013-2625-x

Keywords

Search

Navigation