Published online Jul 25, 2015. doi: 10.4253/wjge.v7.i9.872
Peer-review started: April 30, 2015
First decision: May 13, 2015
Revised: May 20, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: July 25, 2015
Processing time: 103 Days and 22.3 Hours
Endoscopic diagnosis with histological evidence is necessary to decide the best strategy for treating esophageal squamous cell carcinoma and Barrett’s-associated neoplasia, and the recent development of endoscopic technologies have made possible real-time information of malignant hallmarks. We focused on the development of optical coherence tomography (OCT), the only technology that can depict real-time cross-sectional images with high resolution. With the improvements in image resolution, acquisition rate and demonstrable area of three-dimensional devices with Doppler capability, OCT imaging was shown to enable visualization of structural/functional alterations in the mucosal/submucosal tissue of the esophagus, resulting in more accurate preoperative diagnosis of such malignancies. Moreover, it approved to be useful for targeting malignant areas for biopsy and treatment as well as for predicting the treatment effects. Therefore, further development of this technology is expected to overcome the current clinical issues in management strategies of esophageal malignancies.
Core tip: Optical coherence tomography (OCT) provides real-time cross-sectional images with extremely high resolution. We previously reported that OCT provided significantly more accurate preoperative staging of esophageal squamous carcinoma (ESCC) than endosonography. With remarkable improvements in this technology, such as three-dimensional devices with Doppler capability, for the detection of Barrett’s-associated neoplasia, the diagnostic accuracy gradually became better through enhanced visualization of structural/functional alterations in mucosal/submucosal tissue. Recent reports suggested its usefulness for targeting malignant lesions for endoscopic intervention and for predicting treatment effects. Therefore, further development of OCT should promote improved management strategies for esophageal malignancies, including ESCC.