ArticleGastrointestinal endoscopy2011
Reflectance confocal microscopy for the diagnosis of eosinophilic esophagitis: a pilot study conducted on biopsy specimens.
Article in Gastrointestinal endoscopy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 44 citations in OpenAlex.
- Diagnosing Eosinophilic Chronic Rhinosinusitis in Excised Tissue Using Optical Coherence Tomography.The Laryngoscope · 2026Article
- The role of confocal laser endomicroscopy in pediatric gastrointestinal diseases: a narrative review.Frontiers in pediatrics · 2025Review
- Fiber-optic large-depth 3D chromatic confocal endomicroscopy.Biomedical optics express · 2022Article
- Article
- Multimodal microscopy for the simultaneous visualization of five different imaging modalities using a single light source.Biomedical optics express · 2021Article
- Deep Learning-Based Denoising in High-Speed Portable Reflectance Confocal Microscopy.Lasers in surgery and medicine · 2021Article
- High-speed label-free confocal microscopy ofBiomedical optics express · 2021Article
- Novel Insights Into Tissue-Specific Biochemical Alterations in Pediatric Eosinophilic Esophagitis Using Raman Spectroscopy.Clinical and translational gastroenterology · 2020Observational
- Transnasal Endoscopy in Unsedated Children With Eosinophilic Esophagitis Using Virtual Reality Video Goggles.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2019Article
- A miniaturized, tethered, spectrally-encoded confocal endomicroscopy capsule.Lasers in surgery and medicine · 2019Article
- Rapid tissue histology using multichannel confocal fluorescence microscopy with focus tracking.Quantitative imaging in medicine and surgery · 2018Article
- Clinical Translation of Tethered Confocal Microscopy Capsule for Unsedated Diagnosis of Eosinophilic Esophagitis.Scientific reports · 2018Article
- Eosinophilic Esophagitis Is an Underlying Cause for Gastrointestinal Concerns in Children.Frontiers in pediatrics · 2018Review
- Automatic and robust segmentation of endoscopic OCT images and optical staining.Biomedical optics express · 2017Article
- Sticky Steroids: In Search of an Approved Treatment for Eosinophilic Esophagitis.Journal of pediatric gastroenterology and nutrition · 2017Article
- Current Approach to the Management of Eosinophilic Esophagitis in Adults.Current treatment options in gastroenterology · 2015Article
- Advances in clinical management of eosinophilic esophagitis.Gastroenterology · 2014Review
- Comprehensive confocal endomicroscopy of the esophagus in vivo.Endoscopy international open · 2014Article
- Tethered confocal endomicroscopy capsule for diagnosis and monitoring of eosinophilic esophagitis.Biomedical optics express · 2013Article
- Confocal microscopy with strip mosaicing for rapid imaging over large areas of excised tissue.Journal of biomedical optics · 2013Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDiagnosis of eosinophilic esophagitis (EoE) currently requires endoscopic biopsy and histopathologic analysis of the biopsy specimens to count intraepithelial eosinophils. Reflectance confocal microscopy (RCM) is an endomicroscopy technology that is capable of obtaining high-resolution, optically sectioned images of esophageal mucosa without the administration of exogenous contrast.
objectiveIn this study, we investigated the capability of a high-speed form of RCM, termed spectrally encoded confocal microscopy (SECM), to count intraepithelial esophageal eosinophils and characterize other microscopic findings of EoE.
designA total of 43 biopsy samples from 35 pediatric patients and 8 biopsy samples from 8 adult patients undergoing EGD for EoE were imaged by SECM immediately after their removal and then processed for routine histopathology. Two SECM readers, trained on adult cases, prospectively counted intraepithelial eosinophils and detected the presence of abscess, degranulation, and basal cell hyperplasia on SECM images from the pediatric patients. A pathologist blinded to the SECM data analyzed the same from corresponding slides.
settingThe Gastrointestinal Unit, Massachusetts General Hospital.
resultsEosinophils by SECM demonstrated a higher reflectance than the surrounding cells and other inflammatory cells. There was good correlation between SECM and histology maximum eosinophil counts/high-power field (R = 0.76, P < .0001). Intra- and interobserver correlations for SECM counts were very good (R = 0.93 and R = 0.92, respectively; P < .0001). For the commonly used eosinophil count cutoff of 15 per high-power field, the sensitivity and specificity of SECM for EoE were 100%. The sensitivity and specificity for abscess, degranulation, and basal cell hyperplasia were 100% and 82%, 91% and 60%, and 94% and 80%, respectively. Intra- and interobserver agreements for these microscopic features of EoE were very good (κ = 0.9/0.9, 0.84/1.0, 0.91/0.81, respectively). LIMITATION: Ex vivo study.
conclusionsThis study demonstrates that RCM can be used to accurately count intraepithelial eosinophils and identify other microscopic abnormalities associated with EoE on freshly excised biopsy samples. These findings suggest that RCM may be developed into a tool for assessing eosinophilic infiltration in the esophagus in vivo.
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