We developed OCT-TCE devices with either guidewire or propylene glycol infusion tethers and tested pullback force and tissue damage over different distances of the small intestine in living swine. For all devices, the maximum force was below our safety threshold of 2N across intestinal lengths of 4m or less. At lengths > 4m, the force was > 4N for the infusion tube devices and > 5N for the guidewire devices, and the proximal intestine showed visible damage matching the tether shape. In conclusion, TCE may be safe for jejunal imaging but likely needs further improvement for ileum imaging in humans.
The Tearney Lab at the Massachusetts General Hospital (MGH) has conducted a study using Tethered Capsule Endomicroscopy (TCE), a technique that involves swallowing a tethered capsule device that circumferentially scans an optical coherence technology (OCT) beam inside the body as it traverses the gastrointestinal tract. Throughout the procedure, microscopic images of the esophagus are acquired in real time in an unsedated subject. OCT TCE was used to screen for Barrett’s Esophagus in a setting of 2 primary care practices at MGH.The OCT TCE show promising results identifying BE in a primary care population.
For OCT-tethered capsule endomicroscopy (TCE) to be a useful minimally invasive tool for evaluating Crohn’s disease, the capsule must be able to be localized within the terminal ileum where the disease often manifests. Here, we developed a machine learning algorithm to assign OCT images of the small intestine into their corresponding anatomical regions. We selected a convolutional neural network and trained it on a set of 2108 cross-sectional images obtained from four swine ex vivo imaging studies to classify images into duodenum, jejunum, or terminal ileum. The model achieved 93±1.72% (95% confidence interval) accuracy on a separate test set of 846 images. These results suggest machine learning may be used to automatically determine when the capsule is in the terminal ileum, enabling microscopic evaluation of this anatomical segment that exhibits pathology in Crohn’s disease.
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