Optical coherence tomography of small intestine allograft biopsies using a handheld surgical probe.

• Type of Material: Article
• Authors: Evan T. Jelly, Duke University; Jean Kwun, Duke University; Robin Schmitz, Duke University; Alton Farris III, Emory University; Zachary A. Steelman, Duke University; Debra L. Sudan, Duke University; Stuart J. Knechtle, Duke University; Adam Wax, Duke University
• Language: English
• Date: 2021-09
• Publisher: SPIE
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1117/1.JBO.26.9.096008
• Title of Journal or Parent Work: J Biomed Opt
• Volume: 26
• Issue: 9
• Grant/Funding Information: Funding for this study was provided by the Coulter Translational Partnership, the National Science Foundation (NSF) (IIP-1827560), and the National Cancer Institute (R01-CA210544).
• Keywords: endoscopy; diagnostic imaging; optical coherence tomography; gastroenterology; imaging systems
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

SIGNIFICANCE: The current gold standard for monitoring small intestinal transplant (IT) rejection is endoscopic visual assessment and biopsy of suspicious lesions; however, these lesions are only superficially visualized by endoscopy. Invasive biopsies provide a coarse sampling of tissue health without depicting the true presence and extent of any pathology. Optical coherence tomography (OCT) presents a potential alternative approach with significant advantages over traditional white-light endoscopy. AIM: The aim of our investigation was to evaluate OCT performance in distinguishing clinically relevant morphological features associated with IT graft failure. APPROACH: OCT was applied to evaluate the small bowel tissues of two rhesus macaques that had undergone IT of the ileum. The traditional assessment from routine histological observation was compared with OCT captured using a handheld surgical probe during the days post-transplant and subsequently was compared with histophaology. RESULTS: The reported OCT system was capable of identifying major biological landmarks in healthy intestinal tissue. Following IT, one nonhuman primate (NHP) model suffered a severe graft ischemia, and the second NHP graft failed due to acute cellular rejection. OCT images show visual evidence of correspondence with histological signs of IT rejection. CONCLUSIONS: Results suggest that OCT imaging has significant potential to reveal morphological changes associated with IT rejection and to improve patient outcomes overall.