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Three-dimensional endomicroscopy of the human colon using optical coherence tomography
Desmond C. Adler, Chao Zhou, Tsung-Han Tsai, Joe Schmitt, Qin Huang, Hiroshi Mashimo, and James G. Fujimoto »View Author Affiliations
1Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139
2LightLab Imaging Inc., Westford, Massachusetts 01886
3Veterans Affairs Boston Healthcare System, Boston, Massachusetts 02130
4Harvard Medical School, Harvard University, Cambridge, Massachusetts 02139
*Corresponding author: jgfuji@mit.edu
Optics Express, Vol. 17, Issue 2, pp. 784-796 (2009)
http://dx.doi.org/10.1364/OE.17.000784
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Abstract
Three-dimensional (3D) endomicroscopy imaging of the human gastrointestinal tract is demonstrated in vivo using a swept source optical coherence tomography (OCT) system. 3D datasets of normal and pathologic regions of the colon, rectum, and anal verge were obtained from seven volunteers undergoing diagnostic or therapeutic colonoscopy. 3D-OCT enables high resolution endomicroscopy examination through visualization of tissue architectural morphology using virtual cross-sectional images with arbitrary orientations as well as en face projection images. Axial image resolutions of 6 μm in tissue are obtained over a ~180 mm2 field with an imaging range of 1.6 mm. A Fourier domain mode locked (FDML) laser providing a tuning range of 180 nm at a sweep rate of 62 kHz is used as the system light source. This clinical pilot study demonstrates the potential of 3D-OCT for distinguishing normal from pathologic colorectal tissue, assessing endoscopic therapies and healing progression.
© 2009 Optical Society of America
OCIS Codes
(110.4500) Imaging systems : Optical coherence tomography
(170.2150) Medical optics and biotechnology : Endoscopic imaging
(170.2680) Medical optics and biotechnology : Gastrointestinal
(170.3880) Medical optics and biotechnology : Medical and biological imaging
(170.6900) Medical optics and biotechnology : Three-dimensional microscopy
ToC Category:
Medical Optics and Biotechnology
History
Original Manuscript: November 7, 2008
Revised Manuscript: December 30, 2008
Manuscript Accepted: January 3, 2009
Published: January 8, 2009
Virtual Issues
Vol. 4, Iss. 3 Virtual Journal for Biomedical Optics
Citation
Desmond C. Adler, Chao Zhou, Tsung-Han Tsai, Joe Schmitt, Qin Huang, Hiroshi Mashimo, and James G. Fujimoto, "Three-dimensional endomicroscopy of the human colon using optical coherence tomography," Opt. Express 17, 784-796 (2009)
http://www.opticsinfobase.org/oe/abstract.cfm?URI=oe-17-2-784
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Dis. Colon Rectum
- V. de Parades, I. Etienney, P. Bauer, J. Bourguignon, N. Meary, B. Mory, S. Sultan, M. Taouk, C. Thomas, and P. Atienza, "Formalin application in the treatment of chronic radiation-induced hemorrhagic proctitis - An effective but not risk-free procedure: A prospective study of 33 patients," Dis. Colon Rectum 48, 1535-1541 (2005). [CrossRef] [PubMed]
- M. E. Lucarotti, R. A. Mountford, and D. C. C. Bartolo, "Surgical-Management of Intestinal Radiation-Injury," Dis. Colon Rectum 34, 865-869 (1991). [CrossRef] [PubMed]
Endoscopy
- Y. Chen, A. D. Aguirre, P. L. Hsiung, S. Desai, P. R. Herz, M. Pedrosa, Q. Huang, M. Figueiredo, S. W. Huang, A. Koski, J. M. Schmitt, J. G. Fujimoto, and H. Mashimo, "Ultrahigh resolution optical coherence tomography of Barrett's esophagus: preliminary descriptive clinical study correlating images with histology," Endoscopy 39, 599-605 (2007). [CrossRef] [PubMed]
- X. D. Li, S. A. Boppart, J. Van Dam, H. Mashimo, M. Mutinga, W. Drexler, M. Klein, C. Pitris, M. L. Krinsky, M. E. Brezinski, and J. G. Fujimoto, "Optical coherence tomography: advanced technology for the endoscopic imaging of Barrett's esophagus," Endoscopy 32, 921-930 (2000). [CrossRef]
- S. Jäckle, N. Gladkova, F. Feldchtein, A. Terentieva, B. Brand, G. Gelikonov, V. Gelikonov, A. Sergeev, A. Fritscher-Ravens, J. Freund, U. Seitz, S. Soehendra, and N. Schrödern, "In vivo endoscopic optical coherence tomography of the human gastrointestinal tract--toward optical biopsy," Endoscopy 32, 743-749 (2000). [CrossRef] [PubMed]
Gastroenterology
- J. M. Poneros, S. Brand, B. E. Bouma, G. J. Tearney, C. C. Compton, and N. S. Nishioka, "Diagnosis of specialized intestinal metaplasia by optical coherence tomography," Gastroenterology 120, 7-12 (2001). [CrossRef] [PubMed]
- S. H. Itzkowitz, and N. Harpaz, "Diagnosis and management of dysplasia in patients with inflammatory bowel diseases," Gastroenterology 126, 1634-1648 (2004). [CrossRef] [PubMed]
- E. V. Loftus, "Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences," Gastroenterology 126, 1504-1517 (2004). [CrossRef] [PubMed]
- H. Mashimo, Y. Chen, S. W. Huang, Q. Huang, A. Aguirre, J. Schmitt, and J. Fujimoto, "Endoscopic optical coherence tomography reveals Barrett's underneath squarnous neo-epithelium after radiofrequency ablation," Gastroenterology 132, A96-A96 (2007).
Gastrointest. Endosc.
- B. A. Standish, V. X. D. Yang, N. R. Munce, L. M. W. K. Song, G. Gardiner, A. Lin, Y. I. Mao, A. Vitkin, N. E. Marcon, and B. C. Wilson, "Doppler optical coherence tomography monitoring of microvascular tissue response during photodynamic therapy in an animal model of Barrett's esophagus," Gastrointest. Endosc. 66, 326-333 (2007). [CrossRef] [PubMed]
- P. L. Hsiung, L. Pantanowitz, A. D. Aguirre, Y. Chen, D. Phatak, T. H. Ko, S. Bourquin, S. J. Schnitt, S. Raza, J. L. Connolly, H. Mashimo, and J. G. Fujimoto, "Ultrahigh-resolution and 3-dimensional optical coherence tomography ex vivo imaging of the large and small intestines," Gastrointest. Endosc. 62, 561-574 (2005). [CrossRef] [PubMed]
- D. M. Jensen, G. A. Machicado, S. Cheng, M. E. Jensen, and R. Jutabha, "A randomized prospective study of endoscopic bipolar electrocoagulation and heater probe treatment of chronic rectal bleeding from radiation telangiectasia," Gastrointest. Endosc. 45, 20-25 (1997). [CrossRef] [PubMed]
- A. C. Fantin, J. Binek, W. R. Suter, and C. Meyenberger, "Argon beam coagulation for treatment of symptomatic radiation-induced proctitis," Gastrointest. Endosc. 49, 515-518 (1999). [CrossRef] [PubMed]
- G. Isenberg, M. V. Sivak, A. Chak, R. C. K. Wong, J. E. Willis, B. Wolf, D. Y. Rowland, A. Das, and A. Rollins, "Accuracy of endoscopic optical coherence tomography in the detection of dysplasia in Barrett's esophagus: a prospective, double-blinded study," Gastrointest. Endosc. 62, 825-831 (2005). [CrossRef] [PubMed]
- M. V. Sivak, Jr., K. Kobayashi, J. A. Izatt, A. M. Rollins, R. Ung-Runyawee, A. Chak, R. C. Wong, G. A. Isenberg, and J. Willis, "High-resolution endoscopic imaging of the GI tract using optical coherence tomography," Gastrointest. Endosc. 51, 474-479 (2000). [CrossRef] [PubMed]
- B. E. Bouma, G. J. Tearney, C. C. Compton, and N. S. Nishioka, "High-resolution imaging of the human esophagus and stomach in vivo using optical coherence tomography," Gastrointest. Endosc. 51, 467-474 (2000). [CrossRef] [PubMed]
- B. J. Vakoc, M. Shishko, S. H. Yun, W. Y. Oh, M. J. Suter, A. E. Desjardins, J. A. Evans, N. S. Nishioka, G. J. Tearney, and B. E. Bouma, "Comprehensive esophageal microscopy by using optical frequency-domain imaging (with video)," Gastrointest. Endosc. 65, 898-905 (2007). [CrossRef] [PubMed]
- M. J. Suter, B. J. Vakoc, P. S. Yachimski, M. Shishkov, G. Y. Lauwers, M. Mino-Kenudson, B. E. Bouma, N. S. Nishioka, and G. J. Tearney, "Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging," Gastrointest. Endosc. 68, 745-753 (2008). [CrossRef] [PubMed]
Gut
- J. A. Eaden, K. R. Abrams, and J. F. Mayberry, "The risk of colorectal cancer in ulcerative colitis: a meta-analysis," Gut 48, 526-535 (2001). [CrossRef] [PubMed]
J. Am. Med. Assoc.
- S. S. Donaldson, "Radiation Proctitis after Prostate Carcinoma-Therapy," JAMA-J. Am. Med. Assoc. 271, 819-820 (1994). [CrossRef]
J. Biomed. Opt.
- B. J. Vakoc, G. J. Tearney, and B. E. Bouma, "Real-time microscopic visualization of tissue response to laser thermal therapy," J. Biomed. Opt. 12, 020501 (2007). [CrossRef] [PubMed]
- B. A. Standish, X. Jin, J. Smolen, A. Mariampillai, N. R. Munce, B. C. Wilson, I. A. Vitkin, and V. X. D. Yang, "Interstitial Doppler optical coherence tomography monitors microvascular changes during photodynamic therapy in a Dunning prostate model under varying treatment conditions," J. Biomed. Opt. 12, 034022 (2007). [CrossRef] [PubMed]
- J. P. Su, J. Zhang, L. F. Yu, H. G. Colt, M. Brenner, and Z. P. Chen, "Real-time swept source optical coherence tomography imaging of the human airway using a microelectromechanical system endoscope and digital signal processor," J. Biomed. Opt. 13, 030506 (2008). [CrossRef] [PubMed]
- X. Qi, M. V. Sivak, G. Isenberg, J. E. Willis, and A. M. Rollins, "Computer-aided diagnosis of dysplasia in Barrett's esophagus using endoscopic optical coherence tomography," J. Biomed. Opt. 11, 044010 (2006). [CrossRef] [PubMed]
Nat. Photonics
- D. C. Adler, Y. Chen, R. Huber, J. Schmitt, J. Connolly, and J. G. Fujimoto, "Three-dimensional endomicroscopy using optical coherence tomography," Nat. Photonics 1, 709-716 (2007). [CrossRef]
Nature Med.
- S. H. Yun, G. J. Tearney, B. J. Vakoc, M. Shishkov, W. Y. Oh, A. E. Desjardins, M. J. Suter, R. C. Chan, J. A. Evans, I. K. Jang, N. S. Nishioka, J. F. de Boer, and B. E. Bouma, "Comprehensive volumetric optical microscopy in vivo," Nature Med. 12, 1429-1433 (2006). [PubMed]
New Engl. J. Med.
- T. Takayama, S. Katsuki, Y. Takahashi, M. Ohi, S. Nojiri, S. Sakamaki, J. Kato, K. Kogawa, H. Miyake, and Y. Niitsu, "Aberrant crypt foci of the colon as precursors of adenoma and cancer," New Engl. J. Med. 339, 1277-1284 (1998). [CrossRef] [PubMed]
Opt. Express
- R. Leitgeb, C. K. Hitzenberger, and A. F. Fercher, "Performance of Fourier domain vs. time domain optical coherence tomography," Opt. Express 11, 889-894 (2003). [CrossRef] [PubMed]
- C. M. Eigenwillig, B. R. Biedermann, G. Palte, and R. Huber, "K-space linear Fourier domain mode locked laser and applications for optical coherence tomography," Opt. Express 16, 8916-8937 (2008). [CrossRef] [PubMed]
- R. Huber, M. Wojtkowski, and J. G. Fujimoto, "Fourier Domain Mode Locking (FDML): A new laser operating regime and applications for optical coherence tomography," Opt. Express 14, 3225-3237 (2006). [CrossRef] [PubMed]
- M. A. Choma, M. V. Sarunic, C. H. Yang, and J. A. Izatt, "Sensitivity advantage of swept source and Fourier domain optical coherence tomography," Opt. Express 11, 2183-2189 (2003). [CrossRef] [PubMed]
Opt. Lett.
- J. F. de Boer, B. Cense, B. H. Park, M. C. Pierce, G. J. Tearney, and B. E. Bouma, "Improved signal-to-noise ratio in spectral-domain compared with time-domain optical coherence tomography," Opt. Lett. 28, 2067-2069 (2003). [CrossRef] [PubMed]
- R. Huber, D. C. Adler, V. J. Srinivasan, and J. G. Fujimoto, "Fourier domain mode locking at 1050 nm for ultra-high-speed optical coherence tomography of the human retina at 236,000 axial scans per second," Opt. Lett. 32, 2049-2051 (2007). [CrossRef] [PubMed]
- R. Huber, D. C. Adler, and J. G. Fujimoto, "Buffered Fourier domain mode locking: unidirectional swept laser sources for optical coherence tomography imaging at 370,000 lines/s," Opt. Lett. 31, 2975-2977 (2006). [CrossRef] [PubMed]
Science
- D. Huang, E. A. Swanson, C. P. Lin, J. S. Schuman, W. G. Stinson, W. Chang, M. R. Hee, T. Flotte, K. Gregory, C. A. Puliafito, and J. G. Fujimoto, "Optical Coherence Tomography," Science 254, 1178-1181 (1991). [CrossRef] [PubMed]
- G. J. Tearney, M. E. Brezinski, B. E. Bouma, S. A. Boppart, C. Pitvis, J. F. Southern, and J. G. Fujimoto, "In vivo endoscopic optical biopsy with optical coherence tomography," Science 276, 2037-2039 (1997). [CrossRef] [PubMed]
Surg. Endosc.
- B. J. Dunkin, J. Martinez, P. A. Bejarano, C. D. Smith, K. Chang, A. S. Livingstone, and W. S. Melvin, "Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device," Surg. Endosc. 20, 125-130 (2006). [CrossRef]
Other
- V. Kumar, A. Abas, and N. Fausto, Robbins and Cotran Pathologic Basis of Disease, 7th Edition (The Curtis Center, Philadelphia, 2005).
2008, Suter, Gastrointest. Endosc.
- M. J. Suter, B. J. Vakoc, P. S. Yachimski, M. Shishkov, G. Y. Lauwers, M. Mino-Kenudson, B. E. Bouma, N. S. Nishioka, and G. J. Tearney, "Comprehensive microscopy of the esophagus in human patients with optical frequency domain imaging," Gastrointest. Endosc. 68, 745-753 (2008). [CrossRef] [PubMed]
- J. P. Su, J. Zhang, L. F. Yu, H. G. Colt, M. Brenner, and Z. P. Chen, "Real-time swept source optical coherence tomography imaging of the human airway using a microelectromechanical system endoscope and digital signal processor," J. Biomed. Opt. 13, 030506 (2008). [CrossRef] [PubMed]
- D. C. Adler, Y. Chen, R. Huber, J. Schmitt, J. Connolly, and J. G. Fujimoto, "Three-dimensional endomicroscopy using optical coherence tomography," Nat. Photonics 1, 709-716 (2007). [CrossRef]
- Y. Chen, A. D. Aguirre, P. L. Hsiung, S. Desai, P. R. Herz, M. Pedrosa, Q. Huang, M. Figueiredo, S. W. Huang, A. Koski, J. M. Schmitt, J. G. Fujimoto, and H. Mashimo, "Ultrahigh resolution optical coherence tomography of Barrett's esophagus: preliminary descriptive clinical study correlating images with histology," Endoscopy 39, 599-605 (2007). [CrossRef] [PubMed]
- B. J. Vakoc, M. Shishko, S. H. Yun, W. Y. Oh, M. J. Suter, A. E. Desjardins, J. A. Evans, N. S. Nishioka, G. J. Tearney, and B. E. Bouma, "Comprehensive esophageal microscopy by using optical frequency-domain imaging (with video)," Gastrointest. Endosc. 65, 898-905 (2007). [CrossRef] [PubMed]
- H. Mashimo, Y. Chen, S. W. Huang, Q. Huang, A. Aguirre, J. Schmitt, and J. Fujimoto, "Endoscopic optical coherence tomography reveals Barrett's underneath squarnous neo-epithelium after radiofrequency ablation," Gastroenterology 132, A96-A96 (2007).
- B. A. Standish, X. Jin, J. Smolen, A. Mariampillai, N. R. Munce, B. C. Wilson, I. A. Vitkin, and V. X. D. Yang, "Interstitial Doppler optical coherence tomography monitors microvascular changes during photodynamic therapy in a Dunning prostate model under varying treatment conditions," J. Biomed. Opt. 12, 034022 (2007). [CrossRef] [PubMed]
- B. A. Standish, V. X. D. Yang, N. R. Munce, L. M. W. K. Song, G. Gardiner, A. Lin, Y. I. Mao, A. Vitkin, N. E. Marcon, and B. C. Wilson, "Doppler optical coherence tomography monitoring of microvascular tissue response during photodynamic therapy in an animal model of Barrett's esophagus," Gastrointest. Endosc. 66, 326-333 (2007). [CrossRef] [PubMed]
- B. J. Vakoc, G. J. Tearney, and B. E. Bouma, "Real-time microscopic visualization of tissue response to laser thermal therapy," J. Biomed. Opt. 12, 020501 (2007). [CrossRef] [PubMed]
- S. H. Yun, G. J. Tearney, B. J. Vakoc, M. Shishkov, W. Y. Oh, A. E. Desjardins, M. J. Suter, R. C. Chan, J. A. Evans, I. K. Jang, N. S. Nishioka, J. F. de Boer, and B. E. Bouma, "Comprehensive volumetric optical microscopy in vivo," Nature Med. 12, 1429-1433 (2006). [PubMed]
- J. A. Evans, J. M. Poneros, B. E. Bouma, J. Bressner, E. F. Halpern, M. Shishkov, G. Y. Lauwers, M. Mino-Kenudson, N. S. Nishioka, and G. J. Tearney, "Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett's esophagus," Clin. Gastroenterol. H. 4, 38-43 (2006). [CrossRef]
- X. Qi, M. V. Sivak, G. Isenberg, J. E. Willis, and A. M. Rollins, "Computer-aided diagnosis of dysplasia in Barrett's esophagus using endoscopic optical coherence tomography," J. Biomed. Opt. 11, 044010 (2006). [CrossRef] [PubMed]
- B. J. Dunkin, J. Martinez, P. A. Bejarano, C. D. Smith, K. Chang, A. S. Livingstone, and W. S. Melvin, "Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device," Surg. Endosc. 20, 125-130 (2006). [CrossRef]
- P. L. Hsiung, L. Pantanowitz, A. D. Aguirre, Y. Chen, D. Phatak, T. H. Ko, S. Bourquin, S. J. Schnitt, S. Raza, J. L. Connolly, H. Mashimo, and J. G. Fujimoto, "Ultrahigh-resolution and 3-dimensional optical coherence tomography ex vivo imaging of the large and small intestines," Gastrointest. Endosc. 62, 561-574 (2005). [CrossRef] [PubMed]
- V. de Parades, I. Etienney, P. Bauer, J. Bourguignon, N. Meary, B. Mory, S. Sultan, M. Taouk, C. Thomas, and P. Atienza, "Formalin application in the treatment of chronic radiation-induced hemorrhagic proctitis - An effective but not risk-free procedure: A prospective study of 33 patients," Dis. Colon Rectum 48, 1535-1541 (2005). [CrossRef] [PubMed]
- G. Isenberg, M. V. Sivak, A. Chak, R. C. K. Wong, J. E. Willis, B. Wolf, D. Y. Rowland, A. Das, and A. Rollins, "Accuracy of endoscopic optical coherence tomography in the detection of dysplasia in Barrett's esophagus: a prospective, double-blinded study," Gastrointest. Endosc. 62, 825-831 (2005). [CrossRef] [PubMed]
- B. Shen, G. Zuccaro, Jr., T. L. Gramlich, N. Gladkova, P. Trolli, M. Kareta, C. P. Delaney, J. T. Connor, B. A. Lashner, C. L. Bevins, F. Feldchtein, F. H. Remzi, M. L. Bambrick, and V. W. Fazio, "In vivo colonoscopic optical coherence tomography for transmural inflammation in inflammatory bowel disease," Clin. Gastroenterol. H. 2, 1080-1087 (2004). [CrossRef]
- E. V. Loftus, "Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences," Gastroenterology 126, 1504-1517 (2004). [CrossRef] [PubMed]
- S. H. Itzkowitz, and N. Harpaz, "Diagnosis and management of dysplasia in patients with inflammatory bowel diseases," Gastroenterology 126, 1634-1648 (2004). [CrossRef] [PubMed]
- J. M. Poneros, S. Brand, B. E. Bouma, G. J. Tearney, C. C. Compton, and N. S. Nishioka, "Diagnosis of specialized intestinal metaplasia by optical coherence tomography," Gastroenterology 120, 7-12 (2001). [CrossRef] [PubMed]
- J. A. Eaden, K. R. Abrams, and J. F. Mayberry, "The risk of colorectal cancer in ulcerative colitis: a meta-analysis," Gut 48, 526-535 (2001). [CrossRef] [PubMed]
- M. Kennedy, K. Bruninga, E. A. Mutlu, J. Losurdo, S. Choudhary, and A. Keshavarzian, "Successful and sustained treatment of chronic radiation proctitis with antioxidant vitamins E and C," Am. J. Gastroenterol. 96, 1080-1084 (2001). [CrossRef] [PubMed]
- M. Ventrucci, M. P. Di Simone, P. Giulietti, and G. De Luca, "Efficacy and safety of Nd : YAG laser for the treatment of bleeding from radiation proctocolitis," Digest. Liver Dis. 33, 230-233 (2001). [CrossRef]
- B. E. Bouma, G. J. Tearney, C. C. Compton, and N. S. Nishioka, "High-resolution imaging of the human esophagus and stomach in vivo using optical coherence tomography," Gastrointest. Endosc. 51, 467-474 (2000). [CrossRef] [PubMed]
- S. Jäckle, N. Gladkova, F. Feldchtein, A. Terentieva, B. Brand, G. Gelikonov, V. Gelikonov, A. Sergeev, A. Fritscher-Ravens, J. Freund, U. Seitz, S. Soehendra, and N. Schrödern, "In vivo endoscopic optical coherence tomography of the human gastrointestinal tract--toward optical biopsy," Endoscopy 32, 743-749 (2000). [CrossRef] [PubMed]
- M. V. Sivak, Jr., K. Kobayashi, J. A. Izatt, A. M. Rollins, R. Ung-Runyawee, A. Chak, R. C. Wong, G. A. Isenberg, and J. Willis, "High-resolution endoscopic imaging of the GI tract using optical coherence tomography," Gastrointest. Endosc. 51, 474-479 (2000). [CrossRef] [PubMed]
- X. D. Li, S. A. Boppart, J. Van Dam, H. Mashimo, M. Mutinga, W. Drexler, M. Klein, C. Pitris, M. L. Krinsky, M. E. Brezinski, and J. G. Fujimoto, "Optical coherence tomography: advanced technology for the endoscopic imaging of Barrett's esophagus," Endoscopy 32, 921-930 (2000). [CrossRef]
- A. C. Fantin, J. Binek, W. R. Suter, and C. Meyenberger, "Argon beam coagulation for treatment of symptomatic radiation-induced proctitis," Gastrointest. Endosc. 49, 515-518 (1999). [CrossRef] [PubMed]
- T. Takayama, S. Katsuki, Y. Takahashi, M. Ohi, S. Nojiri, S. Sakamaki, J. Kato, K. Kogawa, H. Miyake, and Y. Niitsu, "Aberrant crypt foci of the colon as precursors of adenoma and cancer," New Engl. J. Med. 339, 1277-1284 (1998). [CrossRef] [PubMed]
- D. M. Jensen, G. A. Machicado, S. Cheng, M. E. Jensen, and R. Jutabha, "A randomized prospective study of endoscopic bipolar electrocoagulation and heater probe treatment of chronic rectal bleeding from radiation telangiectasia," Gastrointest. Endosc. 45, 20-25 (1997). [CrossRef] [PubMed]
- G. J. Tearney, M. E. Brezinski, B. E. Bouma, S. A. Boppart, C. Pitvis, J. F. Southern, and J. G. Fujimoto, "In vivo endoscopic optical biopsy with optical coherence tomography," Science 276, 2037-2039 (1997). [CrossRef] [PubMed]
- S. S. Donaldson, "Radiation Proctitis after Prostate Carcinoma-Therapy," JAMA-J. Am. Med. Assoc. 271, 819-820 (1994). [CrossRef]
- M. E. Lucarotti, R. A. Mountford, and D. C. C. Bartolo, "Surgical-Management of Intestinal Radiation-Injury," Dis. Colon Rectum 34, 865-869 (1991). [CrossRef] [PubMed]
- D. Huang, E. A. Swanson, C. P. Lin, J. S. Schuman, W. G. Stinson, W. Chang, M. R. Hee, T. Flotte, K. Gregory, C. A. Puliafito, and J. G. Fujimoto, "Optical Coherence Tomography," Science 254, 1178-1181 (1991). [CrossRef] [PubMed]
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