Ms. Huizi Gao Profile

Huizi Gao

at Massachusetts General Hospital

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Publications (4)

Proceedings Article | 7 March 2022 Presentation

Feasibility and safety of tethered capsule endomicroscopy in studying the natural history of Barrett’s esophagus: a multi-center study

Jing Dong, Catriona Grant, Barry Vuong, Norman Nishioka, Anna Huizi Gao, Matthew Beatty, Grace Baldwin, Aaron Bailargeon, Ara Bablouzian, Patricia Grahmann, Nitasha G. Bhat, Emily Ryan, Amilcar Barrios, Paola Leon Alarcon, Sarah Giddings, Tim Ford, Émilie Beaulieu-Ouellet, Seyed Hamid Hosseiny, Irene Lerman, Wolfgang Trasischker, Rohith Reddy, Kanwarpal Singh, Michalina Gora, Daryl Hyun, Lucille Quénéhervé, Michael Wallace, Wolfsen Herbert, Prateek Sharma, Kenneth Wang, Cadman Leggett, John Poneros, Julian Abrams, Charles Lightdale, Samantha Leeds, Mireille Rosenberg, Guillermo Tearney

Proceedings Volume PC11937, PC119370N (2022) https://doi.org/10.1117/12.2610595

KEYWORDS: Esophagus, Optical coherence tomography, Endoscopy, Endomicroscopy, Safety, Tissues, Imaging systems, Biopsy, Diagnostics, Yield improvement

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Proceedings Article | 5 March 2021 Poster + Presentation

Screening for Barrett’s Esophagus in the primary care setting using tethered capsule endomicroscopy

Anita Chung, Anna Gao, Catriona Grant, Emily Ryan, Nitasha Bhat, Alfred Kyrollos Kelada, Amilcar Pojoy Barrios, Jing Dong, Aaron Baillargeon, Patricia Grahmann, Mikayla Tinus, Ara Bablouzian, Rachel Smith, Joshua Metlay, Leigh Simmons, Karen Blumenthal, Donna Krauth, Luis Henkel, Andrew Fauteux, Emily Brown, Katherine Wolcott, Guillermo Tearney

Proceedings Volume 11620, 116200H (2021) https://doi.org/10.1117/12.2577743

KEYWORDS: Optical coherence tomography, Esophagus, Endomicroscopy, Image segmentation, Microscopy

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Proceedings Article | 4 March 2019 Presentation

Duodenal imaging by tethered capsule OCT endomicroscopy in adolescents with environmental enteric dysfunction (Conference Presentation)

Jing Dong, Kamran Sadiq, Catriona Grant, Omair Shakil, David Otuya, Hamid Farrokhi, Anna Gao, Nitasha Bhat, Sarah Giddings, Kumail Ahmed, Seema Rani, Mireille Rosenberg, Alessio Fasano, Christopher Damman, Asad Ali, Guillermo Tearney

Proceedings Volume 10854, 1085408 (2019) https://doi.org/10.1117/12.2513965

KEYWORDS: Optical coherence tomography, Endomicroscopy, Intestine, Endoscopy, Inflammation, Biopsy, 3D image processing, Visualization, Control systems

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Environmental Enteric Dysfunction (EED) is a poorly understood condition of the small intestine that is prevalent in regions of the world with inadequate sanitation and hygiene. EED affects 25% of all children globally and causes over a million deaths each year. The condition is associated with increased intestinal permeability, bacterial translocation, inflammation and villous blunting. The loss of absorptive area and intestinal function leads to nutrient malabsorption, with long term outcomes characterized by stunted growth and neurocognitive development. Currently, the only way to directly evaluate the morphology of the intestine is endoscopy with mucosal biopsy. Yet because EED is endemic in low and middle-income countries, endoscopy is untenable for studying EED. As a result, the diagnosis of EED and the assessment of the efficacy of EED interventions is hampered by an inability to evaluate the intestinal mucosa. Our lab has previously developed a technology termed tethered capsule OCT endomicroscopy (TCE). The method involves swallowing an optomechanically-engineered pill that generates 3D images of the GI tract as it traverses the lumen of the organ via peristalsis, assisted by gravity. In order to study the potential of using TCE to investigate EED, we initiated and conducted a TCE study in adolescents at Aga Khan Medical Center in Pakistan. To make swallowing easier, the tethered capsule’s size was reduced from 11x25 mm to 8x22 mm. Villous morphologic visualization was enhanced by building a notch (x mm deep, y mm wide) in the capsule’s imaging window. To date, 26 Pakistani subjects with ages ranging from 14 to 18 y/o (16.4 +/- 1.0) have been enrolled and imaged. A total of 19 subjects were able to swallow the capsule. Of those, 9 successfully passed through the pylorus, allowing successful microscopic imaging of the entire duodenum. There were no adverse events in any of the cases. Maximum villous height and width were measured from 3 randomly chosen, representative frames from each Pakistan subject as well as a matching number from US controls. Preliminary results, comparing Pakistani vs US villous morphology, indicated that subjects from Pakistan have shorter (628.6 +/- 22.0 um and 492.3 +/- 13.2 um, respectively, p< 0.0001) and wider duodenal villi (244.9 +/- 8.8 um and 293.4 +/- 13.2 um, respectively, p< 0.0001). These findings suggest that OCT TCE of the duodenum may be a useful tool for evaluating villous morphology in EED.

Proceedings Article | 4 March 2019 Presentation

Natural history of Barrett’s esophagus using tethered capsule OCT endomicroscopy and portable OCT imaging system: initial experience (Conference Presentation)

Jing Dong, Barry Vuong, Timothy Ford, Matthew Beatty, Seyed Hamid Hosseiny, Emilie Beaulieu-Ouellet, Rohith Reddy, Kanwarpal Singh, Hany Osman, Catriona Grant, Anna Huizi Gao, Samantha Leeds, Norman Nishioka, John Poneros, Julian Abrams, Charles Lightdale, Prateek Sharma, Michael Wallace, Herbert Wolfsen, Kenneth Wang, Cadman Leggett, Mireille Rosenberg, Guillermo Tearney

Proceedings Volume 10867, 108670T (2019) https://doi.org/10.1117/12.2511523

KEYWORDS: Optical coherence tomography, Esophagus, Imaging systems, Endomicroscopy, Endoscopy, Biopsy, 3D image processing, Clinical trials, Image resolution, Tissues

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While the most common method used to evaluate and survey patients with Barrett’s Esophagus (BE) is endoscopic biopsy, this procedure is invasive, time-consuming, and suffers from sampling errors. Moreover, it requires patient sedation that increases cost and mandates its operation in specialized settings. Our lab has developed a new imaging tool termed tethered capsule endomicroscopy (TCE) that involves swallowing a tethered capsule which utilizes optical coherence tomography (OCT) to obtain three-dimensional microscopic (10µm) images of the entire esophageal wall as it traverses the luminal organ via peristalsis or is retrieved by pulling up tether. As opposed to endoscopy, TCE procedure is non-invasive, doesn’t require patient sedation and mitigates sampling error by evaluating the microscopic structure of the entire esophagus. The merits of TCE make it a suitable device to investigate the microscopic natural history of BE in a longitudinal manner. Here, we present our initial experience of a multicenter (5-site) clinical trial to study the microscopic natural history of BE. The TCE device used for the study is the new generation capsule with the ball lens optical configuration and a distal scan stepper motor, which provides 30µm (lateral) resolution and 40Hz imaging rate. The portable OCT imaging system is a custom in-house built swept source system and provides 7µm (axial) at a 100 kHz A-line rate with a center wavelength of ~1310 nm. To date, we have successfully enrolled 69 subjects at all sites (MGH: 33, Columbia University: 11, Kansas City VA: 10, Mayo Jacksonville: 8, Mayo Rochester: 7) and 59 have swallowed the capsule (85.5%). There have been no reported adverse events associated with TCE procedure. High-quality OCT images were reliably obtained from patients who swallowed the device, and BE tissues were identified by expert readers. Our initial experience with TCE in a multicenter study demonstrates that this technology is easy to use and efficient in multiple clinical settings. Completion of this longitudinal study is likely to provide new insights on the temporal progression of BE that may impact management strategies.

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