Positive correlation of image analysis by mini-endoscopy with micro-PET scan and histology in rats after esophagoduodenal anastomosis

Background Visual inspection of induced carcinogenic transformation is of crucial interest when evaluating growth patterns and therapeutic effects. In previous studies we have used micro-PET scan to analyze the esophageal adenocarcinoma (EAC) transformation in an intact rat model of esophagoduodenal anastomosis (EDA), in which intestinal metaplasia and EAC were reproduced successfully. Our current study aimed to test the feasibility of evaluating the outcomes of our EDA model with a recently developed mini-endoscope. Methods EDA was performed as described previously. Postoperative rats underwent evaluation with upper endoscopy with the mini-endoscope (±endoscopic biopsy) and a micro-PET scan with 18 F-FDG 3 months after the EDA procedure. Rats were euthanized and the esophagi were collected for histological observation, immunohistochemical staining, and TdT labeling assay. We compared the endoscopic images with the radiographic images of 18 F-FDG uptake by micro-PET scan and correlated the endoscopic images with the histological changes in the EDA rats. Results The endoscope provided visualization of the entire esophageal tract and upper stomach, with the smallest detectable lesion being 0.5 mm in diameter. Mini-endoscopy was performed regularly and was tolerated without any significant procedure-related alterations in the esophageal tract. The visualized esophageal lesion correlated well with the micro-PET image and the histological changes in the EDA rats. Conclusions The new mini-endoscope constitutes a practical and reliable tool for diagnosis and regular follow-up of the esophagus in rats. Lesions identified by endoscopic observation were consistent with the changes found in the micro-PET scan, histopathology, and alteration of cellular and molecular events in esophageal mucosa. This instrument will allow for serial endoscopic evaluations, similar to endoscopic screening in humans, which will significantly enhance the preclinical development and evaluation of experimental intravesical antitumor therapies.