Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes
Background and aims Peroral endoscopic myotomy (POEM) is a standard treatment option for achalasia patients. Treatment response varies due to factors such as achalasia type, degree of dilatation, pressure and distensibility indices. We present an innovative approach for treatment response prediction...
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| Language: | English |
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BMJ Publishing Group
2024-05-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/11/1/e001396.full |
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| author | Alanna Ebigbo Helmut Messmann Vivian Grünherz Miriam Elia Alessandra Brunner Tamara Krafft Leo Pöller Pia Schneider Fabian Stieler Bernhard Bauer Anna Muzalyova Sandra Nagl |
| author_facet | Alanna Ebigbo Helmut Messmann Vivian Grünherz Miriam Elia Alessandra Brunner Tamara Krafft Leo Pöller Pia Schneider Fabian Stieler Bernhard Bauer Anna Muzalyova Sandra Nagl |
| author_sort | Alanna Ebigbo |
| collection | DOAJ |
| description | Background and aims Peroral endoscopic myotomy (POEM) is a standard treatment option for achalasia patients. Treatment response varies due to factors such as achalasia type, degree of dilatation, pressure and distensibility indices. We present an innovative approach for treatment response prediction based on an automatic three-dimensional (3-D) reconstruction of the tubular oesophagus (TE) and the lower oesophageal sphincter (LES) in patients undergoing POEM for achalasia.Methods A software was developed, integrating data from high-resolution manometry, timed barium oesophagogram and endoscopic images to automatically generate 3-D reconstructions of the TE and LES. Novel normative indices for TE (volume×pressure) and LES (volume/pressure) were automatically integrated, facilitating pre-POEM and post-POEM comparisons. Treatment response was evaluated by changes in volumetric and pressure indices for the TE and the LES before as well as 3 and 12 months after POEM. In addition, these values were compared with normal value indices of non-achalasia patients.Results 50 treatment-naive achalasia patients were enrolled prospectively. The mean TE index decreased significantly (p<0.0001) and the mean LES index increased significantly 3 months post-POEM (p<0.0001). In the 12-month follow-up, no further significant change of value indices between 3 and 12 months post-POEM was seen. 3 months post-POEM mean LES index approached the mean LES of the healthy control group (p=0.077).Conclusion 3-D reconstruction provides an interactive, dynamic visualisation of the oesophagus, serving as a comprehensive tool for evaluating treatment response. It may contribute to refining our approach to achalasia treatment and optimising treatment outcomes.Trial registration number 22-0149. |
| format | Article |
| id | doaj-art-4cbd0dfc37e54676a72904cd4baa8caa |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-4cbd0dfc37e54676a72904cd4baa8caa2025-02-12T07:40:13ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742024-05-0111110.1136/bmjgast-2024-001396Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomesAlanna Ebigbo0Helmut Messmann1Vivian Grünherz2Miriam Elia3Alessandra Brunner4Tamara Krafft5Leo Pöller6Pia Schneider7Fabian Stieler8Bernhard Bauer9Anna Muzalyova10Sandra Nagl11Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Bayern, Germany9Department of Gastroenterology, Augsburg Hospital, Augsburg, GermanyDepartment of Gastroenterology, University Hospital Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyUniversity of Augsburg, Augsburg, GermanyDepartment of Gastroenterology, University Hospital Augsburg, Augsburg, GermanyUniversity Hospital Augsburg, Augsburg, GermanyBackground and aims Peroral endoscopic myotomy (POEM) is a standard treatment option for achalasia patients. Treatment response varies due to factors such as achalasia type, degree of dilatation, pressure and distensibility indices. We present an innovative approach for treatment response prediction based on an automatic three-dimensional (3-D) reconstruction of the tubular oesophagus (TE) and the lower oesophageal sphincter (LES) in patients undergoing POEM for achalasia.Methods A software was developed, integrating data from high-resolution manometry, timed barium oesophagogram and endoscopic images to automatically generate 3-D reconstructions of the TE and LES. Novel normative indices for TE (volume×pressure) and LES (volume/pressure) were automatically integrated, facilitating pre-POEM and post-POEM comparisons. Treatment response was evaluated by changes in volumetric and pressure indices for the TE and the LES before as well as 3 and 12 months after POEM. In addition, these values were compared with normal value indices of non-achalasia patients.Results 50 treatment-naive achalasia patients were enrolled prospectively. The mean TE index decreased significantly (p<0.0001) and the mean LES index increased significantly 3 months post-POEM (p<0.0001). In the 12-month follow-up, no further significant change of value indices between 3 and 12 months post-POEM was seen. 3 months post-POEM mean LES index approached the mean LES of the healthy control group (p=0.077).Conclusion 3-D reconstruction provides an interactive, dynamic visualisation of the oesophagus, serving as a comprehensive tool for evaluating treatment response. It may contribute to refining our approach to achalasia treatment and optimising treatment outcomes.Trial registration number 22-0149.https://bmjopengastro.bmj.com/content/11/1/e001396.full |
| spellingShingle | Alanna Ebigbo Helmut Messmann Vivian Grünherz Miriam Elia Alessandra Brunner Tamara Krafft Leo Pöller Pia Schneider Fabian Stieler Bernhard Bauer Anna Muzalyova Sandra Nagl Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes BMJ Open Gastroenterology |
| title | Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes |
| title_full | Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes |
| title_fullStr | Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes |
| title_full_unstemmed | Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes |
| title_short | Automatic three-dimensional reconstruction of the oesophagus in achalasia patients undergoing POEM: an innovative approach for evaluating treatment outcomes |
| title_sort | automatic three dimensional reconstruction of the oesophagus in achalasia patients undergoing poem an innovative approach for evaluating treatment outcomes |
| url | https://bmjopengastro.bmj.com/content/11/1/e001396.full |
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