scholarly journals Optical Detection and Eradication of Dysplastic Barrett's Esophagus

2003 ◽  
Vol 2 (4) ◽  
pp. 289-302 ◽  
Author(s):  
Louis-Michel Wong Kee Song ◽  
Kenneth K. Wang
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Sampling Error ◽  
Imaging Techniques ◽  
Standard Of Care ◽  
Diagnostic Techniques ◽  
Endoscopic Surveillance ◽  
Current Status ◽  
Delay In Diagnosis ◽  
Multiple Biopsies

Dysplastic Barrett's esophagus is a condition that offers multiple diagnostic and therapeutic challenges. The diagnosis of dysplasia within Barrett's esophagus currently relies on periodic endoscopic surveillance with multiple biopsies, a methodology limited by random sampling error, inconsistent histopathologic interpretation and delay in diagnosis. Optical spectroscopic and imaging techniques have the potential to identify dysplastic or early neoplastic lesions in real-time. These diagnostic modalities are needed to enhance the endoscopic surveillance of Barrett's esophagus in the future as well as help to define lesions for endoscopic therapy. Esophagectomy has been the standard of care for Barrett's esophagus with high-grade dysplasia although it is a procedure associated with significant morbidity and mortality. Minimally invasive endoscopic ablative therapies are attractive and less morbid alternatives to esophagectomy, with promising results obtained from the use of light-activated drugs (i.e., photodynamic therapy). The combination of novel optical diagnostic techniques and therapies will provide the endoscopist with much needed tools that can considerably enhance the management of patients with Barrett's esophagus. This article reviews the current status and future prospects of optical-based modalities for diagnosis and therapy of dysplastic Barrett's esophagus.

scholarly journals Beyond Seattle: WATS and Advanced Imaging in Barrett’s Esophagus

2021 ◽  
Vol 1 (1) ◽  
pp. 32-38
Author(s):  
Sharmila Anandasabapathy ◽  
Nabil M. Mansour
Keyword(s):  
Artificial Intelligence ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Standard Of Care ◽  
Endoscopic Surveillance ◽  
Computer Assisted ◽  
3D Analysis ◽  
Advanced Imaging ◽  
Current Standard

Barrett’s esophagus is the sole known precursor for esophageal adenocarcinoma. Endoscopic surveillance for Barrett’s esophagus is recommended to help identify and manage dysplasia, with the ultimate goal being prevention or early detection of esophageal adenocarcinoma. The current standard of care for endoscopic surveillance for Barrett’s esophagus, the Seattle protocol, has many drawbacks. Methods to overcome these disadvantages have been an active area of research. This review will focus on some of the technologies to help improve dysplasia surveillance in Barrett’s esophagus, including advanced endoscopic imaging, artificial intelligence, and wide-area transepithelial sampling with computer-assisted 3D analysis (WATS-3D).

scholarly journals Su1008 Extent and Determinants of Endoscopic Surveillance in 29,045 Patients With Barrett's Esophagus

2012 ◽  
Vol 142 (5) ◽  
pp. S-397-S-398
Author(s):  
Hashem El-Serag ◽  
Jennifer R. Kramer ◽  
Zhigang Duan ◽  
Marilyn Hinojosa-Lindsey ◽  
Jason Hou ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Endoscopic Surveillance

scholarly journals Detection of early neoplasia in Barrett’s esophagus using lectin-based near-infrared imaging: an ex vivo study on human tissue

Endoscopy ◽  
2018 ◽  
Vol 50 (06) ◽  
pp. 618-625 ◽  
Author(s):  
André Neves ◽  
Massimiliano Di Pietro ◽  
Maria O’Donovan ◽  
Dale Waterhouse ◽  
Sarah Bohndiek ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Ex Vivo ◽  
Sampling Error ◽  
Nir Light ◽  
Nir Imaging ◽  
Nir Fluorescence ◽  
Nir Dye

Abstract Background and study aims Endoscopic surveillance for Barrett’s esophagus (BE) is limited by long procedure times and sampling error. Near-infrared (NIR) fluorescence imaging minimizes tissue autofluorescence and optical scattering. We assessed the feasibility of a topically applied NIR dye-labeled lectin for the detection of early neoplasia in BE in an ex vivo setting. Methods Consecutive patients undergoing endoscopic mucosal resection (EMR) for BE-related early neoplasia were recruited. Freshly collected EMR specimens were sprayed at the bedside with fluorescent lectin and then imaged. Punch biopsies were collected from each EMR under NIR light guidance. We compared the fluorescence intensity from dysplastic and nondysplastic areas within EMRs and from punch biopsies with different histological grades. Results 29 EMR specimens were included from 17 patients. A significantly lower fluorescence was found for dysplastic regions across whole EMR specimens (P < 0.001). We found a 41 % reduction in the fluorescence of dysplastic compared to nondysplastic punch biopsies (P < 0.001), with a sensitivity and specificity for dysplasia detection of 80 % and 82.9 %, respectively. Conclusion Lectin-based NIR imaging can differentiate dysplastic from nondysplastic Barrett’s mucosa ex vivo.

scholarly journals Motion – All Patients with GERD Should Be Offered Once in a Lifetime Endoscopy: Arguments for the Motion

2002 ◽  
Vol 16 (8) ◽  
pp. 549-551 ◽  
Author(s):  
David Armstrong
Keyword(s):  
Health Care ◽  
Gastroesophageal Reflux Disease ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Ph Monitoring ◽  
Diagnostic Techniques ◽  
Proton Pump Inhibitor Therapy ◽  
Initial Management ◽  
Published Evidence ◽  
Esophageal Ph

Proton pump inhibitor therapy is so successful at relieving refluxrelated symptoms and healing esophageal erosions that it has supplanted formal diagnostic techniques, such as endoscopy and esophageal pH monitoring, for the initial management of gastroesophageal reflux disease. The response to antisecretory therapy is not indicative, however, of Barrett’s esophagus or esophageal adenocarcinoma. Patients with prolonged and severe reflux symptoms, especially if they are over the age of 60 years, are at risk of these complications. For them, endoscopy is the only appropriate investigation for detecting Barrett’s esophagus and dysplasia or cancer. Because of the difficulty in distinguishing dysplasia from inflammatory and regenerative changes, endoscopy should be undertaken while the patient is on effective antisecretory therapy. Endoscopy should be offered only to patients who are suitable for further therapy (especially esophagectomy), and only if they understand the implications of abnormal findings. The published evidence suggests that the application of clear guidelines would not overwhelm health care resources, and that fewer than 20% of patients with Barrett’s esophagus would eventually undergo endoscopic surveillance.

Sign in / Sign up

Export Citation Format

Share Document