Clin Endosc.  2011 Dec;44(2):87-92. 10.5946/ce.2011.44.2.87.

Endoscopic Imaging in Barrett's Oesophagus: Applications in Routine Clinical Practice and Future Outlook

Affiliations
  • 1Lyell McEwin Hospital, University of Adelaide, South Australia, Australia. rajvindersingh2003@yahoo.com

Abstract

The practice for endoscopic surveillance of Barrett's oesophagus has evolved from "blind" or random 4 quadrant biopsies (Seattle protocol) to a more "intelligent" targeted biopsy approach. This evolution has been possible due to the rapid advances in endoscopic imaging technology and expertise in the last decade. Previous endoscopes had relatively poor image resolution that often did not allow the subtle mucosal changes associated with dysplastic Barrett's mucosa to be identified. Newer endoscopic imaging techniques available today may allow endoscopists to identify areas of dysplasia or malignancy and target biopsies accordingly. These modalities which include narrow band imaging, chromoendoscopy, autofluorescence imaging, and confocal endomicroscopy as well as a few novel imaging modalities on the horizon will be discussed further.

Keyword

Barrett esophagus; Chromoendoscopy; Narrow band imaging; Autofluorescence imaging; Confocal endomicroscopy

MeSH Terms

Barrett Esophagus
Biopsy
Endoscopes
Mucous Membrane
Narrow Band Imaging
Optical Imaging

Reference

1. Dent J. Barrett's esophagus: a historical perspective, an update on core practicalities and predictions on future evolutions of management. J Gastroenterol Hepatol. 2011; 26(Suppl 1):11–30. PMID: 21199510.
Article
2. Portale G, Hagen JA, Peters JH, et al. Modern 5-year survival of resectable esophageal adenocarcinoma: single institution experience with 263 patients. J Am Coll Surg. 2006; 202:588–596. PMID: 16571425.
Article
3. Mandal A, Playford RJ, Wicks AC. Current practice in surveillance strategy for patients with Barrett's oesophagus in the UK. Aliment Pharmacol Ther. 2003; 17:1319–1324. PMID: 12755845.
Article
4. Abrams JA, Kapel RC, Lindberg GM, et al. Adherence to biopsy guidelines for Barrett's esophagus surveillance in the community setting in the United States. Clin Gastroenterol Hepatol. 2009; 7:736–742. PMID: 19268726.
Article
5. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett's esophagus: the Prague C % M criteria. Gastroenterology. 2006; 131:1392–1399. PMID: 17101315.
Article
6. Chang CY, Lee YC, Lee CT, et al. The application of Prague C and M criteria in the diagnosis of Barrett's esophagus in an ethnic Chinese population. Am J Gastroenterol. 2009; 104:13–20. PMID: 19098843.
Article
7. Lee YC, Cook MB, Bhatia S, et al. Interobserver reliability in the endoscopic diagnosis and grading of Barrett's esophagus: an Asian multinational study. Endoscopy. 2010; 42:699–704. PMID: 20806154.
Article
8. Kara MA, Peters FP, Rosmolen WD, et al. High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study. Endoscopy. 2005; 37:929–936. PMID: 16189764.
Article
9. Wolfsen HC, Crook JE, Krishna M, et al. Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. Gastroenterology. 2008; 135:24–31. PMID: 18442484.
Article
10. Sharma P, Meining A, Coron E, et al. Detection of neoplastic tissue in Barrett's esophagus with in vivo probe-based confocal endomicroscopy (DONT BIOPCE). Final results of a prospective international RCT: image guided versus 4 quadrant random biopsies? Gastroenterology. 2010; 138(5 Suppl 1):S-155.
11. Singh R, Karageorgiou H, Owen V, et al. Comparison of high-resolution magnification narrow-band imaging and white-light endoscopy in the prediction of histology in Barrett's oesophagus. Scand J Gastroenterol. 2009; 44:85–92. PMID: 18821132.
Article
12. Fortun PJ, Anagnostopoulos GK, Kaye P, et al. Acetic acid-enhanced magnification endoscopy in the diagnosis of specialized intestinal metaplasia, dysplasia and early cancer in Barrett's oesophagus. Aliment Pharmacol Ther. 2006; 23:735–742. PMID: 16556175.
Article
13. Longcroft-Wheaton G, Duku M, Mead R, Poller D, Bhandari P. Acetic acid spray is an effective tool for the endoscopic detection of neoplasia in patients with Barrett's esophagus. Clin Gastroenterol Hepatol. 2010; 8:843–847. PMID: 20601133.
14. Canto MI, Setrakian S, Willis JE, Chak A, Petras RE, Sivak MV. Methylene blue staining of dysplastic and nondysplastic Barrett's esophagus: an in vivo and ex vivo study. Endoscopy. 2001; 33:391–400. PMID: 11396755.
Article
15. Ngamruengphong S, Sharma VK, Das A. Diagnostic yield of methylene blue chromoendoscopy for detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus: a meta-analysis. Gastrointest Endosc. 2009; 69:1021–1028. PMID: 19215918.
Article
16. Wild CP, Sturmey RG, Olliver JR, Sahay P, Hardie LJ. Methylene blue, chromoendoscopy and DNA damage in human esophageal cells. Proc Am Assoc Cancer Res. 2005; 46:517–518.
17. Sharma P, Weston AP, Topalovski M, Cherian R, Bhattacharyya A, Sampliner RE. Magnification chromoendoscopy for the detection of intestinal metaplasia and dysplasia in Barrett's oesophagus. Gut. 2003; 52:24–27. PMID: 12477754.
Article
18. Curvers WL, Singh R, Wallace MB, et al. Identification of predictive factors for early neoplasia in Barrett's esophagus after autofluorescence imaging: a stepwise multicenter structured assessment. Gastrointest Endosc. 2009; 70:9–17. PMID: 19394009.
Article
19. Niepsuj K, Niepsuj G, Cebula W, et al. Autofluorescence endoscopy for detection of high-grade dysplasia in short-segment Barrett's esophagus. Gastrointest Endosc. 2003; 58:715–719. PMID: 14595307.
Article
20. Thomas T, Singh R, Ragunath K. Trimodal imaging-assisted endoscopic mucosal resection of early Barrett's neoplasia. Surg Endosc. 2009; 23:1609–1613. PMID: 19296171.
Article
21. Borovicka J, Fischer J, Neuweiler J, et al. Autofluorescence endoscopy in surveillance of Barrett's esophagus: a multicenter randomized trial on diagnostic efficacy. Endoscopy. 2006; 38:867–872. PMID: 16981102.
Article
22. Curvers WL, Herrero LA, Wallace MB, et al. Endoscopic tri-modal imaging is more effective than standard endoscopy in identifying early-stage neoplasia in Barrett's esophagus. Gastroenterology. 2010; 139:1106–1114. PMID: 20600033.
Article
23. Kara MA, Smits ME, Rosmolen WD, et al. A randomized crossover study comparing light-induced fluorescence endoscopy with standard videoendoscopy for the detection of early neoplasia in Barrett's esophagus. Gastrointest Endosc. 2005; 61:671–678. PMID: 15855970.
Article
24. Curvers WL, Singh R, Song LM, et al. Endoscopic tri-modal imaging for detection of early neoplasia in Barrett's oesophagus: a multi-centre feasibility study using high-resolution endoscopy, autofluorescence imaging and narrow band imaging incorporated in one endoscopy system. Gut. 2008; 57:167–172. PMID: 17965067.
Article
25. Curvers WL, van Vilsteren FG, Baak LC, et al. Endoscopic trimodal imaging versus standard video endoscopy for detection of early Barrett's neoplasia: a multicenter, randomized, crossover study in general practice. Gastrointest Endosc. 2011; 73:195–203. PMID: 21168835.
Article
26. Canto MI. Endomicroscopy of Barrett's esophagus. Gastroenterol Clin North Am. 2010; 39:759–769. PMID: 21093753.
Article
27. Wallace MB, Meining A, Canto MI, et al. The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. Aliment Pharmacol Ther. 2010; 31:548–552. PMID: 20002025.
Article
28. Neumann H, Kiesslich R, Wallace MB, Neurath MF. Confocal laser endomicroscopy: technical advances and clinical applications. Gastroenterology. 2010; 139:388–392. PMID: 20561523.
Article
29. Kiesslich R, Gossner L, Goetz M, et al. In vivo histology of Barrett's esophagus and associated neoplasia by confocal laser endomicroscopy. Clin Gastroenterol Hepatol. 2006; 4:979–987. PMID: 16843068.
Article
30. Dunbar KB, Okolo P 3rd, Montgomery E, Canto MI. Confocal laser endomicroscopy in Barrett's esophagus and endoscopically inapparent Barrett's neoplasia: a prospective, randomized, double-blind, controlled, crossover trial. Gastrointest Endosc. 2009; 70:645–654. PMID: 19559419.
Article
31. Leung KK, Maru D, Abraham S, Hofstetter WL, Mehran R, Anandasabapathy S. Optical EMR: confocal endomicroscopy-targeted EMR of focal high-grade dysplasia in Barrett's esophagus. Gastrointest Endosc. 2009; 69:170–172. PMID: 18582880.
Article
32. Pohl H, Rösch T, Vieth M, et al. Miniprobe confocal laser microscopy for the detection of invisible neoplasia in patients with Barrett's oesophagus. Gut. 2008; 57:1648–1653. PMID: 18755886.
Article
33. Bajbouj M, Vieth M, Rösch T, et al. Probe-based confocal laser endomicroscopy compared with standard four-quadrant biopsy for evaluation of neoplasia in Barrett's esophagus. Endoscopy. 2010; 42:435–440. PMID: 20506064.
Article
34. Cengia G, Missale G, Minelli L, Villanacci V, Rossi E, Cestari R. Screening for and surveillance of Barrett's esophagus is clinically indicated. Dig Dis. 2007; 25:197–202. PMID: 17827939.
Article
35. Jin Z, Cheng Y, Gu W, et al. A multicenter, double-blinded validation study of methylation biomarkers for progression prediction in Barrett's esophagus. Cancer Res. 2009; 69:4112–4115. PMID: 19435894.
Article
36. Rabinovitch PS, Longton G, Blount PL, Levine DS, Reid BJ. Predictors of progression in Barrett's esophagus III: baseline flow cytometric variables. Am J Gastroenterol. 2001; 96:3071–3083. PMID: 11721752.
Article
37. Zagaynova E, Gladkova N, Shakhova N, Gelikonov G, Gelikonov V. Endoscopic OCT with forward-looking probe: clinical studies in urology and gastroenterology. J Biophotonics. 2008; 1:114–128. PMID: 19343643.
Article
38. Waxman I, Konda VJ. Endoscopic techniques for recognizing neoplasia in Barrett's esophagus: which should the clinician use? Curr Opin Gastroenterol. 2010; 26:352–360. PMID: 20571387.
Article
39. Georgakoudi I, Jacobson BC, Van Dam J, et al. Fluorescence, reflectance, and light-scattering spectroscopy for evaluating dysplasia in patients with Barrett's esophagus. Gastroenterology. 2001; 120:1620–1629. PMID: 11375944.
Article
40. El-Serag HB, Naik AD. Surveillance in Barrett's esophagus: lessons from behavioral economics. Gastroenterology. 2009; 137:763–765. PMID: 19643189.
Article
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr