Clin Endosc.  2024 Jan;57(1):1-10. 10.5946/ce.2023.031.

Advanced endoscopic imaging for detection of Barrett’s esophagus

• Zilberstein N
• Godbee M
• Mehta NA
• Waxman I

• KMID: 2551184
• DOI: http://doi.org/10.5946/ce.2023.031

Abstract

Barrett’s esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

Keyword

Artificial intelligence; Barrett Esophagus; Diagnostic Techniques and Procedures; Endoscopy; Esophageal Neoplasms

Figure

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  Fig. 1. High-quality endoscopic Barrett’s esophagus examination using high-definition white light endoscopy (A) and narrow-band imaging (B) to identify dysplastic lesions.

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  Fig. 2. Images of confocal laser endomicroscopy using a through-the-scope probe showing. (A) Non-dysplastic Barrett’s esophagus. (B) Dysplastic Barrett’s esophagus.

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  Fig. 3. Volumetric laser endomicroscopy (VLE) images showing a classic VLE image with Barrett’s esophagus dysplasia (A) and magnified image of A showing the dysplastic area (B).

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  Fig. 4. Laser markings of esophageal mucosa during volumetric laser endomicroscopy examination.

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  Fig. 5. EsoCheck device (Lucid Dx Labs) with an inflatable silicone balloon attached to a syringe.

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