Acetic acid chromoendoscopy in Barrett's esophagus surveillance is superior to the standardized random biopsy protocol: results from a large cohort study (with video)

Tholoor, Shareef; Bhattacharyya, Rupam; Tsagkournis, Orestis; Longcroft‐Wheaton, Gaius; Bhandari, Pradeep

doi:10.1016/j.gie.2014.01.041

Cited by 57 publications

(41 citation statements)

References 17 publications

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“…Methylene blue does not add much,35 nor does indigo carmine 36. Acetic acid (figure 1) may improve sensitivity of dysplasia detection, but the evidence is conflicting 3738 The advent of virtual chromoendoscopy, which is activated by a toggle button on the endoscope, has reduced the need for these dyes through the manipulation of the white light images.…”

Section: Endoscopic Techniquesmentioning

confidence: 99%

Monitoring the premalignant potential of Barrett's oesophagus'

Graham

Lipman

Sehgal

et al. 2016

Frontline Gastroenterol

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The landscape for patients with Barrett's oesophagus (BE) has changed significantly in the last decade. Research and new guidelines have helped gastroenterologists to better identify those patients with BE who are particularly at risk of developing oesophageal adenocarcinoma. In parallel, developments in endoscopic image enhancement technology and optical biopsy techniques have improved our ability to detect high-risk lesions. Once these lesions have been identified, the improvements in minimally invasive endoscopic therapies has meant that these patients can potentially be cured of early cancer and high-risk dysplastic lesions without the need for surgery, which still has a significant morbidity and mortality. The importance of reaching an accurate diagnosis of BE remains of paramount importance. More work is needed, however. The vast majority of those undergoing surveillance for their BE do not progress towards cancer and thus undergo a regular invasive procedure, which may impact on their psychological and physical well-being while incurring significant cost to the health service. New work that explores cheaper endoscopic or non-invasive ways to identify the at-risk individual provides exciting avenues for research. In future, the diagnosis and monitoring of patients with BE could move away from hospitals and into primary care.

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Section: Endoscopic Techniquesmentioning

confidence: 99%

Monitoring the premalignant potential of Barrett's oesophagus'

Graham

Lipman

Sehgal

et al. 2016

Frontline Gastroenterol

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“…23 Although no randomized studies have been performed to date, acetic acid has been shown to significantly improve the detection of neoplasia as compared with WLE with routine random biopsies. 23,24 For a variety of reasons, dye-based chromoendoscopy has not gained widespread clinical use, including a perception that the technique is time consuming and tedious, the concurrent need for high-magnification endoscopy, and concerns regarding the potential to cause bodily harm to the patient. In addition, no standardized classification criteria have been established for dye-based chromoendoscopy, leading to wide variability in sensitivity and specificity.…”

Section: Dye-based Chromoendoscopymentioning

confidence: 99%

“…In addition, no standardized classification criteria have been established for dye-based chromoendoscopy, leading to wide variability in sensitivity and specificity. 10,11,[16][17][18][19][20][22][23][24] In summary, dye-based chromoendoscopy seems to have a limited role in the evaluation of patients with suspected or established BE. This technique has been largely supplanted by optical chromoendoscopy because of the ease and safety of this method.…”

Section: Dye-based Chromoendoscopymentioning

confidence: 99%

Advanced Imaging in Barrett's Esophagus

Muthusamy

Kim

Wallace

2015

Gastroenterology Clinics of North America

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“…However, this method has several drawbacks such as time required, low compliance, and increased risk of sampling error [16,17]. Recently, target biopsies using advanced imaging techniques have been reported to feature similar diagnostic proportions of specialized intestinal metaplasia with fewer biopsies and better detection rates of dysplastic lesions as compared with the random 4-quadrant biopsy protocol [18,19]. Indeed, advanced imaging techniques such as magnifying endoscopy with narrow-band imaging, chromoendoscopy, and confocal endomicroscopy have been proposed to increase the efficiency and accuracy of endoscopic surveillance [20,21], though the classification systems used with those techniques are too complicated to be widely employed in clinical settings [22].…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology of Barrett's Esophagus-Associated Neoplasia: Circumferential Spatial Predilection

et al. 2014

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The prevalence rates of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) arising from BE show striking geographic patterns as they are much more common in Western as compared with Asian countries. However, recent epidemiological studies indicate that the number of patients with BE and EAC are gradually increasing in Asia including Japan, corresponding to the increase in prevalence of gastroesophageal reflux disease (GERD). Because the prognosis of patients with advanced-stage EAC remains poor, early detection of neoplastic lesion in those with BE has led to recent interest in effective treatment. Several promising studies have revealed that early neoplasia in BE is mainly located in the right anterior wall of the distal esophagus. Interestingly, this endoscopic characteristic has been found in both Western and Japanese populations. Potential pathophysiologic explanations underlying the circumferential distribution of neoplasia in BE include a nonuniform asymmetric distribution of esophageal acid exposure, with a tendency toward mucosal acid-related injury on the right side of the esophageal wall in patients with GERD, and the functional structure of the lower esophageal sphincter. Findings of the present study should improve lesion detection and aid in developing a target biopsy protocol for surveillance of BE.

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Acetic acid chromoendoscopy in Barrett's esophagus surveillance is superior to the standardized random biopsy protocol: results from a large cohort study (with video)

Cited by 57 publications

References 17 publications

Monitoring the premalignant potential of Barrett's oesophagus'

Monitoring the premalignant potential of Barrett's oesophagus'

Advanced Imaging in Barrett's Esophagus

Pathophysiology of Barrett's Esophagus-Associated Neoplasia: Circumferential Spatial Predilection

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