Detection of buried Barrett’s glands after radiofrequency ablation with volumetric laser endomicroscopy

Swager, Anne-Fré; Boerwinkel, David F.; Bruin, Daniël M. de; Faber, Dirk J.; Leeuwen, Ton G. van; Weusten, Bas L.; Meijer, Sybren L.; Bergman, Jacques; Curvers, Wouter L.

doi:10.1016/j.gie.2015.05.028

Cited by 52 publications

(47 citation statements)

References 30 publications

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“…VLE is a commercially available system based on frequency-domain OCT. A study from the Netherlands published in 2016 evaluating the detection of buried glands after RFA (in patients with HGD or intramucosal EAC) using VLE reported that out of 17 patients, 13 were found to have subsquamous glandular structures by VLE. However, after EMR and histologic evaluation, only 1 out of these 13 subsquamous glandular structures were found to represent SSIM, with Ann Cardiothorac Surg 2017;6(2):75-87 www.annalscts.com the remainder found to be normal histological structures (76). Further data is required regarding the true prevalence, malignant potential, and role of advanced imaging in SSIM before we can make further determinations regarding its true significance.…”

Section: Post-treatment Surveillancementioning

confidence: 99%

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Mansour

El–Serag

Anandasabapathy

2017

Ann. Cardiothorac. Surg.

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Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes. Advanced endoscopic imaging can help increase the efficiency of current endoscopic surveillance.Endoscopic therapy is safe and effective for the treatment of dysplastic BE and intramucosal EAC, but ongoing surveillance following treatment is necessary. This review will cover screening, surveillance, advanced imaging, chemoprevention, endoscopic treatment, and post-treatment surveillance of BE.

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Section: Post-treatment Surveillancementioning

confidence: 99%

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Mansour

El–Serag

Anandasabapathy

2017

Ann. Cardiothorac. Surg.

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“…The NvisionVLETM system was used in all studies [23][24][25][26][27][28][29]. Volumetric laser endomicroscopy is a second-generation optical coherence tomography.…”

Section: Equipment and Techniquesmentioning

confidence: 99%

“…Long segment imaging can be obtained with an axial resolution of 7 µm, a transverse resolution of about 30 µm, and can reach an imaging depth of up to 2 to 3 mm. A total of 1200 images can be obtained in 96 secs [23][24][25][26].…”

Section: Equipment and Techniquesmentioning

confidence: 99%

“…There were 33 cases of BE, 4 cases of low-grade dysplasia (LGD), 13 cases of high-grade dysplasia (HGD) and 12 cases of intramucosal adenocarcinoma (IMC) [23][24][25][26][27][28][29]. The indication for endoscopy was surveillance for IMC or dysplasia among patients with BE or for surveillance of buried Barrett's (BB) among post ablation subjects, except two cases where the indication was therapeutic for LGD and IMC [26].…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

“…In 7 cases, no previous treatment was performed [25,26]. Twenty-eight patients had no information available about prior treatment [23,29], while the rest of patients had received either RFA, EMR or dilation of esophageal stricture [24][25][26][27].…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

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Volumetric Laser Endomicroscopy for Barrett’s Esophagus – Looking at the Fine Print

Jain

Fatima

Jain

et al. 2017

JGLD

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Barrett’s esophagus (BE) is a premalignant condition. The incidence of adenocarcinoma in BE has been reported to be between 0.1-3%. Dysplasia in BE is patchy and extensive biopsy sampling is labor intensive, low yield and does not eliminate the sampling error completely. Volumetric laser endomicroscopy (VLE) is expected to enable endoscopists to do targeted biopsy of dysplastic/cancerous lesions (not visible on white light endoscopy) among patients with BE. We reviewed 7 studies with a total of 62 subjects who had undergone VLE. Of 34 patients with available data, VLE correlated with histology in 17 subjects (50%). It missed the underlying diagnosis in one subject (2.9%). VLE led to inadvertent biopsy in 16 patients (47.1%), and led or would have led to upstaging of disease in 11 subjects (32.4%). In the entire cohort, the sensitivity, specificity, positive predictive value and negative predictive value (NPV) of VLE for diagnosis of dysplasia, buried Barrett’s or intramucosal carcinoma was 92.3%, 23.8%, 42.9% and 83.3%, respectively. High sensitivity and NPV can potentially help space out the surveillance intervals. Low specificity does lead to a high number of biopsies, which are likely less than non targeted biopsies. Volumetric laser endomicroscopy is a safe and sensitive test to identify mucosal lesions in patients with BE which are invisible under standard white light endoscopy.Abbreviations: BE: Barrett’s Esophagus; BB: Buried Barrett’s; EAC: Esophageal adenocarcinoma; EDS: Evans Dysplasia Score; EMR: Endoscopic Mucosal Resection; GERD: Gastro-esophageal reflux disease; HGD: High grade dysplasia; IMC: Intra-mucosal adenocarcinoma; LGD: Low grade dysplasia; NBI: Narrow Band Imaging; OCT-SI: Optical Coherence Tomography Scoring Index; RFA: Radiofrequency ablation; SGS: Sub-squamous glandular structures; VLE: Volumetric Laser Endomicroscopy; WLE: White Light Endoscopy.

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Barrett's oesophagus

Jansen,

Shepherd

2024

Morson and Dawson's Gastrointestinal Pathology

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Detection of buried Barrett’s glands after radiofrequency ablation with volumetric laser endomicroscopy

Cited by 52 publications

References 30 publications

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Volumetric Laser Endomicroscopy for Barrett’s Esophagus – Looking at the Fine Print

Barrett's oesophagus

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