Prospective, Controlled Tandem Endoscopy Study of Narrow Band Imaging for Dysplasia Detection in Barrett's Esophagus

Wolfsen, Herbert C.; Crook, Julia E.; Krishna, Murli; Achem, Sami R.; DeVault, Kenneth R.; Bouras, Ernest P.; Loeb, David S.; Stark, Mark E.; Woodward, Timothy A.; Hemminger, Lois L.; Cayer, Frances K.; Wallace, Michael B.

doi:10.1053/j.gastro.2008.03.019

Cited by 256 publications

(160 citation statements)

References 43 publications

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“…11 Narrowband reflectance imaging uses narrow bands of blue and green illumination to enhance vascular content, indirectly enhancing the appearance of the glandular pit pattern and achieving a sensitivity range of 89% to 100% and a specificity range of 76% to 98% for detecting neoplasia. [12][13][14] Moreover, reported specificities for detecting BE are as low as 65%. 15 Though both technologies enhance mucosal changes in different ways, signal differences have been shown to aid clinical interpretation of mucosal features.…”

Section: Introductionmentioning

confidence: 99%

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

et al. 2013

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Abstract. A modular video endoscope is developed and tested to allow imaging in different modalities. This system incorporates white light imaging (WLI), cross-polarized imaging (CPI), and vital-dye fluorescence imaging (VFI), using interchangeable filter modules. CPI and VFI are novel endoscopic modalities that probe mucosal features associated with Barrett's neoplasia. CPI enhances vasculature, while VFI enhances glandular architecture. In this pilot study, we demonstrate the integration of these modalities by imaging areas of Barrett's metaplasia and neoplasia in an esophagectomy specimen. We verify that those key image features are also observed during an in vivo surveillance procedure. CPI images demonstrate improved visualization of branching blood vessels associated with neoplasia. VFI images show glandular architecture with increased glandular effacement associated with neoplasia. Results suggests that important pathologic features seen in CPI and VFI are not visible during standard endoscopic white light imaging, and thus the modalities may be useful in future in vivo studies for discriminating neoplasia from Barrett's metaplasia. We further demonstrate that the integrated WLI/CPI/VFI endoscope is compatible with complementary high-resolution endomicroscopy techniques such as the high-resolution microendoscope, potentially enabling two-step ("red-flag" widefield plus confirmatory high-resolution imaging) protocols to be enhanced. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Section: Introductionmentioning

confidence: 99%

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

et al. 2013

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“…Although some reports have shown superiority of NBI over WLE (51), it has not improved interobserver agreement or yield of detecting early neoplasia in BE when compared with HRE (39,(52)(53)(54).…”

Section: Chromoendoscopy and Narrow Band Imaging (Nbi)mentioning

confidence: 92%

Endoscopic diagnosis and therapies for Barrett esophagus: a review

Waxman

González-Haba-Ruiz

Vázquez-Sequeiros

2014

Rev. esp. enferm. dig.

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“…All patients had an index upper endoscopy using a high-resolution endoscope with white light and narrow band imaging (Olympus GIF-H180). The Barrett's segment was characterized with an intensive biopsy protocol and expert secondary histology review to confirm the diagnosis of HGD and rule out the presence of erosive esophagitis or stricture (9).…”

Section: Methodsmentioning

confidence: 99%

Pilot Study on Light Dosimetry Variables for Photodynamic Therapy of Barrett's Esophagus with High-Grade Dysplasia

Gill

Wolfsen

Preyer

et al. 2009

Clinical Cancer Research

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Purpose: Photodynamic therapy (PDT) is used to treat Barrett's esophagus with high-grade dysplasia and mucosal carcinoma. Outcomes are variable with some patients having persistent disease, whereas others develop strictures. The aims of this study were (a) to compare porfimer sodium tissue uptake, light dose, and esophageal thickness with clinical outcomes and (b) to determine the selectivity of porfimer sodium uptake in diseased and normal epithelium. Experimental Design: Forty-eight hours after porfimer sodium infusion, patients underwent mucosal biopsy for quantification of the porfimer sodium. Laser light was delivered at 48 hours and again 24 or 48 hours later. Porfimer sodium was extracted from the biopsy samples and quantified using fluorescence spectroscopy. The enhanced photodynamic dose was determined as [porfimer sodium content * light dose/esophageal thickness]. PDT efficacy was determined 6 to 8 weeks later based on persistence or complete ablation of dysplasia or carcinoma. Results: Mean porfimer sodium content of 6.2 mg/kg (range, 2.6-11.2 mg/kg) and mean total light dose of 278 J/cm (range, 225-360 J/cm) resulted in a complete treatment. Mean porfimer sodium tissue content of 3.9 mg/kg (range, 2.1-8.1mg/kg) and mean total light dose of 268 J/cm (range, 250-350 J/cm) resulted in an incomplete treatment. The total esophageal thickness (range, 1.7-6.0 mm) and enhanced photodynamic dose were correlated with treatment outcome. Conclusions: Esophageal thickness is the strongest predictor of treatment outcome. The porfimer sodium content of Barrett's and normal tissue is not significantly different. ''Photodynamic dose'' for esophageal PDTshould incorporate the esophageal thickness.

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Prospective, Controlled Tandem Endoscopy Study of Narrow Band Imaging for Dysplasia Detection in Barrett's Esophagus

Cited by 256 publications

References 43 publications

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

Endoscopic diagnosis and therapies for Barrett esophagus: a review

Pilot Study on Light Dosimetry Variables for Photodynamic Therapy of Barrett's Esophagus with High-Grade Dysplasia

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