Advanced Endoscopic Imaging for Barrett’s Esophagus: Current Options and Future Directions

Barrett’s esophagus is the precursor to esophageal adenocarcinoma, one of the most rapidly increasing cancers in the United States. Given the poor prognosis of late-stage adenocarcinoma, endoscopic surveillance is recommended for subjects with Barrett’s esophagus to detect early neoplasia. Current guidelines recommend “random” four-quadrant biopsies taken every 1–2 cm throughout the Barrett’s segment. However, this only samples a minority of epithelium and has been shown to miss areas of endoscopically- inapparent neoplasia (high grade dysplasia or cancer). Recent efforts have focused on developing novel diagnostic imaging technologies to detect the subtle epithelial changes associated with dysplasia and neoplasia in Barrett’s esophagus. Some of these modalities serve as “red flag” technologies designed to detect areas of abnormality within large surface areas. Other technologies serve to characterize areas of visible abnormality, offering a higher spatial resolution to confirm/exclude the presence of neoplasia. This review summarizes several available and evolving imaging technologies used in the endoscopic diagnosis and surveillance of Barrett’s associated neoplasia.

[1]  J. Fujimoto,et al.  Optical Coherence Tomography , 1991 .

[2]  P J Tadrous,et al.  Methods for imaging the structure and function of living tissues and cells: 1. Optical coherence tomography , 2000, The Journal of pathology.

[3]  B. Wilson,et al.  Autofluorescence endoscopy: feasibility of detection of GI neoplasms unapparent to white light endoscopy with an evolving technology. , 2001, Gastrointestinal endoscopy.

[4]  P. Merlob,et al.  To dye or not to dye: a randomized, clinical trial of a triple dye/alcohol regime versus dry cord care. , 2003, Pediatrics.

[5]  Aleksander Sieroń,et al.  Autofluorescence endoscopy for detection of high-grade dysplasia in short-segment Barrett's esophagus. , 2003, Gastrointestinal endoscopy.

[6]  D. Mankoff,et al.  Hypoxia and Glucose Metabolism in Malignant Tumors: Evaluation by ( 18 F)Fluoromisonidazole and ( 18 F)Fluorodeoxyglucose Positron , 2004 .

[7]  Masahiro Yamaguchi,et al.  Appearance of enhanced tissue features in narrow-band endoscopic imaging. , 2004, Journal of biomedical optics.

[8]  L. Gossner,et al.  Histological analysis of endoscopic resection specimens from 326 patients with Barrett's esophagus and early neoplasia. , 2004, Endoscopy.

[9]  Tammy P. McConnell,et al.  Trends in Umbilical Cord Care: Scientific Evidence for Practice , 2004 .

[10]  F. O’Sullivan,et al.  Hypoxia and Glucose Metabolism in Malignant Tumors , 2004, Clinical Cancer Research.

[11]  E. Jaramillo,et al.  Detection of intestinal metaplasia in distal esophagus and esophagogastric junction by enhanced-magnification endoscopy. , 2004, Gastrointestinal endoscopy.

[12]  S. Larson.  Positron Emission Tomography-Based Molecular Imaging in Human Cancer , 2004, Clinical Cancer Research.

[13]  Paul Fockens,et al.  A randomized crossover study comparing light-induced fluorescence endoscopy with standard videoendoscopy for the detection of early neoplasia in Barrett's esophagus. , 2005, Gastrointestinal endoscopy.

[14]  Amitabh Chak,et al.  Accuracy of endoscopic optical coherence tomography in the detection of dysplasia in Barrett's esophagus: a prospective, double-blinded study. , 2005, Gastrointestinal endoscopy.

[15]  Nizar Mullani,et al.  Uptake of a Fluorescent Deoxyglucose Analog (2-NBDG) in Tumor Cells , 2005, Molecular Imaging and Biology.

[16]  Paul Fockens,et al.  Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett's esophagus. , 2005, Gastrointestinal endoscopy.

[17]  R. Kiesslich,et al.  In vivo histology of Barrett's esophagus and associated neoplasia by confocal laser endomicroscopy. , 2005, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[18]  J. Borovička,et al.  Autofluorescence endoscopy in surveillance of Barrett's esophagus: a multicenter randomized trial on diagnostic efficacy. , 2006, Endoscopy.

[19]  Paul Fockens,et al.  Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett's esophagus. , 2006, Gastrointestinal endoscopy.

[20]  M. Fujishiro,et al.  Ex-vivo study of high-magnification chromoendoscopy in the gastrointestinal tract to determine the optimal staining conditions for endocytoscopy. , 2006, Endoscopy.

[21]  A. Bansal,et al.  The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus. , 2005, Gastrointestinal endoscopy.

[22]  R. Shaw,et al.  Glucose metabolism and cancer. , 2006, Current opinion in cell biology.

[23]  Az Amsterdam,et al.  High-resolution endoscopy plus chromoendoscopy or narrow- band imaging in Barrett's esophagus: A prospective randomized crossover study , 2006 .

[24]  H. Pohl,et al.  Evaluation of endocytoscopy in the surveillance of patients with Barrett's esophagus. , 2007, Endoscopy.

[25]  R. Kiesslich,et al.  Chromoscopy-guided endomicroscopy increases the diagnostic yield of intraepithelial neoplasia in ulcerative colitis. , 2007, Gastroenterology.

[26]  Kenneth K Wang,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 , 2007, Gut.

[27]  O. Pech,et al.  Comparison of computed virtual chromoendoscopy and conventional chromoendoscopy with acetic acid for detection of neoplasia in Barrett’s esophagus , 2007, Endoscopy.

[28]  R. Knuechel,et al.  Can an endocytoscope system (ECS) predict histology in neoplastic lesions? , 2007, Endoscopy.

[29]  M. Vieth,et al.  Miniprobe confocal laser microscopy for the detection of invisible neoplasia in patients with Barrett’s oesophagus , 2008, Gut.

[30]  Michael B Wallace,et al.  Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. , 2008, Gastroenterology.

[31]  Timothy J Muldoon,et al.  High-resolution imaging in Barrett's esophagus: a novel, low-cost endoscopic microscope. , 2008, Gastrointestinal endoscopy.

[32]  M. Wallace,et al.  Mucosal morphology in Barrett’s esophagus: interobserver agreement and role of narrow band imaging , 2008, Endoscopy.

[33]  R. Kiesslich,et al.  Confocal endomicroscopy: in vivo diagnosis of neoplastic lesions of the gastrointestinal tract. , 2008, Anticancer research.

[34]  Marcia Irene Canto,et al.  Confocal laser endomicroscopy in Barrett's esophagus and endoscopically inapparent Barrett's neoplasia: a prospective, randomized, double-blind, controlled, crossover trial. , 2009, Gastrointestinal endoscopy.

[35]  A. Rastogi,et al.  Zooming in on Barrett oesophagus using narrow-band imaging: an international observer agreement study , 2009, European journal of gastroenterology & hepatology.

[36]  Prateek Sharma,et al.  Clinical practice. Barrett's esophagus. , 2009, The New England journal of medicine.

[37]  R. Kiesslich,et al.  High-definition endoscopy with i-Scan and Lugol’s solution for more precise detection of mucosal breaks in patients with reflux symptoms , 2009, Endoscopy.

[38]  K. Sugano,et al.  Diagnosis of endoscopic Barrett’s esophagus by transnasal flexible spectral imaging color enhancement , 2009, Journal of Gastroenterology.

[39]  A. Alavi,et al.  18F-FDG Uptake in Lung, Breast, and Colon Cancers: Molecular Biology Correlates and Disease Characterization* , 2009, Journal of Nuclear Medicine.

[40]  Timothy J. Muldoon,et al.  Molecular imaging of glucose uptake in oral neoplasia following topical application of fluorescently labeled deoxy‐glucose , 2009, International Journal of Cancer.

[41]  Bipan Chand,et al.  High-resolution and high-magnification endoscopes. , 2000, Gastrointestinal endoscopy.

[42]  C. Hawkey,et al.  Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett’s esophagus: a meta-analysis , 2010, Endoscopy.

[43]  Michael B Wallace,et al.  Endoscopic tri-modal imaging is more effective than standard endoscopy in identifying early-stage neoplasia in Barrett's esophagus. , 2010, Gastroenterology.

[44]  Thomas D. Wang,et al.  maging and Advanced Technology olecular Imaging in Gastrointestinal Endoscopy , 2022 .

[45]  R. Chaiteerakij,et al.  Role of digital chromoendoscopy in detecting minimal change esophageal reflux disease. , 2010, World journal of gastrointestinal endoscopy.

[46]  Alexander Meining,et al.  Preliminary accuracy and interobserver agreement for the detection of intraepithelial neoplasia in Barrett's esophagus with probe-based confocal laser endomicroscopy. , 2010, Gastrointestinal endoscopy.

[47]  K. Ragunath,et al.  Era of Barrett's surveillance: does equipment matter? , 2010, World journal of gastroenterology.

[48]  Amy M. Winkler,et al.  In Vivo, Dual-Modality OCT/LIF Imaging Using a Novel VEGF Receptor-Targeted NIR Fluorescent Probe in the AOM-Treated Mouse Model , 2011, Molecular Imaging and Biology.

[49]  Michael Vieth,et al.  In vivo molecular imaging of colorectal cancer with confocal endomicroscopy by targeting epidermal growth factor receptor. , 2010, Gastroenterology.

[50]  Thomas D. Wang,et al.  Affinity peptide for targeted detection of dysplasia in Barrett's esophagus. , 2010, Gastroenterology.

[51]  Markus F Neurath,et al.  Molecular imaging of VEGF in gastrointestinal cancer in vivo using confocal laser endomicroscopy , 2010, Gut.

[52]  J. Bergman,et al.  Autofluorescence and narrow band imaging in Barrett's esophagus. , 2010, Gastroenterology clinics of North America.

[53]  Tsutomu Chiba,et al.  Differences of image enhancement in image-enhanced endoscopy: narrow band imaging versus flexible spectral imaging color enhancement , 2011, Journal of Gastroenterology.

[54]  Michael B Wallace,et al.  Real-time increased detection of neoplastic tissue in Barrett's esophagus with probe-based confocal laser endomicroscopy: final results of an international multicenter, prospective, randomized, controlled trial. , 2011, Gastrointestinal endoscopy.

[55]  Erik Schoon,et al.  Endoscopic trimodal imaging versus standard video endoscopy for detection of early Barrett's neoplasia: a multicenter, randomized, crossover study in general practice. , 2011, Gastrointestinal endoscopy.

[56]  Herbert C Wolfsen,et al.  State of the art in the endoscopic imaging and ablation of Barrett's esophagus. , 2011, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[57]  R. Kiesslich,et al.  Review article: in vivo imaging by endocytoscopy , 2011, Alimentary pharmacology & therapeutics.

[58]  Hiroshi Mashimo,et al.  Durability of radiofrequency ablation in Barrett's esophagus with dysplasia. , 2011, Gastroenterology.

[59]  Prateek Sharma,et al.  American Gastroenterological Association technical review on the management of Barrett's esophagus. , 2011, Gastroenterology.

[60]  Sharmila Anandasabapathy,et al.  Optical molecular imaging for detection of Barrett's-associated neoplasia. , 2011, World journal of gastroenterology.

[61]  S. Anandasabapathy,et al.  Pre-Clinical Evaluation of Fluorescent Deoxyglucose as a Topical Contrast Agent for the Detection of Barrett’s-Associated Neoplasia during Confocal Imaging , 2011, Technology in cancer research & treatment.

[62]  Kenneth K Wang,et al.  Endoscopic evaluation and advanced imaging of Barrett's esophagus. , 2011, Gastrointestinal endoscopy clinics of North America.