Advanced Endoscopic Imaging for Barrett’s Esophagu

Authors: Michelle H Lee Kristin Buterbaugh Rebecca RichardsKortum Sharmila Anandasabapathy

Publish Date: 2012/03/28

Volume: 14, Issue: 3, Pages: 216-225

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Abstract

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 latestage adenocarcinoma endoscopic surveillance is recommended for subjects with Barrett’s esophagus to detect early neoplasia Current guidelines recommend “random” fourquadrant 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

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