A Survey of Expert Practice and Attitudes Regarding Advanced Imaging Modalities in Surveillance of Barrett’s Esophagus

Machicado, Jorge D.; Han, Samuel; Yadlapati, Rena; Simon, Violette C.; Qumseya, Bashar J.; Sultan, Shahnaz; Kushnir, Vladimir; Komanduri, Srinadh; Rastogi, Amit; Muthusamy, V. Raman; Haidry, Rehan; Ragunath, Krish; Singh, Rajvinder; Hammad, Hazem; Shaheen, Nicholas J.; Wani, Sachin

doi:10.1007/s10620-018-5257-3

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…This threshold was partly based on a recent study among a group of international BE experts who reported the minimum incremental diagnostic yield for the use of advanced imaging techniques in BE surveillance. 91 In this study, experts reported a minimum incremental increase in the diagnostic yield of 27% (interquartile range, 20%-50%) for CLE before implementation in clinical practice. Furthermore, the 4 RCTs had a prevalence of dysplasia ranging from 19% to 35%, much higher than the prevalence of dysplasia in the BE population seen by most gastroenterologists at nonspecialized centers.…”

Section: Question 4: In Patients With Be Undergoing Endoscopy For Surmentioning

confidence: 69%

“…However, the question remains of what LGD means on cytology compared with LGD dysplasia on histology. The minimum incremental diagnostic yield of dysplasia for the use of WATS-3D, based on a recent survey of an international group of BE experts, 91 was 27% (95% CI, 20%-50%). Results from our SR and MA demonstrate that WATS-3D exceeds this threshold.…”

Section: Question 4: In Patients With Be Undergoing Endoscopy For Surmentioning

confidence: 99%

“…In addition to the thresholds set by the ASGE PIVI document, international experts in BE reported a minimum incremental increase in the diagnostic yield of dysplasia of 30% (95% CI, 18%-50%) for the use of VLE in routine clinical practice. 91 Validation of VLE features and the VLE prediction score for neoplasia and demonstrating that these thresholds can be achieved in large prospective trials is required. 114,115 Finally, studies defining the role of computer-aided analysis as an aid in VLE interpretation are awaited.…”

Section: Question 4: In Patients With Be Undergoing Endoscopy For Surmentioning

confidence: 99%

See 2 more Smart Citations

ASGE guideline on screening and surveillance of Barrett’s esophagus

Qumseya¹,

Sultan

Bain

et al. 2019

Gastrointestinal Endoscopy

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300

204

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Section: Question 4: In Patients With Be Undergoing Endoscopy For Surmentioning

confidence: 69%

Section: Question 4: In Patients With Be Undergoing Endoscopy For Surmentioning

confidence: 99%

Section: Question 4: In Patients With Be Undergoing Endoscopy For Surmentioning

confidence: 99%

See 1 more Smart Citation

ASGE guideline on screening and surveillance of Barrett’s esophagus

Qumseya¹,

Sultan

Bain

et al. 2019

Gastrointestinal Endoscopy

Self Cite

300

204

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“…In a previous prospective study, Timmer et al used endoscopic brushings to cover larger mucosal surface and increase the biomarker yield [29]. The novel wide-area transepithelial sampling device (WATS 3D) is a promising tool, which could be combined in the future with molecular biomarkers [41,42].…”

Section: Discussionmentioning

confidence: 99%

Aneuploidy in targeted endoscopic biopsies outperforms other tissue biomarkers in the prediction of histologic progression of Barrett's oesophagus: A multi-centre prospective cohort study

et al. 2020

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Background: The cancer risk in Barrett's oesophagus (BO) is difficult to estimate. Histologic dysplasia has strong predictive power, but can be missed by random biopsies. Other clinical parameters have limited utility for risk stratification. We aimed to assess whether a molecular biomarker panel on targeted biopsies can predict neoplastic progression of BO. Methods: 203 patients with BO were tested at index endoscopy for 9 biomarkers (p53 and cyclin A expression; aneuploidy and tetraploidy; CDKN2A (p16), RUNX3 and HPP1 hypermethylation; 9p and 17p loss of heterozygosity) on autofluorescence-targeted biopsies and followed-up prospectively. Data comparing progressors to non-progressors were evaluated by univariate and multivariate analyses using survival curves, Cox-proportional hazards and logistic regression models. Findings: 127 patients without high-grade dysplasia (HGD) or oesophageal adenocarcinoma (OAC) at index endoscopy were included, of which 42 had evidence of any histologic progression over time. Aneuploidy was the only predictor of progression from non-dysplastic BO (NDBO) to any grade of neoplasia (p = 0.013) and HGD/OAC (p = 0.002). Aberrant p53 expression correlated with risk of short-term progression within 12 months, with an odds ratio of 6.0 (95% CI: 3.1À11.2). A panel comprising aneuploidy and p53 had an area under the receiving operator characteristics curve of 0.68 (95% CI: 0.59À0.77) for prediction of any progression. Interpretation: Aneuploidy is the only biomarker that predicts neoplastic progression of NDBO. Aberrant p53 expression suggests prevalent dysplasia, which might have been missed by random biopsies, and warrants early follow up.

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“…Results showed the incremental diagnostic yield for virtual chromoendoscopy to be fairly low (15%, IQR 10-29%) whereas for VLE it was much higher (30%, IQR 20-50%). These results provide benchmarks that need to be met for guidelines to recommend routine use of these technologies (54).…”

Section: Incorporating Imaging Modalities Into Practice: Guidelines and Quality Indicatorsmentioning

confidence: 96%

Barrett’s esophagus: current standards in advanced imaging

Kolb¹,

Wani²

2021

Transl Gastroenterol Hepatol

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Rationale for Barrett's esophagus (BE) screening and surveillance endoscopyBE is the only identifiable precursor lesion of EAC and affects up to 5% of the general population (6). It results from chronic acid exposure of the stratified squamous epithelium in the distal esophagus leading to metaplasia and replacement with intestinal type columnar epithelium. BE is believed to progress from non-dysplastic (NDBE) → low

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A Survey of Expert Practice and Attitudes Regarding Advanced Imaging Modalities in Surveillance of Barrett’s Esophagus

Abstract: These results should inform benchmarks that need to be met for guidelines to recommend the routine use of AIMs in the surveillance of BE patients.

Cited by 7 publications

References 34 publications

ASGE guideline on screening and surveillance of Barrett’s esophagus

ASGE guideline on screening and surveillance of Barrett’s esophagus

Aneuploidy in targeted endoscopic biopsies outperforms other tissue biomarkers in the prediction of histologic progression of Barrett's oesophagus: A multi-centre prospective cohort study

Barrett’s esophagus: current standards in advanced imaging

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