Adjunctive Yield of Wide-Area Transepithelial Sampling for Dysplasia Detection After Advanced Imaging and Random Biopsies in Barrett's Esophagus

Raphael, Kara L.; Stewart, Molly; Sejpal, Divyesh V.; Cheung, Mary; Whitson, Matthew J.; Han, Dennis; Benias, Petros C.; Lee, Calvin; Miller, Larry S.; Trindade, Arvind J.

doi:10.14309/ctg.0000000000000107

Cited by 14 publications

(10 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rigorous examination or oversampling of certain hot zones for dysplasia may help overcome this. In addition, relatively new to BE surveillance is the wide area transepithelial (WATS) brush ( 22 , 23 ). This brush has been shown to increase dysplasia yield versus pinch biopsies ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal and Circumferential Distributions of Dysplasia and Early Neoplasia in Barrett's Esophagus: A Pooled Analysis of Three Prospective Studies

Raphael

Inamdar

McKinley

et al. 2021

Clin Transl Gastroenterol

Self Cite

View full text Add to dashboard Cite

INTRODUCTION: Studies have shown that dysplasia in Barrett's esophagus (BE) has a predilection for the right hemisphere. There is limited information on the longitudinal distribution. The aim was to determine both the longitudinal and circumferential distributions of dysplasia and early neoplasia from 3 prospective studies. METHODS: This is a pooled analysis from 3 prospective studies of patients with treatment-naive BE. Both circumferential and longitudinal locations (for BE segments greater than 1 cm) of dysplastic and early neoplastic lesions were recorded. RESULTS: A total of 177 dysplastic and early neoplastic lesions from 91 patients were included in the pooled analysis; of which 59.3% (n = 105) were seen on high-definition white light endoscopy, 29.4% (n = 52) on advanced imaging, and 11.2% (n = 20) with random biopsies. The average Prague score was C3M5. Of 157 lesions within BE segments greater than 1 cm, 49 (34.8%) lesions were in the proximal half, whereas 92 lesions (65.2%) were in the distal half (P < 0.001). The right hemisphere of the esophagus contained 55% (86/157) of the total lesions compared with 45% (71/157) for the left hemisphere (P = 0.02). This was because of the presence of high-grade dysplasia being concentrated in the right hemisphere compared with the left hemisphere (60% vs 40%, P = 0.002). DISCUSSION: In this pooled analysis of prospective studies, both low-grade dysplasia and high-grade dysplasia are more frequently found in the distal half of the Barrett's segment. This study confirms that the right hemisphere is a hot spot for high-grade dysplasia. Careful attention to these locations is important during surveillance endoscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

Longitudinal and Circumferential Distributions of Dysplasia and Early Neoplasia in Barrett's Esophagus: A Pooled Analysis of Three Prospective Studies

Raphael

Inamdar

McKinley

et al. 2021

Clin Transl Gastroenterol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Among the 29 cases detected by WATS 3D , 23 cases were negative with FB but only 1 case detected by FB was missed by WATS 3D [ 12 ]. Finally, an observational cohort study that spanned 2 years and included 138 patients showed an added yield of 34.3% when WATS 3D was used in conjunction with FB [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…This technique is fast and efficient, and has been shown to have a better diagnostic yield compared to FB following the Seattle protocol [ 20 ]. However, a recent study showed that WATS 3D further increased the diagnostic yield when added to white light endoscopy, NBI, VLE and FB following the Seattle protocol [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

WATS(3D) versus forceps biopsy in screening for Barrett’s esophagus: experience in community endoscopy centers

Agha¹,

Srinivasan²,

Hyder³

et al. 2020

aog

View full text Add to dashboard Cite

Background Barrett’s esophagus (BE) is a premalignant condition diagnosed using systematic 4-quadrant forceps biopsies (FB) during endoscopy. This method is fraught with errors due to the randomness of sampling and variability among operators. Wide-area transepithelial sampling with 3-dimensional computer-assisted analysis (WATS 3D ) is an emerging technique used to collect esophageal samples. The aim of this study was to evaluate WATS 3D as a diagnostic tool for detecting BE in addition to FB, compared to FB alone. Methods A retrospective observational cohort study was conducted and included patients who underwent screening for BE with WATS 3D and FB between January 2015 and January 2019 across 3 endoscopy centers in Wichita, Kansas. The FB specimens were reviewed by community pathologists, while the WATS 3D samples were sent to CDX technology labs, NY. Results A total of 108 patients were screened for BE using both modalities concurrently. FB and WATS 3D detected 62 (57.4%) and 83 (76%) cases of BE, respectively. The absolute difference of 21 cases (18.6%) of BE was attributed to the addition of WATS 3D . The number needed to test with WATS 3D was 5. We divided the sample into 4 groups to compare the agreement across all groups: (FB–; WATS 3D +), (FB–; WATS 3D –), (FB+; WATS 3D +), and (FB+ and WATS 3D –). Overall agreement by kappa statistic was 0.74. Conclusion WATS 3D identified 21 cases of BE missed by FB. Using WATS 3D in addition to FB increased the yield of BE during surveillance endoscopy, with no increase in complications.

show abstract

“…Prospective cohort, retrospective cohort, or case-control studies of endoscopic screening to forecast the mortality and incidence of early gastric cancer will be included to pool and review in this study. Studies assessing the effect of endoscopic screening only in individuals with premalignant conditions, [ 13 ] Barrett esophagus, [ 14 ] and Helicobacter pylori [ 15 ] ( H pylori ) infection were excluded.…”

Section: Methodsmentioning

confidence: 99%

A protocol of systematic review and meta-analysis of narrow band imaging endoscopy in detection of early gastric cancer

Zhang

Liu²,

Gang

et al. 2020

Medicine

View full text Add to dashboard Cite

Background: Early gastric cancer is the fifth common malignancy and the third leading cause of cancer death throughout the world. However, it is not clear how endoscopic screening for early gastric cancer affects incidence or mortality. We performed a systematic review and meta-analysis to evaluate the relationship between endoscopic screening for the mortality and incidence of early gastric cancer. Materials and methods: This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Web of Science, PubMed, EMBASE, and the Cochrane Library were searched for cohort and case-control studies in cases without early gastric cancer until March 31, 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the Eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The relative risk and 95% confidence intervals were used as effect estimate. I-square test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review. Results: The results will be published in a peer-reviewed journal. Conclusion: The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also provide helpful evidence of whether endoscopic screening would reduce the mortality and incidence of early gastric cancer. PROSPERO registration number: CRD42020171053

show abstract

Adjunctive Yield of Wide-Area Transepithelial Sampling for Dysplasia Detection After Advanced Imaging and Random Biopsies in Barrett's Esophagus

Cited by 14 publications

References 42 publications

Longitudinal and Circumferential Distributions of Dysplasia and Early Neoplasia in Barrett's Esophagus: A Pooled Analysis of Three Prospective Studies

Longitudinal and Circumferential Distributions of Dysplasia and Early Neoplasia in Barrett's Esophagus: A Pooled Analysis of Three Prospective Studies

WATS(3D) versus forceps biopsy in screening for Barrett’s esophagus: experience in community endoscopy centers

A protocol of systematic review and meta-analysis of narrow band imaging endoscopy in detection of early gastric cancer

Contact Info

Product

Resources

About