An Inter-Observer Agreement Study of Autofluorescence Endoscopy in Barrett’s Esophagus Among Expert and Non-Expert Endoscopists

Mannath, Jayan; Subramanian, Vishnu; Telakis, Emmanouil; Lau, Karen; Ramappa, Vidyasagar; Wireko, Matthew; Kaye, Philip; Ragunath, Krish

doi:10.1007/s10620-012-2358-2

Cited by 8 publications

(4 citation statements)

References 16 publications

(18 reference statements)

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“…In Barrett's esophagus, accuracy for diagnosing dysplasia using AFI was 69 % -76 %, and this was further improved if high resolution white-light endoscopy (WLE) images were also available; interobserver agreement was fair to moderate [48].…”

Section: Autofluorescence Imaging and Optical Diagnosismentioning

confidence: 99%

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

et al. 2016

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! quality evidence.) Conclusion: Advanced endoscopic imaging can improve mucosal visualization and endoscopic diagnosis; however it requires training and the use of validated classification systems. Blue laser imaging (BLI) Fujifilm Lasereo Japan, China, South America, Asian-Pacific Processor VP-4450HD, Laser Light Source LL-4450 and L590 series endoscopes Autofluorescence imaging (AFI) Olympus Lucera Spectrum Japan, UK Video System Center (CV-260SL), CFH260 colonoscope AZL Confocal laser endoscopy (CLE) Pentax Worldwide Pentax ISC-1000 endomicroscopy system; EC3870K endoscope Mauna Kea Cellvizio Worldwide Cellvizio 100 series system; GastroFlex and ColoFlex UHD probes

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Section: Autofluorescence Imaging and Optical Diagnosismentioning

confidence: 99%

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

et al. 2016

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“…In a further multicenter randomized trial by Curvers et al, 99 patients with Barrett's esophagus and a confirmed low-grade intraepithelial neoplasia underwent ETMI and SVE. The results show that, despite ETMI detecting 22 more suspect lesions for targeted biopsies, there was no significant difference in the overall histological yield (targeted + random) between ETMI and SVE [13]. The false-positive grading of dysplastic areas by AFI might depend-at least in part-on the observer's experience.…”

Section: Afi In Upper Gi Neoplasiamentioning

confidence: 81%

Recent Advances and the Potential for Clinical Use of Autofluorescence Detection of Extra-Ophthalmic Tissues

et al. 2020

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The autofluorescence (AF) characteristics of endogenous fluorophores allow the label-free assessment and visualization of cells and tissues of the human body. While AF imaging (AFI) is well-established in ophthalmology, its clinical applications are steadily expanding to other disciplines. This review summarizes clinical advances of AF techniques published during the past decade. A systematic search of the MEDLINE database and Cochrane Library databases was performed to identify clinical AF studies in extra-ophthalmic tissues. In total, 1097 articles were identified, of which 113 from internal medicine, surgery, oral medicine, and dermatology were reviewed. While comparable technological standards exist in diabetology and cardiology, in all other disciplines, comparability between studies is limited due to the number of differing AF techniques and non-standardized imaging and data analysis. Clear evidence was found for skin AF as a surrogate for blood glucose homeostasis or cardiovascular risk grading. In thyroid surgery, foremost, less experienced surgeons may benefit from the AF-guided intraoperative separation of parathyroid from thyroid tissue. There is a growing interest in AF techniques in clinical disciplines, and promising advances have been made during the past decade. However, further research and development are mandatory to overcome the existing limitations and to maximize the clinical benefits.

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“…Since dysplastic changes are mainly associated with the epithelial morphology and dysplastic epithelium does not feature any prominent fluorophores, the assumption here is that autofluorescent radiation generated in the submucosa will be attenuated differently when passing through the epithelium, highlighting dysplastic changes. Recent studies demonstrated that while AFI can improve the detection rate of HGD in BE when used by an experienced operator 46 , it also has a relatively high false-positive rate (81%) 47 . Therefore, AFI endoscopy could be useful as a rapid initial evaluation technique to identify suspicious locations in BE, but would require subsequent assessment with another more specific technique for HGD confirmation.…”

Section: Resultsmentioning

confidence: 99%

Multispectral light scattering endoscopic imaging of esophageal precancer

et al. 2017

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Esophageal adenocarcinoma is the most rapidly growing cancer in America. Although the prognosis after diagnosis is unfavorable, the chance of a successful outcome increases tremendously if detected early while the lesion is still dysplastic. Unfortunately, the present standard-of-care, endoscopic surveillance, has major limitations, since dysplasia is invisible, often focal, and systematic biopsies typically sample less than one percent of the esophageal lining and therefore easily miss malignancies. To solve this problem we developed a multispectral light scattering endoscopic imaging system. It surveys the entire esophageal lining and accurately detects subcellular dysplastic changes. The system combines light scattering spectroscopy, which detects and identifies invisible dysplastic sites by analyzing light scattered from epithelial cells, with rapid scanning of the entire esophageal lining using a collimated broadband light beam delivered by an endoscopically compatible fiber optic probe. Here we report the results of the first comprehensive multispectral imaging study, conducted as part of routine endoscopic procedures performed on patients with suspected dysplasia. In a double-blind study that characterized the system’s ability to serve as a screening tool, 55 out of 57 patients were diagnosed correctly. In addition, a smaller double-blind comparison of the multispectral data in 24 patients with subsequent pathology at locations where 411 biopsies were collected yielded an accuracy of 90% in detecting individual locations of dysplasia, demonstrating the capability of this method to serve as a guide for biopsy.

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An Inter-Observer Agreement Study of Autofluorescence Endoscopy in Barrett’s Esophagus Among Expert and Non-Expert Endoscopists

Abstract: The IOA for AF positive lesions is fair to moderate using AFI images which improved with addition of HRE. The overall accuracy of identifying dysplasia was modest, and was better when AFI and HRE images were combined.

Cited by 8 publications

References 16 publications

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

Recent Advances and the Potential for Clinical Use of Autofluorescence Detection of Extra-Ophthalmic Tissues

Multispectral light scattering endoscopic imaging of esophageal precancer

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