I-SCAN targeted versus random biopsies in Barrett's oesophagus

Verna, C.; Feyles, Elda; Lorenzi, Luisa; Rolle, Emanuela; Grassini, Mario; Giacobbe, U.; Niola, Paolo; Battaglia, Edda; Bassotti, Gabrio; Villanacci, Vincenzo

doi:10.1016/j.dld.2013.10.005

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…Advanced imaging techniques are a vital part of lesion recognition (eg, NBI, I-scan and volumetric laser endomicroscopy), enhancing abnormal vasculature and mucosal surface patterns, with many hoping targeted biopsies could replace Seattle protocol biopsies. [34][35][36] Dilute acetic acid dye spray which causes a reversible reaction to the BO epithelium with early reversal in dysplastic tissues can be used to help detect dysplasia. It has been found to be cost effective if resulting in targeted samples alone in the surveillance population -particularly in higher risk groups.…”

Section: Advanced Imaging Techniques and Acetic Acid Dye Spraymentioning

confidence: 99%

Developing patient-orientated Barrett’s oesophagus services: the role of dedicated services

Ratcliffe

Britton

Hamdy

et al. 2022

BMJ Open Gastroenterol

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IntroductionBarrett’s oesophagus (BO) is common and is a precursor to oesophageal adenocarcinoma with a 0.33% per annum risk of progression. Surveillance and follow-up services for BO have been shown to be lacking, with studies showing inadequate adherence to guidelines and patients reporting a need for greater disease-specific knowledge. This review explores the emerging role of dedicated services for patients with BO.MethodsA literature search of PubMed, MEDLINE, Embase, Emcare, HMIC, BNI, CiNAHL, AMED and PsycINFO in regard to dedicated BO care pathways was undertaken.ResultsProspective multicentre and randomised trials were lacking. Published cohort data are encouraging with improvements in guideline adherence with dedicated services, with one published study showing significant improvements in dysplasia detection rates. Accuracy of allocation to surveillance endoscopy has been shown to hold cost savings, and a study of a dedicated clinic showed increased discharges from unnecessary surveillance. Training modalities for BO surveillance and dysplasia detection exist, which could be used to educate a BO workforce. Qualitative and quantitative studies have shown patients report high levels of cancer worry and poor disease-specific knowledge, but few studies have explored follow-up care models despite being a patient and clinician priority for research.ConclusionsCost–benefit analysis for dedicated services, considering both financial and environmental impacts, and more robust clinical data must be obtained to support this model of care in the wider health service. Greater understanding is needed of the root causes for poor guideline adherence, and disease-specific models of care should be designed around clinical and patient-reported outcomes to address the unmet needs of patients with BO.

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Section: Advanced Imaging Techniques and Acetic Acid Dye Spraymentioning

confidence: 99%

Developing patient-orientated Barrett’s oesophagus services: the role of dedicated services

Ratcliffe

Britton

Hamdy

et al. 2022

BMJ Open Gastroenterol

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“…Recently, blue laser imaging (BLI), which utilizes two monochromatic lasers at 410 nm and 450 nm, has become available [44]. However, currently available studies on FICE, i-SCAN, and BLI in the diagnosis of EC are limited and appeared to be of controversial utility [58][59][60]. Therefore, further studies are needed to assess whether such techniques could be incorporated in clinical practice for EC diagnosis.…”

Section: Virtual Chromoendoscopymentioning

confidence: 99%

Modern Diagnosis of Early Esophageal Cancer: From Blood Biomarkers to Advanced Endoscopy and Artificial Intelligence

Visaggi

Barberio

Ghisa

et al. 2021

Cancers

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Esophageal cancer (EC) is the seventh most common cancer and the sixth cause of cancer death worldwide. Histologically, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) account for up to 90% and 20% of all ECs, respectively. Clinical symptoms such as dysphagia, odynophagia, and bolus impaction occur late in the natural history of the disease, and the diagnosis is often delayed. The prognosis of ESCC and EAC is poor in advanced stages, being survival rates less than 20% at five years. However, when the diagnosis is achieved early, curative treatment is possible, and survival exceeds 80%. For these reasons, mass screening strategies for EC are highly desirable, and several options are currently under investigation. Blood biomarkers offer an inexpensive, non-invasive screening strategy for cancers, and novel technologies have allowed the identification of candidate markers for EC. The esophagus is easily accessible via endoscopy, and endoscopic imaging represents the gold standard for cancer surveillance. However, lesion recognition during endoscopic procedures is hampered by interobserver variability. To fill this gap, artificial intelligence (AI) has recently been explored and provided encouraging results. In this review, we provide a summary of currently available options to achieve early diagnosis of EC, focusing on blood biomarkers, advanced endoscopy, and AI.

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“…A randomised control trial found that the yields of acetic acid-guided versus i-Scan-guided biopsies in detecting specialised columnar epithelium were comparable 36 . Verna et al found that dysplasia detection rate using this technology was inferior to that using the standard four-quadrant biopsy technique 37 . However, these studies were poorly designed and have small sample sizes.…”

Section: Endoscopic Diagnosismentioning

confidence: 99%

Advances in the endoscopic diagnosis and treatment of Barrett’s neoplasia

et al. 2016

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Barrett’s oesophagus is a well-recognised precursor of oesophageal adenocarcinoma. The incidence of oesophageal adenocarcinoma is continuing to rise in the Western world with dismal survival rates. In recent years, efforts have been made to diagnose Barrett’s earlier and improve surveillance techniques in order to pick up cancerous changes earlier. Recent advances in endoscopic therapy for early Barrett’s cancers have shifted the paradigm away from oesophagectomy and have yielded excellent results.

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I-SCAN targeted versus random biopsies in Barrett's oesophagus

Cited by 11 publications

References 36 publications

Developing patient-orientated Barrett’s oesophagus services: the role of dedicated services

Developing patient-orientated Barrett’s oesophagus services: the role of dedicated services

Modern Diagnosis of Early Esophageal Cancer: From Blood Biomarkers to Advanced Endoscopy and Artificial Intelligence

Advances in the endoscopic diagnosis and treatment of Barrett’s neoplasia

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