Increased detection of Barrett’s esophagus–associated neoplasia using wide-area trans-epithelial sampling: a multicenter, prospective, randomized trial

Vennalaganti, Prashanth; Kaul, Vivek; Wang, Kenneth Ke Ning; Falk, Gary W.; Shaheen, Nicholas J.; Infantolino, Anthony; Johnson, David A.; Eisen, Glenn M.; Gerson, Lauren B.; Smith, Michael S.; Iyer, Prasad G.; Lightdale, Charles J.; Schnoll‐Sussman, Felice; Gupta, Neil; Gross, Seth A.; Abrams, Julian A.; Haber, Gregory B.; Chuttani, Ram; Pleskow, Douglas K.; Kothari, Shivangi; Goldblum, John R.; Zhang, Yaxia; Sharma, Prateek

doi:10.1016/j.gie.2017.07.039

Cited by 87 publications

(103 citation statements)

References 23 publications

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“…Other studies have reported using various computer algorithms to analyze data generated from endomicroscopy to distinguish between non‐dysplastic and neoplastic lesions . Using abrasive brushing of BE mucosa, known as wide‐area transepithelial sampling, paired with computer‐assisted neural network analysis, a recent multicenter trial demonstrated its usefulness in increasing the detection of high‐grade dysplasia and EAC …”

Section: Recent Advances In Diagnostic Surveillance In Be Dysplasiamentioning

confidence: 99%

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Challenges to diagnostic standardization of Barrett's esophagus in Asia

Soh

Lee

Gotoda

et al. 2019

Digestive Endoscopy

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Barrett's esophagus (BE), a premalignant condition of the lower esophagus, is increasingly prevalent in Asia. However, endoscopic and histopathological criteria vary widely between studies across Asia, making it challenging to assess comparability between geographical regions. Furthermore, guidelines from various societies worldwide provide differing viewpoints and definitions, leading to diagnostic challenges that affect prognostication of the condition. In this review, the authors discuss the controversies surrounding the diagnosis of BE, particularly in Asia. Differences between guidelines worldwide are summarized with further discussion regarding various classifications of BE used, different definitions of gastroesophageal junction used across geographical regions and the clinical implications of intestinal metaplasia in the setting of BE. Although many guidelines recommend the Seattle protocol as the preferred approach regarding dysplasia surveillance in BE, some limitations exist, leading to poor adherence. Newer technologies, such as acetic acid‐enhanced magnification endoscopy, narrow band imaging, Raman spectroscopy, molecular approaches and the use of artificial intelligence appear promising in addressing these problems, but further studies are required before implementation into routine clinical practice. The Asian Barrett's Consortium also outlines its ongoing plans to tackle the challenge of standardizing the diagnosis of BE in Asia.

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Section: Recent Advances In Diagnostic Surveillance In Be Dysplasiamentioning

confidence: 99%

“…[96][97][98][99] Using abrasive brushing of BE mucosa, known as wide-area transepithelial sampling, paired with computer-assisted neural network analysis, a recent multicenter trial demonstrated its usefulness in increasing the detection of high-grade dysplasia and EAC. 100 Digestive Endoscopy 2019; 31: 609-618…”

Section: Histological Biomarker Panelsmentioning

confidence: 99%

Challenges to diagnostic standardization of Barrett's esophagus in Asia

Soh

Lee

Gotoda

et al. 2019

Digestive Endoscopy

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“…The studies have demonstrated significant increase in the detection of dysplasia in BE over standard endoscopic biopsies alone . A recent prospective randomized study showed that compared with standard four‐quadrant biopsies every 2 cm (the Seattle protocol), WATS plus standard biopsies provided an absolute increase of 14.4% (95% CI 7.9–19.3) in the cases of HGD/EAC detected, with a number needed to test of seven additional patient tests with WATS in order to detect one additional case of HGD/EAC …”

Section: Surveillancementioning

confidence: 99%

“…30 A recent prospective randomized study showed that compared with standard fourquadrant biopsies every 2 cm (the Seattle protocol), WATS plus standard biopsies provided an absolute increase of 14.4% (95% CI 7.9-19.3) in the cases of HGD/EAC detected, with a number needed to test of seven additional patient tests with WATS in order to detect one additional case of HGD/EAC. 31 Advances in endoscopic imaging beyond conventional white light endoscopy (WLE) may also improve the quality of surveillance to detect neoplasia in patients with BE undergoing surveillance. Besides digital enhancements such as narrow band imaging (NBI; Olympus), I-Scan (Pentax), and flexible spectral imaging color enhancement (FICE; Fujinon) to allow for improved mucosal contrast through virtual chromoendoscopy 32 and marked improvement in optics to allow for high magnification 33 and microscopic Endocytoscopy (Olympus), 34 two major imaging modalities have emerged toward detection of dysplastic and neoplastic lesions: confocal laser endomicroscopy (CLE) and optical coherence tomography (OCT).…”

Section: Surveillancementioning

confidence: 99%

Recent advances in Barrett's esophagus

Inadomi

Alastal

Bonavina

et al. 2018

Annals of the New York Academy of Sciences

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Barrett's esophagus (BE) is the only known precursor of esophageal adenocarcinoma, one of the few cancers with increasing incidence in developed countries. The pathogenesis of BE is unclear with regard to either the cellular origin of this metaplastic epithelium or the manner in which malignant transformation occurs, although recent data indicate a possible junctional origin of stem cells for BE. Treatment of BE may be achieved using endoscopic eradication therapy; however, there is a lack of discriminatory tools to identify individuals at sufficient risk for cancer development in whom intervention is warranted. Reduction in gastroesophageal reflux of gastric contents including acid is mandatory to achieve remission from BE after endoscopic ablation, and can be achieved using medical or nonmedical interventions. Research topics of greatest interest include the mechanism of BE development and transformation to cancer, risk stratification methods to identify individuals who may benefit from ablation of BE, optimization of eradication therapy, and surveillance methods to ensure that remission is maintained after eradication is achieved.

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“…To further enhance dysplasia detection, cells acquired by the brush are then processed through an artificial neural network-based computeraided diagnosis program, which selects cells for evaluation by a pathologist. Although multiple studies have suggested increased detection of dysplasia with WATS compared with surveillance biopsies alone, 13,14 the significance of HGD,…”

mentioning

confidence: 99%

Increased detection of Barrett’s esophagus–associated neoplasia using wide-area trans-epithelial sampling: a multicenter, prospective, randomized trial

Cited by 87 publications

References 23 publications

Challenges to diagnostic standardization of Barrett's esophagus in Asia

Challenges to diagnostic standardization of Barrett's esophagus in Asia

Recent advances in Barrett's esophagus

Dysplasia detection in Barrett's esophagus: Is the glass half full or half empty?

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