Methylene blue–directed biopsies improve detection of intestinal metaplasia and dysplasia in Barrett's esophagus

Canto, Marcia Irene; Setrakian, Sebouh; Willis, Joseph E.; Chak, Amitabh; Petras, Robert E.; Powe, Neil R.; Sivak, Michael

doi:10.1016/s0016-5107(00)70290-2

Cited by 245 publications

(164 citation statements)

References 22 publications

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“…Methylene blue stain binds to the mucosa of areas of intestinal metaplasia but will not bind if there is high grade dysplasia or cancer present. The method by which methylene blue is applied and the degree of mucus clearing performed prior to application of the methylene blue affects this technique (65). Studies have had mixed results and prospective crossover studies have not found a clear advantage to methylene blue chromoscopy in comparison to random four quadrant biopsies in detection of dysplasia (66)(67)(68).…”

Section: Imaging In Barrett's Esophagusmentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,278

893

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PREAMBLEThe guidelines for the diagnosis, surveillance and therapy of Barrett's esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002. These and other guidelines undergo periodic review. Significant advances have occurred in the area of Barrett's esophagus over the past four years leading to another revision of the prior guidelines. These advances include the potential use of esophageal capsule endoscopy for the diagnosis and screening of Barrett's esophagus, data regarding the outcome of low-grade dysplasia, the treatment of high-grade dysplasia using photodynamic therapy, and the development of new ablation techniques such as radiofrequency ablation. These guidelines are intended to be applied by physicians who see Barrett's esophagus patients and are intended to indicate a preferred, but certainly not the only, acceptable approach. Physicians need to choose the course best suited to the individual patient and to the variables that exist at the time of decision making. The guidelines are for adult patients with the diagnosis of Barrett's esophagus, as defined herein.Both these and the original guidelines were developed under auspices of the American College of Gastroenterology and the Practice Parameters Committee and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and once again reviewed using the National Library of Medicine database. Search terms used included Barrett's esophagus, esophageal neoplasm, esophagus, intestinal metaplasia, esophageal diseases, and adenocarcinoma, all appropriate studies and any additional ones found in reference to these papers were obtained and reviewed. Evidence was available from a hierarchy of trials and randomized controlled trials were given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations are based on expert opinion. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), Grade B indicates that the evidence would be level 2 or 3 which are cohort studies or case control studies. Grade C recommendations are based on level 4 studies meaning case series or poor quality cohort studies, and Grade D recommendations are based on level 5 evidence meaning expert opinion.

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Section: Imaging In Barrett's Esophagusmentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,278

893

View full text Add to dashboard Cite

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“…The three best studied dyes/chemicals are methylene blue, indigo carmine, and acetic acid. Early studies of methylene blue chromoendoscopy for BE concluded that it improves detection of IM and dysplasia in BE (29). However, subsequent studies were equivocal, and a meta-analysis that included studies from [2000][2001][2002][2003][2004][2005][2006][2007][2008] concluded that methylene blue chromoendoscopy was not superior to standard 4-quadrant biopsies in detecting IM or dysplasia in patients with BE (30).…”

Section: Advanced Imagingmentioning

confidence: 99%

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Mansour

El–Serag

Anandasabapathy

2017

Ann. Cardiothorac. Surg.

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Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes. Advanced endoscopic imaging can help increase the efficiency of current endoscopic surveillance.Endoscopic therapy is safe and effective for the treatment of dysplastic BE and intramucosal EAC, but ongoing surveillance following treatment is necessary. This review will cover screening, surveillance, advanced imaging, chemoprevention, endoscopic treatment, and post-treatment surveillance of BE.

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“…Methylene blue is the most commonly used and is actively absorbed by the mucosa with IM. Some studies have shown that this method has a higher diagnostic accuracy for the diagnosis of IM with a lower number of biopsies needed compared to fourquadrant random biopsies (38,39). However, some other studies have found that the use of methylene blue is not superior to WLE with random biopsies for the diagnosis of IM or dysplasia (40).…”

Section: Diagnosis Of Bementioning

confidence: 99%

Optimizing the diagnosis and therapy of Barrett’s esophagus

2017

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Methylene blue–directed biopsies improve detection of intestinal metaplasia and dysplasia in Barrett's esophagus

Cited by 245 publications

References 22 publications

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Optimizing the diagnosis and therapy of Barrett’s esophagus

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