Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett’s esophagus: a meta-analysis

Mannath, Jayan; Subramanian, Venkat R.; Hawkey, CJ; Ragunath, Krish

doi:10.1055/s-0029-1243949

Cited by 172 publications

(115 citation statements)

References 22 publications

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“…12 Narrowband imaging reveals some glandular features that have been documented and have been used to identify neoplasia with high sensitivity 12,13 but low specificity in identifying Barrett's metaplasia. 15 Since VFI uses a nuclear stain, it provides a more direct assessment of glandular architecture. The added benefit of using VFI is the potential for implementing high-resolution imaging at the same time, thus providing the ability to monitor nuclear changes at two different scales.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] Moreover, reported specificities for detecting BE are as low as 65%. 15 Though both technologies enhance mucosal changes in different ways, signal differences have been shown to aid clinical interpretation of mucosal features. 10,11 However, limitations associated with false positives reinforce the need for new imaging techniques.…”

Section: Introductionmentioning

confidence: 99%

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Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

et al. 2013

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Abstract. A modular video endoscope is developed and tested to allow imaging in different modalities. This system incorporates white light imaging (WLI), cross-polarized imaging (CPI), and vital-dye fluorescence imaging (VFI), using interchangeable filter modules. CPI and VFI are novel endoscopic modalities that probe mucosal features associated with Barrett's neoplasia. CPI enhances vasculature, while VFI enhances glandular architecture. In this pilot study, we demonstrate the integration of these modalities by imaging areas of Barrett's metaplasia and neoplasia in an esophagectomy specimen. We verify that those key image features are also observed during an in vivo surveillance procedure. CPI images demonstrate improved visualization of branching blood vessels associated with neoplasia. VFI images show glandular architecture with increased glandular effacement associated with neoplasia. Results suggests that important pathologic features seen in CPI and VFI are not visible during standard endoscopic white light imaging, and thus the modalities may be useful in future in vivo studies for discriminating neoplasia from Barrett's metaplasia. We further demonstrate that the integrated WLI/CPI/VFI endoscope is compatible with complementary high-resolution endomicroscopy techniques such as the high-resolution microendoscope, potentially enabling two-step ("red-flag" widefield plus confirmatory high-resolution imaging) protocols to be enhanced. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

et al. 2013

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“…NBI ( Figure 1) is generally the most widely available system, and subsequently the one most studied. NBI was shown to have >90% sensitivity and specificity for the detection of high grade dysplasia or EAC in two meta-analyses (28,32).…”

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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“…Recent studies have shown a sensitivity of 95% and a specificity of 65% for the detection of BE, and a sensitivity and specificity for the detection of HGD of 96% and 94% respectively (36). The combination of this technique with magnifying endoscopes has led to the identification of specific mucosal and microvascular patterns that are useful for the identification of IM, dysplasia and cancer (36,37). The ability of this technique to study mucosal and vascular patterns, its integration with standard endoscopic devices, and the ease of use, are some of the advantages offered for the evaluation of BE.…”

Section: Diagnosis Of Bementioning

confidence: 99%

Optimizing the diagnosis and therapy of Barrett’s esophagus

2017

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Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett’s esophagus: a meta-analysis

Abstract: NBI with magnification is accurate with high diagnostic precision for diagnosis of HGD in Barrett's esophagus on the basis of irregular mucosal pit patterns and/or irregular microvasculature. NBI has high sensitivity but poor specificity for characterizing SIM.

Cited by 172 publications

References 22 publications

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

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

Optimizing the diagnosis and therapy of Barrett’s esophagus

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