Volumetric laser endomicroscopy in the management of Barrett's esophagus

Abstract

VLE is a new advanced imaging platform for Barrett's esophagus with considerable promise to target Barrett's esophagus-associated neoplasia. The following are needed to establish VLE's clinical role: studies showing incremental yield of dysplasia detection using VLE, studies to determine VLE's in-vivo diagnostic accuracy for identifying and classifying Barrett's esophagus-associated neoplasia, and studies on the cost-efficacy of VLE.

Volumetric laser endomicroscopy features of dysplasia at the gastric cardia in Barrett’s oesophagus: results from an observational cohort study

“…Surface intensity and effacement are criteria often used to help identify dysplasia in the oesophagus 12 14 15. These terms were not used in this study as the gastric cardia normally has a high surface intensity compared with the subsurface and does not have layering 19 20 28…”

“…To date, in vivo OCT and ex vivo VLE criteria have been developed for VLE features of dysplasia in the oesophagus 12–15. These criteria have been used for more effective detection of oesophageal dysplasia in clinical practice 16–21…”

Volumetric Laser Endomicroscopy in Barrett's Esophagus

“…Prior to endoscopic eradication therapy, some centers use VLE to evaluate the esophageal mucosa to identify abnormalities that require additional attention 37 . Identifying lesions during VLE not seen on white light endoscopy could potentially lead to upstaging of neoplasia or a change in management.…”

Advances in the diagnosis and surveillance of Barrett’s esophagus (with videos)

“…org). 20 A safety and efficacy study was performed evaluating VLE with a prototype laser marking device in 16 patients with BE, with 222 laser marks placed. 21 The study showed that laser marking was safe and efficacious, with an 85% positional accuracy rate of the laser marks.…”