Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett's esophagus

Mohammed A. Kara, Femke P. Peters, Fiebo J. W. ten Kate, Sander J. van Deventer, Paul Fockens, Jacques J. G. H. M. Bergman

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Abstract

Background: The aim of this study was to investigate the feasibility of detecting high-grade dysplasia (HGD) and early cancer (EC) in Barrett's esophagus (BE) with a prototype video autofluorescence endoscope. Methods: Sixty patients with BE were evaluated with a prototype, high-resolution videoendoscope that has separate charge-coupled devices for white light endoscopy (WLE) and autofluorescence imaging (AFT). Nondysplastic BE appears green on AFT, whereas potentially neoplastic areas appear blue/violet. The BE was first screened with WLE for visible abnormalities and then was examined by AFT to detect additional lesions. Lesions that raised a suspicion of neoplasia and control areas that were normal on AFT were sampled for histopathologic assessment. Finally, random 4-quadrant biopsy specimens were obtained at 2-cm intervals. Results: A diagnosis of HGD/EC was made in 22 patients; one patient had no visible abnormality, and 21 had endoscopically detectable areas with HGD/EC. In 6 of the latter 21 patients, the HGD/EC was detected with AFT alone; in another patient, HGD/EC was detected with AFT and random biopsies. In 14 patients, HGD/EC was detected with both WLE and AFT; in 3 of these 14 patients, additional lesions containing HGD/EC were detected by AFT alone. Conclusions: The results of this study suggest that video AFT may improve the detection of HGD/EC in patients with BE
Original languageEnglish
Pages (from-to)679-685
JournalGastrointestinal Endoscopy
Volume61
Issue number6
DOIs
Publication statusPublished - 2005

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