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Added value of narrow band imaging and confocal laser endomicroscopy in detecting Barrett's esophagus neoplasia.
Endoscopy 2012; 44(12):1089-95E

Abstract

BACKGROUND AND STUDY AIMS

Advances in endoscopic imaging techniques have enabled more accurate identification of subtle mucosal abnormalities. The aim of the study was to assess the accuracy of predicting high grade dysplasia (HGD) and intramucosal cancer (IMC) in mucosa predicted as being nondysplastic vs. dysplastic by high definition white light endoscopy (HD-WLE), narrow band imaging (NBI), and confocal laser endomicroscopy (CLE).

PATIENTS AND METHODS

A cross-sectional study was performed in a tertiary referral setting between February 2010 and September 2011. A total of 50 consecutive patients who were referred to St Vincent's Hospital for management of dysplastic Barrett's esophagus were included. A prediction of likely histology was made for each mucosal point (four-quadrant every 1 cm and any visible mucosal abnormality), first with HD-WLE, followed by NBI, and finally CLE. Biopsies were taken at all of these points.

RESULTS

A total of 1190 individual biopsy points were assessed. At histology, 39 biopsy points were found to harbor HGD and 52 biopsy points harbored IMC. For the detection of HGD/IMC the sensitivity, specificity, and accuracy were: HD - WLE, 79.1 %, 83.1 %, and 82.8 %; NBI, 89.0 %, 80.1 %, and 81.4 %; and CLE, 75.7 %, 80.0 %, and 79.9 %, respectively. All mucosal points with IMC and all patients with HGD were detected by targeted biopsies guided by HD-WLE and NBI without the need for random Seattle protocol biopsies.

CONCLUSIONS

HD-WLE in combination with NBI is highly accurate in the detection of HGD/IMC. Performing targeted biopsies in the surveillance of Barrett's esophagus is possible in expert centers.

Authors+Show Affiliations

Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia. chatura.jayasekera@mh.org.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23188660

Citation

Jayasekera, C, et al. "Added Value of Narrow Band Imaging and Confocal Laser Endomicroscopy in Detecting Barrett's Esophagus Neoplasia." Endoscopy, vol. 44, no. 12, 2012, pp. 1089-95.
Jayasekera C, Taylor AC, Desmond PV, et al. Added value of narrow band imaging and confocal laser endomicroscopy in detecting Barrett's esophagus neoplasia. Endoscopy. 2012;44(12):1089-95.
Jayasekera, C., Taylor, A. C., Desmond, P. V., Macrae, F., & Williams, R. (2012). Added value of narrow band imaging and confocal laser endomicroscopy in detecting Barrett's esophagus neoplasia. Endoscopy, 44(12), pp. 1089-95. doi:10.1055/s-0032-1325734.
Jayasekera C, et al. Added Value of Narrow Band Imaging and Confocal Laser Endomicroscopy in Detecting Barrett's Esophagus Neoplasia. Endoscopy. 2012;44(12):1089-95. PubMed PMID: 23188660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Added value of narrow band imaging and confocal laser endomicroscopy in detecting Barrett's esophagus neoplasia. AU - Jayasekera,C, AU - Taylor,A C F, AU - Desmond,P V, AU - Macrae,F, AU - Williams,R, Y1 - 2012/11/27/ PY - 2012/11/29/entrez PY - 2012/11/29/pubmed PY - 2013/5/18/medline SP - 1089 EP - 95 JF - Endoscopy JO - Endoscopy VL - 44 IS - 12 N2 - BACKGROUND AND STUDY AIMS: Advances in endoscopic imaging techniques have enabled more accurate identification of subtle mucosal abnormalities. The aim of the study was to assess the accuracy of predicting high grade dysplasia (HGD) and intramucosal cancer (IMC) in mucosa predicted as being nondysplastic vs. dysplastic by high definition white light endoscopy (HD-WLE), narrow band imaging (NBI), and confocal laser endomicroscopy (CLE). PATIENTS AND METHODS: A cross-sectional study was performed in a tertiary referral setting between February 2010 and September 2011. A total of 50 consecutive patients who were referred to St Vincent's Hospital for management of dysplastic Barrett's esophagus were included. A prediction of likely histology was made for each mucosal point (four-quadrant every 1 cm and any visible mucosal abnormality), first with HD-WLE, followed by NBI, and finally CLE. Biopsies were taken at all of these points. RESULTS: A total of 1190 individual biopsy points were assessed. At histology, 39 biopsy points were found to harbor HGD and 52 biopsy points harbored IMC. For the detection of HGD/IMC the sensitivity, specificity, and accuracy were: HD - WLE, 79.1 %, 83.1 %, and 82.8 %; NBI, 89.0 %, 80.1 %, and 81.4 %; and CLE, 75.7 %, 80.0 %, and 79.9 %, respectively. All mucosal points with IMC and all patients with HGD were detected by targeted biopsies guided by HD-WLE and NBI without the need for random Seattle protocol biopsies. CONCLUSIONS: HD-WLE in combination with NBI is highly accurate in the detection of HGD/IMC. Performing targeted biopsies in the surveillance of Barrett's esophagus is possible in expert centers. SN - 1438-8812 UR - https://www.unboundmedicine.com/medline/citation/23188660/Added_value_of_narrow_band_imaging_and_confocal_laser_endomicroscopy_in_detecting_Barrett's_esophagus_neoplasia_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0032-1325734 DB - PRIME DP - Unbound Medicine ER -