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Diagnosis by Endoscopy and Advanced Imaging of Barrett's Neoplasia.
Adv Exp Med Biol 2016; 908:81-98AE

Abstract

Evaluation of patients with Barrett's esophagus (BE) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BE because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia. The evaluation and treatment of patients with BE and early stage neoplasia should be centralized in tertiary referral centers, where procedures are performed under optimal conditions, by expert endoscopists. Lesions that require resection are almost always detected by HD-WLE, although advanced imaging techniques can detect additional flat lesions. However, these are of limited clinical significance because they are effectively eradicated by ablation therapy. No endoscopic imaging technique can reliably assess submucosal or lymphangio invasion. Endoscopic resection of early stage neoplasia in patients with BE is important for staging and management. Optical chromoendoscopy can also be used to evaluate lesions before endoscopic resection and in follow-up after successful ablation therapy.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Academic Medical Center, Room B1-245, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, Eindhoven, 5623 EJ, The Netherlands.Department of Gastroenterology and Hepatology, Academic Medical Center, Room B1-245, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. j.j.bergman@amc.uva.nl.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27573768

Citation

Swager, Anne-Fré, et al. "Diagnosis By Endoscopy and Advanced Imaging of Barrett's Neoplasia." Advances in Experimental Medicine and Biology, vol. 908, 2016, pp. 81-98.
Swager AF, Curvers WL, Bergman JJ. Diagnosis by Endoscopy and Advanced Imaging of Barrett's Neoplasia. Adv Exp Med Biol. 2016;908:81-98.
Swager, A. F., Curvers, W. L., & Bergman, J. J. (2016). Diagnosis by Endoscopy and Advanced Imaging of Barrett's Neoplasia. Advances in Experimental Medicine and Biology, 908, pp. 81-98. doi:10.1007/978-3-319-41388-4_5.
Swager AF, Curvers WL, Bergman JJ. Diagnosis By Endoscopy and Advanced Imaging of Barrett's Neoplasia. Adv Exp Med Biol. 2016;908:81-98. PubMed PMID: 27573768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis by Endoscopy and Advanced Imaging of Barrett's Neoplasia. AU - Swager,Anne-Fré, AU - Curvers,Wouter L, AU - Bergman,Jacques J, PY - 2016/8/31/entrez PY - 2016/8/31/pubmed PY - 2017/1/26/medline KW - Advanced imaging techniques KW - Autofluorescence imaging KW - Barrett’s esophagus KW - Chromoendoscopy KW - Confocal laser endomicroscopy KW - Detection of neoplasia KW - Optical coherence tomography KW - Surveillance SP - 81 EP - 98 JF - Advances in experimental medicine and biology JO - Adv. Exp. Med. Biol. VL - 908 N2 - Evaluation of patients with Barrett's esophagus (BE) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BE because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia. The evaluation and treatment of patients with BE and early stage neoplasia should be centralized in tertiary referral centers, where procedures are performed under optimal conditions, by expert endoscopists. Lesions that require resection are almost always detected by HD-WLE, although advanced imaging techniques can detect additional flat lesions. However, these are of limited clinical significance because they are effectively eradicated by ablation therapy. No endoscopic imaging technique can reliably assess submucosal or lymphangio invasion. Endoscopic resection of early stage neoplasia in patients with BE is important for staging and management. Optical chromoendoscopy can also be used to evaluate lesions before endoscopic resection and in follow-up after successful ablation therapy. SN - 0065-2598 UR - https://www.unboundmedicine.com/medline/citation/27573768/Diagnosis_by_Endoscopy_and_Advanced_Imaging_of_Barrett's_Neoplasia_ L2 - https://dx.doi.org/10.1007/978-3-319-41388-4_5 DB - PRIME DP - Unbound Medicine ER -