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Future of diagnosing neoplasia in Barrett’s esophagus: volumetric laser endomicroscopy

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Abstract

Esophageal adenocarcinoma (EAC) is one of the deadliest carcinoma faced by gastroenterologists. Any insult to esophagus that causes replacement of normal squamous epithelium with columnar intestinal epithelium is labelled as the initiating event of the metaplasia–neoplasia sequence. Barrett’s esophagus is the precursor to EAC. Currently, endoscopically obtained biopsies are used to detect neoplastic changes in patients with Barrett’s esophagus (BE); however, it is not cost effective and hence a better screening modality is needed. Volumetric laser endomicroscopy (VLE) has been under study for the past few years and has shown promising results to overcome the shortcoming faced in the biopsy samplings. It is a second-generation optical coherence tomography (OCT) that provides high-resolution cross-sectional imaging of the esophageal mucosa using near-infrared light. The principle is similar to endosonography, but image formation in OCT depends on variations in the reflection of light from different tissue layers rather than ultrasonic waves.

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References

  1. Zhang Y. Epidemiology of esophageal cancer. World J Gastroenterol. 2013;19:5598.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pera M, Manterola C, Vidal O, et al. Epidemiology of esophageal adenocarcinoma. J Surg Oncol. 2005;92:151–9.

    Article  PubMed  Google Scholar 

  3. Enzinger P, Mayer R. Esophageal cancer. N Engl J Med. 2003;349:2241–52.

    Article  PubMed  CAS  Google Scholar 

  4. Cancer of the Esophagus—Cancer Stat Facts [Internet]. Seer.cancer.gov. 2017 [cited 14 December 2017]. https://seer.cancer.gov/statfacts/html/esoph.html.

  5. Spechler S, Sharma P, Souza R, et al. American gastroenterological association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:e18–e52.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Shaheen N, Falk G, Iyer P, et al. ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2015;111:30–50.

    Article  PubMed  CAS  Google Scholar 

  7. Carignan C, Yagi Y. Optical endomicroscopy and the road to real-time, in vivo pathology: present and future. Diagn Pathol. 2012;7:98.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Lightdale C. Optical coherence tomography in Barrett’s esophagus. Gastrointest Endosc Clin N Am. 2013;23:549–63.

    Article  PubMed  Google Scholar 

  9. Davis-Yadley A, Neill K, Malafa M, et al. Advances in the endoscopic diagnosis of Barrett esophagus. Cancer Control. 2016;23:67–77.

    Article  PubMed  Google Scholar 

  10. Trindade A, Smith M, Pleskow D. The new kid on the block for advanced imaging in Barrett’s esophagus: a review of volumetric laser endomicroscopy. Therapeutic Adv Gastroenterol. 2016;9:408–16.

    Article  Google Scholar 

  11. Sergeev A, Gelikonov V, Gelikonov G, et al. In vivo endoscopic OCT imaging of precancer and cancer states of human mucosa. Opt Express. 1997;1:432.

    Article  PubMed  CAS  Google Scholar 

  12. Bouma B, Tearney G, Compton C, et al. High-resolution imaging of the human esophagus and stomach in vivo using optical coherence tomography. Gastrointest Endosc. 2000;51:467–74.

    Article  PubMed  CAS  Google Scholar 

  13. Wolfsen H, Sharma P, Wallace M, et al. Safety and feasibility of volumetric laser endomicroscopy in patients with Barrett’s esophagus (with videos). Gastrointest Endosc. 2015;82:631–40.

    Article  PubMed  Google Scholar 

  14. Swager A, van der Sommen F, Klomp S, et al. Computer-aided detection of early Barrett’s neoplasia using volumetric laser endomicroscopy. Gastrointest Endosc. 2017;86:839–46.

    Article  PubMed  Google Scholar 

  15. Swager A, Boerwinkel D, de Bruin D, et al. Detection of buried Barrett’s glands after radiofrequency ablation with volumetric laser endomicroscopy. Gastrointest Endosc. 2016;83:80–8.

    Article  PubMed  Google Scholar 

  16. Swager A, Tearney G, Leggett C, et al. Identification of volumetric laser endomicroscopy features predictive for early neoplasia in Barrett’s esophagus using high-quality histological correlation. Gastrointest Endosc. 2017;85:918–26.e7.

    Article  PubMed  Google Scholar 

  17. Suter M, Gora M, Lauwers G, et al. Esophageal-guided biopsy with volumetric laser endomicroscopy and laser cautery marking: a pilot clinical study. Gastrointest Endosc. 2014;79:886–96.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Trindade A, George B, Berkowitz J, et al. Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus. Endoscopy Int Open. 2016;04:E318-E322.

    Google Scholar 

  19. Evans J, Poneros J, Bouma B, et al. Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4:38–43.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Leggett C, Gorospe E, Chan D, et al. Comparative diagnostic performance of volumetric laser endomicroscopy and confocal laser endomicroscopy in the detection of dysplasia associated with Barrett’s esophagus. Gastrointest Endosc. 2016;83:880–8.e2.

    Article  PubMed  Google Scholar 

  21. Swager A, de Groof A, Meijer S, et al. Feasibility of laser marking in Barrett’s esophagus with volumetric laser endomicroscopy: first-in-man pilot study. Gastrointest Endosc. 2017;86:464–72.

    Article  PubMed  Google Scholar 

  22. Trindade A, Inamdar S, Smith M, et al (2017) Learning curve and competence for volumetric laser endomicroscopy in Barrett’s esophagus using cumulative sum analysis. Endoscopy

  23. Trindade A, Inamdar S, Smith M, et al. Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users. Gastrointest Endosc. 2017;86:133–9.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Mr. Pat MacCarthy of NinePoint Medical for supplying image 1–3 and Dr. Prateek Sharma of Kansas City VA medical center for supplying image 4–5 for this manuscript.

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Correspondence to Muhammad Aziz.

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Aziz, M., Fatima, R. Future of diagnosing neoplasia in Barrett’s esophagus: volumetric laser endomicroscopy. Clin J Gastroenterol 11, 179–183 (2018). https://doi.org/10.1007/s12328-018-0863-3

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  • DOI: https://doi.org/10.1007/s12328-018-0863-3

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