Document Detail


Endoscopic tri-modal imaging for detection of early neoplasia in Barrett's oesophagus: a multi-centre feasibility study using high-resolution endoscopy, autofluorescence imaging and narrow band imaging incorporated in one endoscopy system.
MedLine Citation:
PMID:  17965067     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the diagnostic potential of endoscopic tri-modal imaging and the relative contribution of each imaging modality (i.e. high-resolution endoscopy (HRE), autofluorescence imaging (AFI) and narrow-band imaging (NBI)) for the detection of early neoplasia in Barrett's oesophagus. DESIGN: Prospective multi-centre study. SETTING: Tertiary referral centres. PATIENTS: 84 Patients with Barrett's oesophagus. INTERVENTIONS: The Barrett's oesophagus was inspected with HRE followed by AFI. All lesions detected with HRE and/or AFI were subsequently inspected in detail by NBI for the presence of abnormal mucosal and/or microvascular patterns. Biopsies were obtained from all suspicious lesions for blinded histopathological assessment followed by random biopsies. MAIN OUTCOME MEASURES: (1) Number of patients with early neoplasia diagnosed by HRE and AFI; (2) number of lesions with early neoplasia detected with HRE and AFI; and (3) reduction of false positive AFI findings after NBI. RESULTS: Per patient analysis: AFI identified all 16 patients with early neoplasia identified with HRE and detected an additional 11 patients with early neoplasia that were not identified with HRE. In three patients no abnormalities were seen but random biopsies revealed HGIN. After HRE inspection, AFI detected an additional 102 lesions; 19 contained HGIN/EC (false positive rate of AFI after HRE: 81%). Detailed inspection with NBI reduced this false positive rate to 26%. CONCLUSIONS: In this international multi-centre study, the addition of AFI to HRE increased the detection of both the number of patients and the number of lesions with early neoplasia in patients with Barrett's oesophagus. The false positive rate of AFI was reduced after detailed inspection with NBI.
Authors:
W L Curvers; R Singh; L-M Wong-Kee Song; H C Wolfsen; K Ragunath; K Wang; M B Wallace; P Fockens; J J G H M Bergman
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-10-26
Journal Detail:
Title:  Gut     Volume:  57     ISSN:  1468-3288     ISO Abbreviation:  Gut     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-14     Completed Date:  2008-02-12     Revised Date:  2008-07-03    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  167-72     Citation Subset:  AIM; IM    
Affiliation:
Department of Gastroenterology and Hepatology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Barrett Esophagus / pathology*
Endoscopy, Digestive System / methods*
Esophageal Neoplasms / pathology*
Feasibility Studies
Female
Humans
Male
Microscopy, Fluorescence / methods
Middle Aged
Precancerous Conditions / pathology*

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