Future of diagnosing neoplasia in Barrett’s esophagus: volumetric laser endomicroscopy
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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.
KeywordsBarrett’s esophagus Esophageal adenocarcinoma Optical coherence tomography Volumetric laser endomicroscopy
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.
Compliance with ethical standards
Conflict of interest
The Authors declare no conflict of interest whatsoever in the preparation of this manuscript.
The manuscript is a review and does not involve any human subjects.
Informed consent was not needed for preparation of this manuscript.
- 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.
- 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
- 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. EndoscopyGoogle Scholar