Clinical Journal of Gastroenterology

, Volume 11, Issue 3, pp 179–183 | Cite as

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

Clinical Review
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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.

Keywords

Barrett’s esophagus Esophageal adenocarcinoma Optical coherence tomography Volumetric laser endomicroscopy 

Notes

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.

Compliance with ethical standards

Conflict of interest

The Authors declare no conflict of interest whatsoever in the preparation of this manuscript.

Human rights

The manuscript is a review and does not involve any human subjects.

Informed consent

Informed consent was not needed for preparation of this manuscript.

References

  1. 1.
    Zhang Y. Epidemiology of esophageal cancer. World J Gastroenterol. 2013;19:5598.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Pera M, Manterola C, Vidal O, et al. Epidemiology of esophageal adenocarcinoma. J Surg Oncol. 2005;92:151–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Enzinger P, Mayer R. Esophageal cancer. N Engl J Med. 2003;349:2241–52.CrossRefPubMedGoogle Scholar
  4. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. 7.
    Carignan C, Yagi Y. Optical endomicroscopy and the road to real-time, in vivo pathology: present and future. Diagn Pathol. 2012;7:98.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Lightdale C. Optical coherence tomography in Barrett’s esophagus. Gastrointest Endosc Clin N Am. 2013;23:549–63.CrossRefPubMedGoogle Scholar
  9. 9.
    Davis-Yadley A, Neill K, Malafa M, et al. Advances in the endoscopic diagnosis of Barrett esophagus. Cancer Control. 2016;23:67–77.CrossRefPubMedGoogle Scholar
  10. 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.CrossRefGoogle Scholar
  11. 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.CrossRefPubMedGoogle Scholar
  12. 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.CrossRefPubMedGoogle Scholar
  13. 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.CrossRefPubMedGoogle Scholar
  14. 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.CrossRefPubMedGoogle Scholar
  15. 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.CrossRefPubMedGoogle Scholar
  16. 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.CrossRefPubMedGoogle Scholar
  17. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 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.CrossRefPubMedGoogle Scholar
  21. 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.CrossRefPubMedGoogle Scholar
  22. 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
  23. 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.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityUSA
  2. 2.Department of Internal MedicineDow University of Health SciencesKarachiPakistan

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