Diagnosis by Endoscopy and Advanced Imaging of Barrett’s Neoplasia

  • Anne-Fré Swager
  • Wouter L. Curvers
  • Jacques J. BergmanEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 908)


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.


Barrett’s esophagus Surveillance Detection of neoplasia Advanced imaging techniques Chromoendoscopy Autofluorescence imaging Confocal laser endomicroscopy Optical coherence tomography 



Autofluorescence imaging


Barrett’s esophagus


Blue laser imaging


Confocal laser endomicroscopy


Esophageal adenocarcinoma


Endoscopic trimodal


Fujifilm intelligent chromo-endoscopy




High-grade dysplasia


Intramucosal carcinoma


Low-grade dysplasia


Narrow band imaging


Optical coherence tomography


Optical frequency domain imaging


Volumetric laser endomicroscopy


White light endoscopy


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Anne-Fré Swager
    • 1
  • Wouter L. Curvers
    • 2
  • Jacques J. Bergman
    • 1
    Email author
  1. 1.Department of Gastroenterology and HepatologyAcademic Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Gastroenterology and HepatologyCatharina HospitalEindhovenThe Netherlands

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