Ortiz-Fernandez-Sordo, J;
Sami, SS;
Mansilla-Vivar, R;
Subramanian, V;
Mannath, J;
Telakis, E;
Ragunath, K;
(2018)
Evaluation of a novel infra-red endoscopy system in the assessment of early neoplasia in Barretts esophagus: pilot study from a single center.
Diseases of the Esophagus
, 31
(3)
, Article dox137. 10.1093/dote/dox137.
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Abstract
Infrared endoscopy (IRE) has been shown to be useful in detecting submucosal (SM) invasion in early gastric cancer. Its role in the endoscopic assessment of Barrett's neoplasia has not been reported to date. We aimed in this study to evaluate the role of IRE in the detection and characterization of early neoplastic lesions within Barrett's esophagus (BE). The secondary aim was to explore its usefulness for the assessment of the presence of submucosal invasion in these early neoplastic Barrett's lesions. We included in the study patients with dysplastic BE who were referred to our institution for endoscopic therapy of a previously diagnosed early Barrett's neoplasia. An examination with white light high resolution endoscopy (HRE) and near IRE after intravenous injection of indocyanine green was performed for all patients using an infrared endoscope prototype. Staining on IRE and correlation with final histological staging by endoscopic mucosal resection/surgery or histological diagnosis on mapping biopsies was analyzed. A total of 23 patients were enrolled in our study: 17 of them with 19 visible lesions and 6 patients with flat BE and no lesions. Staining on IRE was noted in 18 cases: 17 (94%) had at least high grade dysplasia (HGD). No stain was noted in 7 cases: final histology was <HGD in 5 (71%) and ≥HGD in 2 (29%). There was statistically significant difference between cases with no stain and any staining on IRE with regard to the presence of ≥HGD [2/7 (29%) vs. 17/18 (94%) P = 0.0022]. Stain was reported as faint in 12 and dense in 6. All 6 cases with dense staining had at least HGD. We concluded that IRE can provide additional information to the currently available white light endoscopy for detecting early neoplastic lesions within BE. IRE also allows detecting HGD and most advanced histology in BE. Usefulness of IRE to detect submucosal involvement in early Barrett's neoplastic lesions needs to be assessed further in larger cohort studies.
| Type: | Article |
|---|---|
| Title: | Evaluation of a novel infra-red endoscopy system in the assessment of early neoplasia in Barretts esophagus: pilot study from a single center |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/dote/dox137 |
| Publisher version: | https://doi.org/10.1093/dote/dox137 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | advanced imaging, Barrett’s esophagus, early esophageal cancer, endoscopic imaging, esophageal neoplasms |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10061284 |
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