Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett's esophagus.
BACKGROUND
The aim of this study was to investigate the feasibility of detecting high-grade dysplasia (HGD) and early cancer (EC) in Barrett's esophagus (BE) with a prototype video autofluorescence endoscope.


METHODS
Sixty patients with BE were evaluated with a prototype, high-resolution videoendoscope that has separate charge-coupled devices for white light endoscopy (WLE) and autofluorescence imaging (AFI). Nondysplastic BE appears green on AFI, whereas potentially neoplastic areas appear blue/violet. The BE was first screened with WLE for visible abnormalities and then was examined by AFI to detect additional lesions. Lesions that raised a suspicion of neoplasia and control areas that were normal on AFI were sampled for histopathologic assessment. Finally, random 4-quadrant biopsy specimens were obtained at 2-cm intervals.


RESULTS
A diagnosis of HGD/EC was made in 22 patients; one patient had no visible abnormality, and 21 had endoscopically detectable areas with HGD/EC. In 6 of the latter 21 patients, the HGD/EC was detected with AFI alone; in another patient, HGD/EC was detected with AFI and random biopsies. In 14 patients, HGD/EC was detected with both WLE and AFI; in 3 of these 14 patients, additional lesions containing HGD/EC were detected by AFI alone.


CONCLUSIONS
The results of this study suggest that video AFI may improve the detection of HGD/EC in patients with BE.
Kara
Mohammed A
MA
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
Peters
Femke P
FP
Ten Kate
Fiebo J W
FJ
Van Deventer
Sander J
SJ
Fockens
Paul
P
Bergman
Jacques J G H M
JJ
D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D001706:Biopsy; D019723:Endoscopes; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005453:Fluorescence; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D011230:Precancerous Conditions / Q000473:pathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014741:Video Recording