title: Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett's esophagus.
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Kara
authors.forename: Femke P
authors.initials: FP
authors.lastname: Peters
authors.forename: Fiebo J W
authors.initials: FJ
authors.lastname: Ten Kate
authors.forename: Sander J
authors.initials: SJ
authors.lastname: Van Deventer
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Jacques J G H M
authors.initials: JJ
authors.lastname: Bergman
mesh_terms: 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