title: Laser Imaging Facilitates Early Detection of Synchronous Adenocarcinomas in Patients with Barrett's Esophagus.
abstract: Barrett's adenocarcinoma may occur in multiple sites, and recurrence and metachronous lesions are the major problems with endoscopic resection. Therefore, early detection of such lesions is ideal to achieve complete resection and obtain improved survival rates with minimally invasive treatment. Laser imaging systems allow multiple modalities of endoscopic imaging by using white light laser, flexible spectral imaging color enhancement (FICE), blue laser imaging (BLI), and linked color imaging even at a distant view. However, the usefulness of these modalities has not been sufficiently reported regarding Barrett's adenocarcinoma. Here, we report on a patient with three synchronous lesions followed by one metachronous lesion in a long segment with changes of Barrett's esophagus, all diagnosed with this new laser endoscopic imaging system and enhanced by using FICE and/or BLI with high contrast compared with the surrounding mucosa. Laser endoscopic imaging may facilitate the detection of malignancies in patients with early Barrett's adenocarcinoma.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Iwashita
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Osawa
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Takezawa
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ino
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.affiliation: Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Alan K
authors.initials: AK
authors.lastname: Lefor
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
keywords: Barrett esophagus; Blue laser imaging; Early synchronous neoplasms; Endoscopic submucosal dissection; Flexible spectral image color enhancement