TITLE

Elastic scattering spectroscopy accurately detects high grade dysplasia and cancer in Barrett's oesophagus

AUTHOR(S)
Lovat, L. B.; Johnson, K.; Mackenzie, G. D.; Clark, B. R.; Novelli, M. R.; Davies, S.; O'Donovan, M.; Selvasekar, C.; Thorpe, S. M.; Pickard, D.; Fitzgerald, R.; Fearn, T.; Bigio, I.; Bown, S. G.
PUB. DATE
August 2006
SOURCE
Gut;Aug2006, Vol. 55 Issue 8, p1078
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background and aims: Endoscopic surveillance of Barrett's oesophagus currently relies on multiple random biopsies. This approach is time consuming, has a poor diagnostic yield, and significant interobserver variability. Elastic scattering spectroscopy is a real time in vivo optical technique which detects changes in the physical properties of cells. The aim of this study was to assess the potential for elastic scattering to detect high grade dysplasia or cancer within Barrett's oesophagus. Methods: Elastic scattering spectroscopy measurements collected in vivo were matched with histological specimens taken from identical sites within Barrett's oesophagus. All biopsies were reviewed by three gastrointestinal pathologists and defined as either "low risk" (non-dysplastic or low grade dysplasia) or "high risk" (high grade dysplasia or cancer). Two different statistical approaches (leave one out and block validation) were used to validate the model. Results: A total of 181 matched biopsy sites from 81 patients, where histopathological consensus was reached, were analysed. There was good pathologist agreement in differentiating high grade dysplasia and cancer from other pathology (kappa=0.72). Elastic scattering spectroscopy detected high risk sites with 92% sensitivity and 60% specificity and differentiated high risk sites from inflammation with a sensitivity and specificity of 79%. If used to target biopsies during endoscopy, the number of low risk biopsies taken would decrease by 60% with minimal loss of accuracy. A negative spectroscopy result would exclude high grade dysplasia or cancer with an accuracy of >99.5%. Conclusions: These preliminary results show that elastic scattering spectroscopy has the potential to target conventional biopsies in Barrett's surveillance saving significant endoscopist and pathologist time with consequent financial savings. This technique now requires validation in prospective studies.
ACCESSION #
21843674

 

Related Articles

  • Atypical Regenerative Hyperplasia of the Esophagus in Endoscopic Biopsy. Arista-Nasr, Julián; Rivera, Irene; Martinez-Benitez, Braulio; Bornstein-Quevedo, Leticia; Orozco, Héctor; Lugo-Guevara, Yadira // Archives of Pathology & Laboratory Medicine;Jul2005, Vol. 129 Issue 7, p899 

    Context.—Atypical regeneration can mimic carcinoma in various epithelia. On endoscopic biopsies, atypical regenerative hyperplasia of the esophagus may show pleomorphism and atypia, simulating esophageal squamous cell carcinoma. Objective.—To establish the most useful histologic...

  • Optimizing Endoscopic Biopsy Detection of Early Cancers in Barrett's High-Grade Dysplasia. Reid, Brian J.; Blount, Patricia L.; Feng, Ziding; Levine, Douglas S. // American Journal of Gastroenterology;Nov2000, Vol. 95 Issue 11, p3089 

    OBJECTIVE: The management of high-grade dysplasia (HGD) in Barrett's esophagus remains controversial, in part, because of uncertainly about the ability of endoscopic biopsies to consistently detect early, curable cancers. METHODS: Here we report cancers we have diagnosed in 45 patients with...

  • Comparison of high-vs low-dose 5-aminolevulinic acid for photodynamic therapy of Barrett's esophagus. Ketty, C. J.; Ackroyd, R.; Brown, N. J.; Brown, S. B.; Reed, M. W. R. // Surgical Endoscopy;Mar2004, Vol. 18 Issue 3, p452 

    Background: Barrett's esophagus is the major risk factor for esophageal adenocarcinoma, the incidence of which is increasing rapidly in the Western world. Aminolevulinic acid for photodynamic therapy (ALA-PDT) is effective in the treatment of Barrett's esophagus, but controversy exists regarding...

  • Routine morphometrical analysis can improve reproducibility of dysplasia grade in Barrett's oesophagus surveillance biopsies. Baak, J.P.A.; ten Kate, F.J.W.; Offerhaus, G.J.A.; van Lanschot, J.J.; Meijer, G.A. // Journal of Clinical Pathology;Dec2002, Vol. 55 Issue 12, p910 

    Background: The grade of dysplasia found in Barrett's oesophagus surveillance biopsies is a major factor to determine follow up and treatment. However, it has been reported that the reproducibility of the grading system is not optimal. Aims: To compare routine and expert dysplasia grades in...

  • Barrett's oesophagus, part 2: Enabling informed patient choice in surveillance. Bailey, Karen // Gastrointestinal Nursing;Nov2009, Vol. 7 Issue 9, p30 

    Endoscopic surveillance programmes for patients with Barrett's oesophagus aim to detect high-grade dysplasia which may be a precursor to adenocarcinoma. However, Karen Bailey explains that before patients can be enrolled in a surveillance programme, they need to be made aware of the potential...

  • Are screening and surveillance for Barrett's oesophagus really worthwhile? Sharma, P.; Sidorenko, E. I. // Gut;Mar2005 Supplement 1, Vol. 54, pi27 

    Oesophageal adenocarcinoma has a low incidence and still remains an uncommon cancer; however, it has been on the rise over the past 20 years. Barrett's oesophagus, a complication of gastro-oesophageal reflux disease, is the only known precursor of this adenocarcinoma. It can often be...

  • New developments in the endoscopic surveillance of Barrett's oesophagus. Bergman, J. J. G. H. M.; Tytgat, G. N. J. // Gut;Mar2005 Supplement 1, Vol. 54, pi38 

    Patients with a Barrett's oesophagus are at risk for developing an adenocarcinoma of the distal oesophagus. Therefore, many patients undergo endoscopic surveillance to detect dysplasia and/or cancer at an early and curable stage. However, early neoplastic lesions are difficult to identify with...

  • Magnification endoscopy, high resolution endoscopy, and chromoscopy; towards a better optical diagnosis. Bruno, M. J. // Gut;Jun2003 Supplement 4, Vol. 52, piv7 

    In the past few years, optical magnification endoscopy and chromoscopy have gained renewed interest in the West as a means for the early detection of minute lesions in patients with Barrett & oesophagus and in patients referred for colonic cancer screening. In Barren's oesophagus, the vast...

  • Novel Probe-Based Confocal Laser Endomicroscopy Criteria and Interobserver Agreement for the Detection of Dysplasia in Barrett's Esophagus. Gaddam, Srinivas; Mathur, Sharad C; Singh, Mandeep; Arora, Jaya; Wani, Sachin B; Gupta, Neil; Overhiser, Andrew; Rastogi, Amit; Singh, Vikas; Desai, Neel; Hall, Sandra B; Bansal, Ajay; Sharma, Prateek // American Journal of Gastroenterology;Nov2011, Vol. 106 Issue 11, p1961 

    OBJECTIVES:Probe-based confocal laser endomicroscopy (pCLE) is an imaging technique that allows real-time in vivo histological assessment of Barrett's esophagus (BE). The objectives of this study were to create and test novel pCLE criteria for dysplastic BE (phase I), and to evaluate accuracy,...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics