Future of diagnosing neoplasia in Barrett's esophagus: volumetric laser endomicroscopy

Clin J Gastroenterol. 2018 Jun;11(3):179-183. doi: 10.1007/s12328-018-0863-3. Epub 2018 Apr 21.

Abstract

Esophageal adenocarcinoma (EAC) is one of the deadliest carcinoma faced by gastroenterologists. Any insult to esophagus that causes replacement of normal squamous epithelium with columnar intestinal epithelium is labelled as the initiating event of the metaplasia-neoplasia sequence. Barrett's esophagus is the precursor to EAC. Currently, endoscopically obtained biopsies are used to detect neoplastic changes in patients with Barrett's esophagus (BE); however, it is not cost effective and hence a better screening modality is needed. Volumetric laser endomicroscopy (VLE) has been under study for the past few years and has shown promising results to overcome the shortcoming faced in the biopsy samplings. It is a second-generation optical coherence tomography (OCT) that provides high-resolution cross-sectional imaging of the esophageal mucosa using near-infrared light. The principle is similar to endosonography, but image formation in OCT depends on variations in the reflection of light from different tissue layers rather than ultrasonic waves.

Keywords: Barrett’s esophagus; Esophageal adenocarcinoma; Optical coherence tomography; Volumetric laser endomicroscopy.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / pathology
  • Barrett Esophagus / pathology*
  • Biopsy
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / pathology
  • Esophagus / diagnostic imaging
  • Esophagus / pathology
  • Humans
  • Tomography, Optical Coherence / methods*

Supplementary concepts

  • Adenocarcinoma Of Esophagus