Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 6/2014

01-06-2014 | Esophagus (L Gerson, Section Editor)

Enhanced Mucosal Imaging and the Esophagus—Ready for Prime Time?

Authors: Yutaka Tomizawa, Irving Waxman

Published in: Current Gastroenterology Reports | Issue 6/2014

Login to get access

Abstract

Innovation of endoscopic technology has recently been introduced to improve real-time visualization of mucosal architecture and subepithelial vascular structures. Since the esophagus is easily accessible using endoscopy and the length of required observation is limited, many different types of new imaging modalities have been reported and showing promising data. Early detection of neoplastic changes in the esophagus is devoted to the treatment in early stage cancer and theoretically leads to better prognosis. This review will focus on the emerging endoscopic technologies for the management of esophageal cancer.
Literature
1.
American Cancer Society. American Cancer Society: cancer facts and figures 2012. Atlanta: American Cancer Society; 2012.
2.
Liu L, Hofstetter WL, Rashid A, Swisher SG, Correa AM, Ajani JA, et al. Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. Am J Surg Pathol. 2005;29:1079–85.PubMed
3.
Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–37.PubMedCrossRef
4.
Eloubeidi MA, Mason AC, Desmond RA, El-Serag HB. Temporal trends (1973–1997) in survival of patients with esophageal adenocarcinoma in the United States: a glimmer of hope? Am J Gastroenterol. 2003;98:1627–33.PubMed
5.
ASGE Technology Committee, Kwon RS, Adler DG, Chand B, Conway JD, Diehl DL, et al. High-resolution and high-magnification endoscopes. Gastrointest Endosc. 2009;69:399–407.PubMedCrossRef
6.
Stevens PD, Lightdale CJ, Green PHR, Siegel LM, Garcia-Carrasquillo RJ, Rotterdam H. Combined magnification endoscopy with chromoendoscopy for the evaluation of Barrett’s esophagus. Gastrointest Endosc. 1994;40:747–9.PubMedCrossRef
7.
Sharma P, Weston AP, Topalovski M, Cherian R, Bhattacharyya A, Sampliner RE. Magnification chromoendoscopy for the detection of intestinal metaplasia and dysplasia in Barrett’s oesophagus. Gut. 2003;52:24–7.PubMedCentralPubMedCrossRef
8.
Meining A, Rösch T, Kiesslich R, Muders M, Sax F, Heldwein W. Inter- and intra-observer variability of magnification chromoendoscopy for detecting specialized intestinal metaplasia at the gastroesophageal junction. Endoscopy. 2004;36:160–4.PubMedCrossRef
9.
Mayinger B, Oezturk Y, Stolte M, Faller G, Benninger J, Schwab D, et al. Evaluation of sensitivity and inter- and intra-observer variability in the detection of intestinal metaplasia and dysplasia in Barrett’s esophagus with enhanced magnification endoscopy. Scand J Gastroenterol. 2006;41:349–56.PubMedCrossRef
10.
Kara MA, Peters FP, Rosmolen WD, Krishnadath KK, ten Kate FJ, Fockens P, et al. High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett’s esophagus: a prospective randomized crossover study. Endoscopy. 2005;37:929–36.PubMedCrossRef
11.
Curvers W, Baak L, Kiesslich R, Van Oijen A, Rabenstein T, Ragunath K, et al. Chromoendoscopy and narrow-band imaging compared with high-resolution magnification endoscopy in Barrett’s esophagus. Gastroenterology. 2008;134:670–9.PubMedCrossRef
12.
Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ, American Gastroenterological Association. American Gastroenterological Association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:e18–52.PubMedCentralPubMedCrossRef
13.
Kumagai Y, Inoue H, Nagai K, Kawano T, Iwai T. Magnifying endoscopy, stereoscopic microscopy, and the microvascular architecture of superficial esophageal carcinoma. Endoscopy. 2002;34:369–75.PubMedCrossRef
14.
Goda K, Tajiri H, Ikegami M, Yoshida Y, Yoshimura N, Kato M, et al. Magnifying endoscopy with narrow band imaging for predicting the invasion depth of superficial esophageal squamous cell carcinoma. Dis Esophagus. 2009;22:453–60.PubMedCrossRef
15.
Gono K, Obi T, Yamaguchi M, Ohyama N, Machida H, Sano Y, et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt. 2004;9:568–77.PubMedCrossRef
16.
Sharma P, Bansal A, Mathur S, Wani S, Cherian R, McGregor D, et al. The utility of a novel narrow band imaging endoscopy system in patients with Barrett’s esophagus. Gastrointest Endosc. 2006;64:167–75.PubMedCrossRef
17.
Kara MA, Ennahachi M, Fockens P, ten Kate F, Bergman J. Detection and classification of the mucosal and vascular patterns (mucosal morphology) in Barrett’s esophagus by using narrow band imaging. Gastrointest Endosc. 2006;64:155–66.PubMedCrossRef
18.
Singh R, Anagnostopoulos GK, Yao K, Karageorgiou H, Fortun PJ, Shonde A, et al. Narrow-band imaging with magnification in Barrett’s esophagus: validation of a simplified grading system of mucosal morphology patterns against histology. Endoscopy. 2008;40:457–63.PubMedCrossRef
19.
Mannath J, Subramanian V, Hawkey CJ, Ragunath K. Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett’s esophagus: a meta-analysis. Endoscopy. 2010;42:351–9.PubMedCrossRef
20.
Wolfsen HC, Crook JE, Krishna M, Achem SR, Devault KR, Bouras EP, et al. Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett’s Esophagus. Gastroenterology. 2008;135:24–31.PubMedCrossRef
21.••
Sharma P, Hawes RH, Bansal A, Gupta N, Curvers W, Rastogi A, et al. Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett’s oesophagus: a prospective, international, randomised controlled trial. Gut. 2013;62:15–21. This international multicenter randomized crossover trial showed NBI is equivalent to current gold standard of Seattle protocol biopsies in predicting high-grade dysplasia and NBI detected more areas with dysplasia in Barrett’s esophagus. PubMedCrossRef
22.
Takenaka R, Kawahara Y, Okada H, Hori K, Inoue M, Kawano S, et al. Narrow-band imaging provides reliable screening for esophageal malignancy in patients with head and neck cancers. Am J Gastroenterol. 2009;104:2942–8.PubMedCrossRef
23.
Nonaka S, Saito Y, Oda I, Kozu T, Saito D. Narrow-band imaging endoscopy with magnification is useful for detecting metachronous superficial pharyngeal cancer in patients with esophageal squamous cell carcinoma. J Gastroenterol Hepatol. 2010;25:264–9.PubMedCrossRef
24.•
Muto M, Minashi K, Yano T, Saito Y, Oda I, Nonaka S, et al. Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. J Clin Oncol. 2010;28:1566–72. This multicenter randomized crossover study showed that NBI detected more early squamous cell cancer of the esophagus, and the sensitivity and accuracy were significantly higher compared to conventional white light endoscopy. PubMedCentralPubMedCrossRef
25.
Lee CT, Chang CY, Lee YC, Tai CM, Wang WL, Tseng PH, et al. Narrow-band imaging with magnifying endoscopy for the screening of esophageal cancer in patients with primary head and neck cancers. Endoscopy. 2010;42:613–9.PubMedCrossRef
26.
Lecleire S, Antonietti M, Iwanicki-Caron I, Duclos A, Lemoine F, Pessot FL, et al. Lugol chromo-endoscopy versus narrow band imaging for endoscopic screening of esophageal squamous-cell carcinoma in patients with a history of cured esophageal cancer: a feasibility study. Dis Esophagus. 2011;24:418–22.PubMedCrossRef
27.
Kantsevoy SV, Adler DG, Conway JD, Diehl DL, Farraye FA, Kaul V, et al. Confocal laser endomicroscopy. Gastrointest Endosc. 2009;70:197–200.PubMedCrossRef
28.
Kiesslich R, Gossner L, Goetz M, Dahlmann A, Vieth M, Stolte M, et al. In vivo histology of Barrett’s esophagus and associated neoplasia by confocal laser endomicroscopy. Clin Gastroenterol Hepatol. 2006;4:979–87.PubMedCrossRef
29.
Dunbar KB, Okolo 3rd P, Montgomery E, Canto MI. Confocal laser endomicroscopy in Barrett’s esophagus and endoscopically inapparent Barrett’s neoplasia: a prospective, randomized, double-blind, controlled, crossover trial. Gastrointest Endosc. 2009;70:645–54.PubMedCentralPubMedCrossRef
30.
Pohl H, Rösch T, Vieth M, Koch M, Becker V, Anders M, et al. Miniprobe confocal laser microscopy for the detection of invisible neoplasia in patients with Barrett’s oesophagus. Gut. 2008;57:1648–53.PubMedCrossRef
31.
Bajbouj M, Vieth M, Rösch T, Miehlke S, Becker V, Anders M, et al. Probe-based confocal laser endomicroscopy compared with standard four-quadrant biopsy for evaluation of neoplasia in Barrett’s esophagus. Endoscopy. 2010;42:435–40.PubMedCrossRef
32.
Wallace MB, Sharma P, Lightdale C, Wolfsen H, Coron E, Buchner A, et al. Preliminary accuracy and interobserver agreement for the detection of intraepithelial neoplasia in Barrett’s esophagus with probe-based confocal laser endomicroscopy. Gastrointest Endosc. 2010;72:19–24.PubMedCentralPubMedCrossRef
33.•
Sharma P, Meining AR, Coron E, Lightdale CJ, Wolfsen HC, Bansal A, et al. Real-time increased detection of neoplastic tissue in Barrett’s esophagus with probe-based confocal laser endomicroscopy: final results of an international multicenter, prospective, randomized, controlled trial. Gastrointest Endosc. 2011;74:465–72. This international multicenter randomized study showed adding confocal laser endomicroscopy to white light endoscopy and NBI increased sensitivity in predicting neoplasia in Barrett’s esophagus but it still remains to be improved. PubMedCentralPubMedCrossRef
34.
Liu H, Li YQ, Yu T, Zhao YA, Zhang JP, Zuo XL, et al. Confocal laser endomicroscopy for superficial esophageal squamous cell carcinoma. Endoscopy. 2009;41:99–106.PubMedCrossRef
35.
Pech O, Rabenstein T, Manner H, Petrone MC, Pohl J, Vieth M, et al. Confocal laser endomicroscopy for in vivo diagnosis of early squamous cell carcinoma in the esophagus. Clin Gastroenterol Hepatol. 2008;6:89–94.PubMedCrossRef
36.
Song LM, Banerjee S, Desilets D, Diehl DL, Farraye FA, Kaul V, et al. Autofluorescence imaging. Gastrointest Endosc. 2011;73:647–50.PubMedCrossRef
37.
Kara MA, Peters FP, ten Kate FJ, van Deventer SJ, Fockens P, Bergman JJ. Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett’s esophagus. Gastrointest Endosc. 2005;61:679–85.PubMedCrossRef
38.
Kara MA, Peters FP, Fockens P, ten Kate FJ, Bergman JJ. Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett’s esophagus. Gastrointest Endosc. 2006;64:176–85.PubMedCrossRef
39.
Curvers WL, Herrero LA, Wallace MB, Wong Kee Song LM, Ragunath K, Wolfsen HC. Endoscopic tri-modal imaging is more effective than standard endoscopy in identifying early-stage neoplasia in Barrett’s esophagus. Gastroenterology. 2010;139:1106–14.PubMedCrossRef
40.••
Boerwinkel DF, Holz JA, Kara MA, Meijer SL, Wallace MB, Wong Kee Song LM, et al. Effects of autofluorescence imaging on detection and treatment of early neoplasia in patients with Barrett’s Esophagus. Clin Gastroenterol Hepatol. 2013. This study systematically analyzed the published data on autofluorescence imaging in the management of Barrett’s esophagus and revealed that this modality has little effect on the diagnosis of early-stage neoplasia or therapeutic decision making..
41.
Yoshida Y, Goda K, Tajiri H, Urashima M, Yoshimura N, Kato T. Assessment of novel endoscopic techniques for visualizing superficial esophageal squamous cell carcinoma: autofluorescence and narrow-band imaging. Dis Esophagus. 2009;22:439–46.PubMedCrossRef
42.
Suzuki H, Saito Y, Ikehara H, Oda I. Evaluation of visualization of squamous cell carcinoma of esophagus and pharynx using an autofluorescence imaging videoendoscope system. Gastroenterol Hepatol. 2009;24:1834–9.CrossRef
43.
Ishihara R, Inoue T, Hanaoka N, Takeuchi Y, Tsujii Y, Kanzaki H, et al. Autofluorescence imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia: a phase II study. J Gastroenterol Hepatol. 2012;27:86–90.PubMedCrossRef
44.
Pohl J, May A, Rabenstein T, Pech O, Ell C. Computed virtual chromoendoscopy: a new tool for enhancing tissue surface structures. Endoscopy. 2007;39:80–3.PubMedCrossRef
45.
Camus M, Coriat R, Leblanc S, Brezault C, Terris B, Pommaret E, et al. Helpfulness of the combination of acetic acid and FICE in the detection of Barrett’s epithelium and Barrett’s associated neoplasias. World J Gastroenterol. 2012;18:1921–5.PubMedCentralPubMedCrossRef
46.
Hoffman A, Korczynski O, Tresch A, Hansen T, Rahman F, Goetz M et al. Acetic acid compared with i-scan imaging for detecting Barrett’s esophagus: a randomized, comparative trial. Gastrointest Endosc 2014;79:46–54.
47.
Konda V, Banerjee S, Barth BA, Bhat YM, Chauhan SS, Gottlieb KT, et al. Enhanced imaging in the GI tract: spectroscopy and optical coherence tomography. Gastrointest Endosc. 2013;78:568–73.CrossRef
48.
Chen Y, Aguirre AD, Hsiung PL, Desai S, Herz PR, Pedrosa M, et al. Ultrahigh resolution optical coherence tomography of Barrett’s esophagus: preliminary descriptive clinical study correlating images with histology. Endoscopy. 2007;39:599–605.PubMedCrossRef
49.
Isenberg G, Sivak Jr MV, Chak A, Wong RC, Willis JE, Wolf B, et al. Accuracy of endoscopic optical coherence tomography in the detection of dysplasia in Barrett’s esophagus: a prospective, double-blinded study. Gastrointest Endosc. 2005;62:825–31.PubMedCrossRef
50.
Leggett CL, Gorospe EC, Sun G, Uno K, Anderson M, Lutzke LS, et al. Comparison of volumetric LASER endomicroscopy and endoscopic confocal LASER endomicroscopy for the detection of dysplasia in Barrett’s Esophagus. Gastrointest Endosc. 2013;77:AB151.CrossRef
51.•
Sharma P, Kanakadandi V, Wang KK, Tearney GJ, Giacchino M, Wallace MB, et al. Feasibility of using a novel imaging technique in patients with Barrett’s Esophagus: 3 dimensional volumetric laser endomicroscopy. Gastroenterology. 2013;144:S-892. This large multicenter study applied the 3 dimensional new generation OCT to patients with BE and showed the feasibility and safety with 100 % accuracy of dysplasia detection. CrossRef
Metadata
Title
Enhanced Mucosal Imaging and the Esophagus—Ready for Prime Time?
Authors
Yutaka Tomizawa
Irving Waxman
Publication date
01-06-2014
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 6/2014
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-014-0389-x

Other articles of this Issue 6/2014

Current Gastroenterology Reports 6/2014 Go to the issue

Esophagus (L Gerson, Section Editor)

New Therapies for Non-cardiac Chest Pain

Inflammatory Bowel Disease (S Hanauer, Section Editor)

Positioning Therapy for Crohn’s Disease

Small Intestine (J Sellin, Section Editor)

Tropical Sprue in 2014: the New Face of an Old Disease

Nutrition and Obesity (S McClave, Section Editor)

New Pharmacological Treatments for the Management of Obesity
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits