Screening for Barrett’s Esophagus

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Presentation transcript:

Screening for Barrett’s Esophagus Massimiliano di Pietro, Daniel Chan, Rebecca C. Fitzgerald, Kenneth K. Wang Gastroenterology Volume 148, Issue 5, Pages 912-923 (May 2015) DOI: 10.1053/j.gastro.2015.02.012 Copyright © 2015 AGA Institute Terms and Conditions

Figure 1 Three cases of BE imaged with 3 different types of TNE systems (left panel), with a corresponding picture taken with a conventional white light Olympus system (right panel images). (Top left panel, Pentax TNE; middle left panel, office-based EndoSheath; bottom left panel, office-based EG scan). Gastroenterology 2015 148, 912-923DOI: (10.1053/j.gastro.2015.02.012) Copyright © 2015 AGA Institute Terms and Conditions

Figure 2 Examples of VLE. (A) A VLE circular scan with imaging of the multilayered squamous esophagus and identification of the layered structure. Sections of the scan can be expanded in the device. It is apparent that this resolution is superior than can be seen with even the highest-resolution endoscopic ultrasound probes. (B) Sector magnification of VLE shows a mucosa without a great degree of surface scattering, indicating a likelihood of nondysplastic BE. The glands indicated by the arrowheads suggest the presence of an abnormal submucosal microenvironment. Gastroenterology 2015 148, 912-923DOI: (10.1053/j.gastro.2015.02.012) Copyright © 2015 AGA Institute Terms and Conditions

Figure 3 Layered epithelium in the cross sectional view on the left with a much enhanced sector view on the right showing the individual layers of the squamous mucosa. Gastroenterology 2015 148, 912-923DOI: (10.1053/j.gastro.2015.02.012) Copyright © 2015 AGA Institute Terms and Conditions

Figure 4 Use of the Cytosponge. (A) Cytosponge embedded in a gelatin capsule. (B) The Cytosponge is swallowed and descends to the stomach through the esophagus. (C) The expanded Cytosponge. (D) The Cytosponge is retrieved by an assistant who pulls the string. (E) Immunohistochemical analysis of TTF3 in cells collected by the Cytosponge as well as BE cells (arrows). Gastroenterology 2015 148, 912-923DOI: (10.1053/j.gastro.2015.02.012) Copyright © 2015 AGA Institute Terms and Conditions