Barrett's esophagus: diagnosis and management

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Barrett's esophagus: diagnosis and management Swathi Eluri, MD, MSCR, Nicholas J. Shaheen, MD, MPH Gastrointestinal Endoscopy Volume 85, Issue 5, Pages 889-903 (May 2017) DOI: 10.1016/j.gie.2017.01.007 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Schematic for management of non-nodular Barrett’s esophagus.8 Surveillance upper endoscopy at 1-year intervals is an acceptable alternative to endoscopic eradication therapy. T1a esophageal adenocarcinoma is amenable for endoscopic therapy. (Image reproduced with permission). BE, Barrett’s esophagus; LGD, low-grade dysplasia; HGD, high-grade dysplasia; EAC, esophageal adenocarcinoma; PPI, proton-pump inhibitor. Gastrointestinal Endoscopy 2017 85, 889-903DOI: (10.1016/j.gie.2017.01.007) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Classification of regular and irregular mucosal and vascular patterns by using the validated Barrett’s International NBI Group criteria for detection of high-grade dysplasia and esophageal adenocarcinoma using narrow-band imaging in Barrett’s esophagus.69 (Image reproduced with permission.) NBI, Narrow-band imaging. Gastrointestinal Endoscopy 2017 85, 889-903DOI: (10.1016/j.gie.2017.01.007) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Available radiofrequency ablation devices include a circumferential device that can be used for ablation of large areas and focal devices comprising a paddle that can be either attached to the tip or placed through the working channel of an upper endoscope. All rights reserved. Used with the permission of Medtronic, New Haven, Connecticut. Gastrointestinal Endoscopy 2017 85, 889-903DOI: (10.1016/j.gie.2017.01.007) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Kaplan-Meier plot of intestinal metaplasia recurrence among patients (n = 1613) who achieved complete eradication of intestinal metaplasia after radiofrequency ablation, with pre-treatment histology nondysplastic Barrett’s esophagus, low-grade dysplasia, and high-grade dysplasia.138 (Image reproduced with permission). CEIM, complete eradication of intestinal metaplasia; BE, Barrett’s esophagus; LGD, low-grade dysplasia; HGD, high-grade dysplasia; IMC, intramucosal carcinoma. Gastrointestinal Endoscopy 2017 85, 889-903DOI: (10.1016/j.gie.2017.01.007) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions