Anne-Fré Swager1, Guillermo J Tearney2, Cadman L Leggett3, Martijn G H van Oijen4, Sybren L Meijer5, Bas L Weusten1, Wouter L Curvers6, Jacques J G H M Bergman1. 1. Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands. 2. Department of Pathology and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. 4. Department of Medical Oncology, Academic Medical Center, Amsterdam, the Netherlands. 5. Department of Pathology, Academic Medical Center, Amsterdam, the Netherlands. 6. Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands.
Abstract
BACKGROUND AND AIMS: Volumetric laser endomicroscopy (VLE) provides a circumferential scan that enables visualization of the subsurface layers of the esophageal wall at 7 μm resolution. The aims of this study were to identify VLE features of Barrett's esophagus (BE) neoplasia and to develop a VLE prediction score. METHODS: A database of VLE images from endoscopic resection specimens, precisely correlated with histology, from patients with BE with and without neoplasia was used. Features potentially predictive for early BE neoplasia were identified by unblinded evaluation of 25 VLE-histology images. In a learning phase, 20 VLE images with or without BE neoplasia were scored by 2 VLE experts, blinded to histology. A prediction score was created by using multivariable logistic regression analyses and validated by scoring 40 VLE images (50% neoplastic) by using area under receiver operating characteristic (ROC) curve (AUC) analysis. RESULTS: Three VLE features independently predictive for BE neoplasia were identified: (1) lack of layering; (2) higher surface than subsurface signal; (3) presence of irregular, dilated glands/ducts. A VLE neoplasia prediction score was developed with the following: (1) 6 points; (2) 6 or 8 points for equal or higher surface signal; and (3) 5 points. The ROC curve of this prediction score showed an AUC of 0.81 (95% confidence interval, 0.71-0.90). A cut-off value of ≥8 was associated with sensitivity and specificity of 83% and 71%, respectively. CONCLUSIONS: When high-quality ex vivo VLE-histology correlation was used, the VLE features of layering, surface signal, and irregular glands/ducts were independently and significantly associated with BE neoplasia. A VLE prediction score for BE neoplasia was developed and validated, with promising accuracy. (Clinical trial registration number: NCT01862666.).
BACKGROUND AND AIMS: Volumetric laser endomicroscopy (VLE) provides a circumferential scan that enables visualization of the subsurface layers of the esophageal wall at 7 μm resolution. The aims of this study were to identify VLE features of Barrett's esophagus (BE) neoplasia and to develop a VLE prediction score. METHODS: A database of VLE images from endoscopic resection specimens, precisely correlated with histology, from patients with BE with and without neoplasia was used. Features potentially predictive for early BE neoplasia were identified by unblinded evaluation of 25 VLE-histology images. In a learning phase, 20 VLE images with or without BE neoplasia were scored by 2 VLE experts, blinded to histology. A prediction score was created by using multivariable logistic regression analyses and validated by scoring 40 VLE images (50% neoplastic) by using area under receiver operating characteristic (ROC) curve (AUC) analysis. RESULTS: Three VLE features independently predictive for BE neoplasia were identified: (1) lack of layering; (2) higher surface than subsurface signal; (3) presence of irregular, dilated glands/ducts. A VLE neoplasia prediction score was developed with the following: (1) 6 points; (2) 6 or 8 points for equal or higher surface signal; and (3) 5 points. The ROC curve of this prediction score showed an AUC of 0.81 (95% confidence interval, 0.71-0.90). A cut-off value of ≥8 was associated with sensitivity and specificity of 83% and 71%, respectively. CONCLUSIONS: When high-quality ex vivo VLE-histology correlation was used, the VLE features of layering, surface signal, and irregular glands/ducts were independently and significantly associated with BE neoplasia. A VLE prediction score for BE neoplasia was developed and validated, with promising accuracy. (Clinical trial registration number: NCT01862666.).
Authors: Osman O Ahsen; Kaicheng Liang; Hsiang-Chieh Lee; Michael G Giacomelli; Zhao Wang; Benjamin Potsaid; Marisa Figueiredo; Qin Huang; Vijaysekhar Jayaraman; James G Fujimoto; Hiroshi Mashimo Journal: Endoscopy Date: 2018-09-27 Impact factor: 10.093
Authors: Hsiang-Chieh Lee; Osman O Ahsen; Kaicheng Liang; Zhao Wang; Marisa Figueiredo; Michael G Giacomelli; Benjamin Potsaid; Qin Huang; Hiroshi Mashimo; James G Fujimoto Journal: Gastrointest Endosc Date: 2017-02-05 Impact factor: 9.427
Authors: Muhammad Aziz; Chandra S Dasari; Tarun Rai; Benjamin Alsop; Neil Gupta; Prashanth Vennalaganti; Viveksandeep Thoguluva Chandrasekar; Kelsey Able; Kevin Kennedy; Michael B Wallace; Kenneth K Wang; Herbert C Wolfsen; Prateek Sharma; Cadman L Leggett Journal: Transl Gastroenterol Hepatol Date: 2022-01-25
Authors: Amrit K Kamboj; Allon Kahn; Tarek Sawas; Lori S Lutzke; Prasad G Iyer; Kenneth K Wang; Cadman L Leggett Journal: Gastrointest Endosc Date: 2018-10-16 Impact factor: 9.427