Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett's esophagus

Gastrointest Endosc. 2005 May;61(6):679-85. doi: 10.1016/s0016-5107(04)02577-5.


Background: The aim of this study was to investigate the feasibility of detecting high-grade dysplasia (HGD) and early cancer (EC) in Barrett's esophagus (BE) with a prototype video autofluorescence endoscope.

Methods: Sixty patients with BE were evaluated with a prototype, high-resolution videoendoscope that has separate charge-coupled devices for white light endoscopy (WLE) and autofluorescence imaging (AFI). Nondysplastic BE appears green on AFI, whereas potentially neoplastic areas appear blue/violet. The BE was first screened with WLE for visible abnormalities and then was examined by AFI to detect additional lesions. Lesions that raised a suspicion of neoplasia and control areas that were normal on AFI were sampled for histopathologic assessment. Finally, random 4-quadrant biopsy specimens were obtained at 2-cm intervals.

Results: A diagnosis of HGD/EC was made in 22 patients; one patient had no visible abnormality, and 21 had endoscopically detectable areas with HGD/EC. In 6 of the latter 21 patients, the HGD/EC was detected with AFI alone; in another patient, HGD/EC was detected with AFI and random biopsies. In 14 patients, HGD/EC was detected with both WLE and AFI; in 3 of these 14 patients, additional lesions containing HGD/EC were detected by AFI alone.

Conclusions: The results of this study suggest that video AFI may improve the detection of HGD/EC in patients with BE.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Barrett Esophagus / pathology*
  • Biopsy
  • Endoscopes
  • Equipment Design
  • Esophageal Neoplasms / pathology*
  • Esophagoscopy / methods*
  • Feasibility Studies
  • Female
  • Fluorescence*
  • Follow-Up Studies
  • Humans
  • Intestinal Mucosa / pathology
  • Male
  • Precancerous Conditions / pathology*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Video Recording*