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Volumetric laser endomicroscopy

Arvind J Trindade, Cadman L Leggett, Kenneth J Chang
PURPOSE OF REVIEW: The incidence of esophageal adenocarcinoma is on the rise despite widespread appreciation that the precursor lesion is Barrett's esophagus. Studies have shown that some patients known to have Barrett's esophagus develop cancer despite their enrollment in conventional endoscopic surveillance programs. This highlights the need for advanced endoscopic imaging to help identify early neoplasia and prevent its progression to esophageal cancer. Recently, a wide-field, second-generation optical coherence tomography endoscopic platform called volumetric laser endomicroscopy (VLE) was cleared by the Food and Drug Administration and made commercially available for advanced imaging in Barrett's esophagus...
April 11, 2017: Current Opinion in Gastroenterology
A Swager, F van der Sommen, S R Klomp, S Zinger, S L Meijer, E J Schoon, J J Bergman, P H N de With, W L Curvers
BACKGROUND AND AIMS: Volumetric laser endomicroscopy (VLE) is an advanced imaging system that provides a near-microscopic resolution scan of the esophageal wall layers up to 3 mm deep. VLE has the potential to improve detection of early neoplasia in Barrett's esophagus (BE). However, interpretation of VLE images is complex due to the large amount of data that needs to be interpreted in real-time. The aim of this study was to investigate the feasibility of a computer algorithm to identify early BE neoplasia on ex vivo VLE images...
March 16, 2017: Gastrointestinal Endoscopy
W K Tan, M di Pietro, R C Fitzgerald
Barrett's oesophagus is a condition which predisposes towards development of oesophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence in the Western world over the past three decades. There have been tremendous advances in the field of Barrett's oesophagus, not only in diagnostic modalities, but also in therapeutic strategies available to treat this premalignant disease. In this review, we discuss the past, present and future of Barrett's oesophagus. We describe the historical and new evolving diagnostic criteria of Barrett's oesophagus, while also comparing and contrasting the British Society of Gastroenterology guidelines, American College of Gastroenterology guidelines and International Benign Barrett's and CAncer Taskforce (BOBCAT) for Barrett's oesophagus...
February 16, 2017: European Journal of Surgical Oncology
A Swager, A J de Groof, S L Meijer, B L Weusten, W L Curvers, Jacques J Bergman
BACKGROUND AND AIM: Volumetric laser endomicroscopy (VLE) provides a circumferential scan of the esophageal wall layers and has potential to improve detection of neoplasia in Barrett's esophagus (BE). The novel VLE laser marking system enables direct in vivo marking of suspicious areas as identified on VLE. These laser marked areas can subsequently be targeted for biopsies. The aim was to evaluate the visibility and positional accuracy of laser marks (LMs) in different esophageal tissue types on white light endoscopy (WLE) and VLE...
February 2, 2017: Gastrointestinal Endoscopy
Arvind J Trindade, Sumant Inamdar, Divyesh V Sejpal, Arvind Rishi, Keith Sultan
No abstract text is available yet for this article.
February 2017: Endoscopy
Herbert C Wolfsen
No abstract text is available yet for this article.
November 2016: Gastroenterology & Hepatology
Arvind J Trindade, Sumant Inamdar, Michael S Smith, Kenneth J Chang, Cadman L Leggett, Charles J Lightdale, Douglas K Pleskow, Divyesh V Sejpal, Guillermo J Tearney, Rebecca M Thomas, Michael B Wallace
BACKGROUND AND AIMS: Targeting neoplasia in Barrett's esophagus (BE) is challenging. Volumetric laser endomicroscopy (VLE) is a new imaging technique that allows for real time cross-sectional microstructure imaging that can detect BE neoplasia. The interobserver agreement among users in practice is unknown. METHODS: Eight high-volume users of VLE from different academic centers in the United States evaluated 120 stored VLE images blinded to the endoscopic and clinical findings...
November 27, 2016: Gastrointestinal Endoscopy
Anne-Fré Swager, Guillermo J Tearney, Cadman L Leggett, Martijn G H van Oijen, Sybren L Meijer, Bas L Weusten, Wouter L Curvers, Jacques J G H M Bergman
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...
May 2017: Gastrointestinal Endoscopy
Arvind J Trindade, Michael S Smith, Douglas K Pleskow
Advanced imaging techniques used in the management of Barrett's esophagus include electronic imaging enhancement (e.g. narrow band imaging, flexible spectral imaging color enhancement, and i-Scan), chromoendoscopy, and confocal laser endomicroscopy. Electronic imaging enhancement is used frequently in daily practice, but use of the other advanced technologies is not routine. High-definition white light endoscopy and random four quadrant biopsy remain the standard of care for evaluation of Barrett's esophagus; this is largely due to the value of advanced imaging technologies not having been validated in large studies or in everyday practice...
May 2016: Therapeutic Advances in Gastroenterology
Ashley H Davis-Yadley, Kevin G Neill, Mokenge P Malafa, Luis R Pena
BACKGROUND: Barrett esophagus (BE) continues to be a major risk factor for developing esophageal adenocarcinoma. METHODS: We review the risk factors, diagnosis, and management of BE, with an emphasis on the most current endoscopic diagnostic modalities for BE. RESULTS: Novel diagnostic modalities have emerged to address the inadequacies of standard, untargeted biopsies, such as dye-based and virtual chromoendoscopy, endoscopic mucosal resection, molecular biomarkers, optical coherence tomography, confocal laser endomicroscopy, volumetric laser endomicroscopy, and endocytoscopy...
January 2016: Cancer Control: Journal of the Moffitt Cancer Center
Arvind J Trindade, Benley J George, Joshua Berkowitz, Divyesh V Sejpal, Matthew J McKinley
Methods and study aims: The incidence of esophageal cancer is rising despite increased surveillance efforts. Volumetric laser endomicroscopy (VLE) is a new endoscopic imaging tool that can allow for targeted biopsy of neoplasia in Barrett's esophagus. We report a series of 6 patients with long-segment Barrett's esophagus ( > 3 cm), who underwent a session of endoscopy with volumetric laser endomicroscopy, after a separate prior session of standard high-definition endoscopy with narrow band imaging (NBI) and random biopsies that did not reveal neoplasia...
March 2016: Endoscopy International Open
Arvind J Trindade, Arvind Rishi, Peter H Stein, Divyesh V Sejpal
No abstract text is available yet for this article.
August 2016: Gastrointestinal Endoscopy
Christopher Atkinson, Satish Singh, P Marco Fisichella
No abstract text is available yet for this article.
June 2016: Digestive and Liver Disease
Arvind J Trindade, Keith Sultan, Arunan S Vamadevan, Cathy Fan, Divyesh V Sejpal
No abstract text is available yet for this article.
January 2016: Therapeutic Advances in Gastroenterology
Cadman L Leggett, Emmanuel C Gorospe, Daniel K Chan, Prasuna Muppa, Victoria Owens, Thomas C Smyrk, Marlys Anderson, Lori S Lutzke, Guillermo Tearney, Kenneth K Wang
BACKGROUND AND AIMS: Probe-based confocal laser endomicroscopy (pCLE) and volumetric laser endomicroscopy (VLE) (also known as frequency domain optical coherence tomography) are advanced endoscopic imaging modalities that may be useful in the diagnosis of dysplasia associated with Barrett's esophagus (BE). We performed pCLE examination in ex-vivo EMR specimens and compared the diagnostic performance of using the current VLE scoring index (previously established as OCT-SI) and a novel VLE diagnostic algorithm (VLE-DA) for the detection of dysplasia...
May 2016: Gastrointestinal Endoscopy
Anne-Fré Swager, David F Boerwinkel, Daniel M de Bruin, Dirk J Faber, Ton G van Leeuwen, Bas L Weusten, Sybren L Meijer, Jacques J Bergman, Wouter L Curvers
BACKGROUND AND AIMS: The prevalence and clinical relevance of buried Barrett's glands (BB) after radiofrequency ablation (RFA) in Barrett's esophagus (BE) are debated. Recent optical coherence tomography studies demonstrated a high prevalence of BBs. Direct histological correlation, however, has been lacking. Volumetric laser endomicroscopy (VLE) is a second-generation optical coherence tomography system capable of scanning a large surface of the esophageal wall layers with low-power microscopy resolution...
January 2016: Gastrointestinal Endoscopy
Arvind J Trindade, Arunan S Vamadevan, Divyesh V Sejpal
No abstract text is available yet for this article.
October 2015: Gastrointestinal Endoscopy
Herbert C Wolfsen, Prateek Sharma, Michael B Wallace, Cadman Leggett, Guillermo Tearney, Kenneth K Wang
BACKGROUND: Volumetric laser endomicroscopy (VLE) produces high-resolution, cross-sectional surface, and subsurface images for detecting neoplasia, targeting biopsies, and guiding real-time treatment. OBJECTIVE: To evaluate the safety and feasibility of the Nvision VLE system. DESIGN: Prospective, multicenter study. SETTING: Tertiary-care medical centers. PATIENTS: One hundred patients with suspected Barrett's esophagus, including 52 patients with prior endotherapy...
October 2015: Gastrointestinal Endoscopy
A Swager, D F Boerwinkel, D M de Bruin, B L Weusten, D J Faber, S L Meijer, T G van Leeuwen, W L Curvers, J J Bergman
Volumetric laser endomicroscopy (VLE) is a novel balloon-based optical coherence tomography (OCT) imaging technique that may improve detection of early neoplasia in Barrett's esophagus (BE). Most OCT studies lack a direct correlation between histology and OCT images. The aim is to investigate the optimal approach for achieving one-to-one correlation of ex-vivo VLE images of endoscopic resection (ER) specimens with histology. BE patients with and without early neoplasia underwent ER after delineating areas with electrocoagulation markers (ECM)...
August 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Melissa J Suter, Michalina J Gora, Gregory Y Lauwers, Thomas Arnason, Jenny Sauk, Kevin A Gallagher, Lauren Kava, Khay M Tan, Amna R Soomro, Timothy P Gallagher, Joseph A Gardecki, Brett E Bouma, Mireille Rosenberg, Norman S Nishioka, Guillermo J Tearney
BACKGROUND: Biopsy surveillance protocols for the assessment of Barrett's esophagus can be subject to sampling errors, resulting in diagnostic uncertainty. Optical coherence tomography is a cross-sectional imaging technique that can be used to conduct volumetric laser endomicroscopy (VLE) of the entire distal esophagus. We have developed a biopsy guidance platform that places endoscopically visible marks at VLE-determined biopsy sites. OBJECTIVE: The objective of this study was to demonstrate in human participants the safety and feasibility of VLE-guided biopsy in vivo...
June 2014: Gastrointestinal Endoscopy
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