Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging

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dc.citation.journalTitleJournal of Visualized Experimentsen_US
dc.citation.volumeNumber87en_US
dc.contributor.authorPerl, Daniel P.en_US
dc.contributor.authorParikh, Neilen_US
dc.contributor.authorChang, Shannonen_US
dc.contributor.authorPeng, Paulen_US
dc.contributor.authorThekkek, Nadhien_US
dc.contributor.authorLee, Michelle H.en_US
dc.contributor.authorPolydorides, Alexandros D.en_US
dc.contributor.authorMitcham, Josephineen_US
dc.contributor.authorRichards-Kortum, Rebeccaen_US
dc.contributor.authorAnandasabapathy, Sharmilaen_US
dc.date.accessioned2017-06-05T20:44:20Zen_US
dc.date.available2017-06-05T20:44:20Zen_US
dc.date.issued2014en_US
dc.description.abstractThe ability to differentiate benign metaplasia in Barrett’s Esophagus (BE) from neoplasia in vivo remains difficult as both tissue types can be flat and indistinguishable with white light imaging alone. As a result, a modality that highlights glandular architecture would be useful to discriminate neoplasia from benign epithelium in the distal esophagus. VFI is a novel technique that uses an exogenous topical fluorescent contrast agent to delineate high grade dysplasia and cancer from benign epithelium. Specifically, the fluorescent images provide spatial resolution of 50 to 100 μm and a field of view up to 2.5 cm, allowing endoscopists to visualize glandular morphology. Upon excitation, classic Barrett’s metaplasia appears as continuous, evenly-spaced glands and an overall homogenous morphology; in contrast, neoplastic tissue appears crowded with complete obliteration of the glandular framework. Here we provide an overview of the instrumentation and enumerate the protocol of this new technique. While VFI affords a gastroenterologist with the glandular architecture of suspicious tissue, cellular dysplasia cannot be resolved with this modality. As such, one cannot morphologically distinguish Barrett’s metaplasia from BE with Low-Grade Dysplasia via this imaging modality. By trading off a decrease in resolution with a greater field of view, this imaging system can be used at the very least as a red-flag imaging device to target and biopsy suspicious lesions; yet, if the accuracy measures are promising, VFI may become the standard imaging technique for the diagnosis of neoplasia (defined as either high grade dysplasia or cancer) in the distal esophagus.en_US
dc.identifier.citationPerl, Daniel P., Parikh, Neil, Chang, Shannon, et al.. "Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging." <i>Journal of Visualized Experiments,</i> 87, (2014) JoVE: https://doi.org/10.3791/50992.en_US
dc.identifier.doihttps://doi.org/10.3791/50992en_US
dc.identifier.urihttps://hdl.handle.net/1911/94800en_US
dc.language.isoengen_US
dc.publisherJoVEen_US
dc.rightsArticle is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.en_US
dc.titleDiagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imagingen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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