Published online Jul 7, 2019. doi: 10.3748/wjg.v25.i25.3108
Peer-review started: February 18, 2019
First decision: April 30, 2019
Revised: May 8, 2019
Accepted: May 18, 2019
Article in press: May 18, 2019
Published online: July 7, 2019
Processing time: 138 Days and 5.9 Hours
Esophageal cancer is on the rise. The known precursor lesion is Barrett’s esophagus (BE). Patients with dysplasia are at higher risk of developing esophageal cancer. Currently the gold standard for surveillance endoscopy involves taking targeted biopsies of abnormal areas as well as random biopsies every 1-2 cm of the length of the Barrett’s. Unfortunately studies have shown that this surveillance can miss dysplasia and cancer. Advanced imaging technologies have been developed that may help detect dysplasia in BE. This opinion review discusses advanced imaging in BE surveillance endoscopy and its utility in clinical practice.
Core tip: Barrett’s esophagus (BE) is a precursor of esophageal cancer, the incidence of which is on the rise worldwide. Advanced imaging in BE includes dye chromoendoscopy, electronic chromoendoscopy narrow band imaging (NBI), confocal laser endomicroscopy and volumetric laser endomicroscopy (VLE). The decision to perform these procedures ultimately depends on if the benefit outweighs the cost and any added time performing the procedure. In our practice the added benefits of NBI and VLE outweighs the costs and added time and thus we have incorporated this into our Barrett’s surveillance routine.