• Humans
• Barrett Esophagus/diagnostic imaging
• Barrett Esophagus/pathology
• Esophageal Neoplasms/diagnostic imaging
• Diagnosis, Computer-Assisted/methods
• Esophagoscopy/methods
• Female
• Male
• Middle Aged
• Narrow Band Imaging/methods
• Aged
• Sensitivity and Specificity
• Video Recording
• Prospective Studies
• Benchmarking
• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• Clinical Competence
• Observer Variation

• Barrett esophagus
• early cancer
• endoscopic resection
• interobserver variability
• staging

• Humans
• Barrett Esophagus/surgery
• Barrett Esophagus/pathology
• Male
• Endoscopic Mucosal Resection/methods
• Female
• Esophageal Neoplasms/surgery
• Esophageal Neoplasms/pathology
• Aged
• Esophagoscopy/methods
• Middle Aged
• Observer Variation
• Neoplasm Staging
• Biopsy
• Neoplasm Invasiveness
• Adenocarcinoma/surgery
• Adenocarcinoma/pathology
• Predictive Value of Tests
• Esophageal Mucosa/pathology
• Esophageal Mucosa/surgery
• Esophageal Mucosa/diagnostic imaging

• Algorithms
• Barrett Esophagus/diagnostic imaging
• Computers
• Esophageal Neoplasms/diagnostic imaging
• Esophagoscopy
• Humans
• Narrow Band Imaging

• Artificial intelligence
• Barrett’s esophagus
• Early neoplasia
• Endoscopy

• Artificial Intelligence
• Barrett Esophagus/complications
• Barrett Esophagus/diagnosis
• Biopsy/methods
• Diagnosis, Computer-Assisted/methods
• Early Detection of Cancer/methods
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/etiology
• Esophagoscopy/methods
• Humans

• Barrett’s esophagus
• Dysplasia
• Endoscopic eradication therapy
• Endoscopic resection
• Quality indicators
• Radiofrequency ablation

• Barrett's esophagus
• computer-aided diagnosis
• confocal laser endomicroscopy
• esophageal cancer
• narrowband imaging
• optical coherence tomography

• Barrett’s oesophagus
• Imaging modalities
• Oesophageal adenocarcinoma
• Screening

• Adenocarcinoma/diagnostic imaging
• Barrett Esophagus/diagnostic imaging
• Diagnostic Imaging
• Esophageal Neoplasms
• Humans

• Asia
• Barrett's esophagus
• columnar-lined esophagus
• gastroesophageal junction
• intestinal metaplasia

Colorectal cancer remains the second leading cause of cancer death in the United States, and increased risk in patients with ulcerative colitis (a subset of inflammatory bowel disease) has motivated studies into early markers of dysplasia. The development of clinically translatable multiphoton imaging systems has allowed for the potential of in vivo label-free imaging of epithelial crypt structures via autofluorescence and/or second harmonic generation (SHG). SHG has been used to investigate collagen structures in various types of cancer, though the changes that colorectal epithelial collagen structures undergo during tumor development, specifically colitis-associated tumors, have not been fully investigated.

This study used two murine models, using A/J mice, one for spontaneous carcinoma and one for colitis-associated carcinoma, to investigate and quantify SHG image features that could potentially inform future study designs of endoscopic multiphoton imaging systems. The spontaneous tumor model comprised a series of six weekly injections of azoxymethane (AOM model). The colitis-associated tumor model comprised a single injection of AOM, followed by cycles of drinking water with dissolved dextran sodium sulfate salt (AOM-DSS model). SHG images of freshly resected murine colon were acquired with a multiphoton imaging system, and image features, such as crypt size, shape and distribution, were quantified using an automated algorithm.

The comparison of quantified features of crypt morphology demonstrated the ability of our quantitative image feature algorithms to detect differences between spontaneous (AOM model) and colitis-associated (AOM-DSS model) murine colorectal tissue specimens. There were statistically significant differences in the mean and standard deviation of nearest neighbor (distance between crypts) and circularity between the Control cohort, AOM and AOM-DSS cohorts. We also saw significance between AOM and AOM-DSS cohorts when calculating nearest neighbor in images acquired at fixed depths.

The results provide insight into the ability of SHG imaging to yield relevant data about the crypt microstructure in colorectal epithelium, specifically the potential to distinguish between spontaneous and colitis-associated murine models using quantification of crypt shape and distribution, informing future design of translational multiphoton imaging systems and protocols.

The online version of this article (10.1186/s12885-019-5639-8) contains supplementary material, which is available to authorized users.

• Azoxymethane
• Colorectal cancer
• Crypt morphology
• Dextran sulfate sodium salt
• Image analysis
• Inflammatory bowel disease
• Multiphoton
• Second harmonic generation

• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• Barrett Esophagus/diagnostic imaging
• Barrett Esophagus/pathology
• Cohort Studies
• Esophageal Neoplasms/diagnostic imaging
• Esophageal Neoplasms/pathology
• Esophagoscopy/methods
• Humans
• Optical Imaging/methods
• Precancerous Conditions/diagnostic imaging
• Precancerous Conditions/pathology
• Prospective Studies

• Barrett’s esophagus
• Endoscopic diagnosis
• Endoscopic treatment
• Esophageal adenocarcinoma

• Barrett esophagus
• Endoscopic imaging
• Narrow band imaging
• Neoplasia
• Transnasal endoscopy
• Wide area transepithelial sampling with 3-dimensional analysis

• Adenocarcinoma/diagnosis
• Adenocarcinoma/etiology
• Barrett Esophagus/diagnosis
• Barrett Esophagus/etiology
• Biopsy
• Coloring Agents
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/etiology
• Esophagoscopy/methods
• Gastroesophageal Reflux/complications
• Gastroesophageal Reflux/diagnosis
• Humans
• Indicators and Reagents
• Optical Imaging
• Precancerous Conditions/diagnosis

• Computer Aided Detection
• Endoscopy
• Molecular Imaging

• Barrett’s Esophagus
• Dysplasia
• Endoscopic Mucosal Resection
• Endoscopic Therapy
• Esophageal Adenocarcinoma
• Quality Indicators
• Radiofrequency Ablation

Endoscopy allows for the screening, early diagnosis, treatment and follow up of superficial esophageal cancer. Endoscopic submucosal dissection has become the gold standard for the resection of superficial squamous cell neoplasia. Combinations of endoscopic mucosal resection and radiofrequency ablation are the mainstay of the management of Barrett’s associated neoplasia. However, protruded, non-lifting or large lesions may be better managed by endoscopic submucosal dissection. Novel ablation tools, such as argon plasma coagulation with submucosal lifting and cryoablation balloons, are being developed for the treatment of residual Barrett’s esophagus, since iatrogenic strictures still hamper the development of extensive circumferential resections in the esophagus. Optimal surveillance modalities after endoscopic resection are still to be determined. The assessment of the risk of lymph-node metastases, as well as of the need for additional treatments based on qualitative and quantitative histological criteria, balanced to the patient’s condition, requires a dedicated multidisciplinary team decision process. The need for trained endoscopists, expert pathologists and surgeons, and specialized multidisciplinary meetings underlines the role of expert centers in the management of superficial esophageal cancer.

• Barrett’s esophagus
• Superficial esophageal neoplasm
• early adenocarcinoma
• endoscopic resection
• endoscopic submucosal dissection
• radiofrequency ablation
• squamous cell carcinoma

• Barrett’s esophagus
• Imaging
• Optical chromoendoscopy

• Barrett’s esophagus
• advanced endoscopic imaging
• esophageal cancer
• optical coherence tomography
• volumetric laser endomicroscopy

• Adaptive sigmoid function
• Color image enhancement
• Unsharp masking
• Wireless capsule endoscopy

• Barrett’s esophagus
• Endoscopic ablation
• Endoscopic eradication therapy
• Quality indicators
• Radiofrequency ablation

• (100.2960) Image analysis
• (170.2150) Endoscopic imaging
• (180.2520) Fluorescence microscopy

• R15 CA202662 NCI NIH HHS

• BARRETT'S OESOPHAGUS
• ENDOSCOPIC PROCEDURES
• SCREENING

• GASTROSCOPY

• Laryngoscopy
• interrater reliability
• intrarater reliability
• narrow band imaging
• observer agreement
• observer reliability

The incidence of esophageal adenocarcinoma (EAC) has dramatically increased in the United States as well as Western European countries. The majority of esophageal adenocarcinomas arise from a backdrop of Barrett’s esophagus (BE), a premalignant lesion that can lead to dysplasia and cancer. Because of the increased risk of EAC, GI society guidelines recommend endoscopic surveillance of patients with BE. The emphasis on early detection of dysplasia in BE through surveillance endoscopy has led to the development of advanced endoscopic imaging technologies. These techniques have the potential to both improve mucosal visualization and characterization and to detect small mucosal abnormalities which are difficult to identify with standard endoscopy. This review summarizes the advanced imaging technologies used in evaluation of BE.

• Esophageal adenocarcinoma
• Barrett’s esophagus
• Dysplasia
• Intestinal metaplasia
• Advanced endoscopic imaging
• Narrow band imaging
• Confocal laser endomicroscopy

• Endoscopy
• Esophageal Cancer
• NDBE
• Risk Factors

• Gastrointestinal endoscopy
• Guideline gastrointestinal endoscopy
• Quality parameters

• Advanced imaging techniques
• Autofluorescence imaging
• Barrett’s esophagus
• Chromoendoscopy
• Confocal laser endomicroscopy
• Detection of neoplasia
• Optical coherence tomography
• Surveillance

• Barrett’s oesophagus
• chromoendoscopy
• confocal endomicroscopy
• narrow band imaging
• optical coherence tomography
• white light endoscopy

• Algorithms
• Colon, Sigmoid/pathology
• Color
• Endoscopy, Digestive System
• Humans
• Image Enhancement
• Image Interpretation, Computer-Assisted
• Neoplasms/pathology
• Polyps/pathology

The incidence of esophageal adenocarcinoma (EAC) has markedly increased in the United States over the last few decades. Barrett’s esophagus (BE) is the most significant known risk factor for this malignancy. Theoretically, screening and treating early BE should help prevent EAC but the exact incidence of BE and its progression to EAC is not entirely known and cost-effectiveness studies for Barrett’s screening are lacking. Over the last few years, there have been major advances in our understanding of the epidemiology, pathogenesis and endoscopic management of BE. These developments focus on early recognition of advanced histology and endoscopic treatment of high-grade dysplasia. Advanced resection techniques now enable us to endoscopically treat early esophageal cancer. In this review, we will discuss these recent advances in diagnosis and treatment of Barrett’s esophagus and early esophageal adenocarcinoma.

• Barrett’s esophagus
• early esophageal adenocarcinoma
• endoscopy

• Advanced imaging
• Barrett's Esophagus
• Red flag techniques

• Adenocarcinoma/diagnosis
• Barrett Esophagus/diagnosis
• Diagnostic Imaging/methods
• Disease Progression
• Early Detection of Cancer
• Esophageal Neoplasms/diagnosis
• Esophagoscopy/methods
• Humans
• Risk Factors

• Argon plasma coagulation
• Autofluorescence imaging
• Barrett's esophagus
• Chromoendoscopy
• Confocal laser endomicroscopy
• Early esophageal adenocarcinoma
• Endoscopic mucosal resection
• Image-enhanced endoscopy
• Intestinal metaplasia
• Narrow band imaging
• Radiofrequency ablation
• Seattle protocol

• Autofluorescence imaging
• Barrett's esophagus
• Chromoendoscopy
• Confocal laser endomicroscopy
• Imaging
• Narrow-band imaging

Modern endoscopes play an important role in diagnosing various gastrointestinal (GI) tract related diseases. The improved visual quality of endoscopic images can provide better diagnosis. This paper presents an efficient color image enhancement method for endoscopic images. It is achieved in two stages: image enhancement at gray level followed by space variant chrominance mapping color reproduction. Image enhancement is achieved by performing adaptive sigmoid function and uniform distribution of sigmoid pixels. Secondly, a space variant chrominance mapping color reproduction is used to generate new chrominance components. The proposed method is used on low contrast color white light images (WLI) to enhance and highlight the vascular and mucosa structures of the GI tract. The method is also used to colorize grayscale narrow band images (NBI) and video frames. The focus value and color enhancement factor show that the enhancement level in the processed image is greatly increased compared to the original endoscopic image. The overall contrast level of the processed image is higher than the original image. The color similarity test has proved that the proposed method does not add any additional color which is not present in the original image. The algorithm has low complexity with an execution speed faster than other related methods.

• Advanced imaging techniques
• Barrett's oesophagus
• Early neoplasia
• Surveillance

Due to its rapidly rising incidence and high mortality, esophageal adenocarcinoma is a major public health concern, particularly in Western countries. The steps involved in the progression from its predisposing condition, gastroesophageal reflux disease, to its premalignant disorder, Barrett’s esophagus, and to cancer, are incompletely understood. Current screening and surveillance methods are limited by the lack of population-wide utility, incomplete sampling of standard biopsies, and subjectivity of evaluation. Advances in endoscopic ablation have raised the hope of effective therapy for eradication of high-risk Barrett’s lesions, but improvements are needed in determining when to apply this treatment and how to follow patients clinically. Researchers have evaluated numerous potential molecular biomarkers with the goal of detecting dysplasia, with varying degrees of success. The combination of biomarker panels with epidemiologic risk factors to yield clinical risk scoring systems is promising. New approaches to sample tissue may also be combined with these biomarkers for less invasive screening and surveillance. The development of novel endoscopic imaging tools in recent years has the potential to markedly improve detection of small foci of dysplasia in vivo. Current and future efforts will aim to determine the combination of markers and imaging modalities that will most effectively improve the rate of early detection of high-risk lesions in Barrett’s esophagus.

• Barrett’s esophagus
• Esophageal adenocarcinoma
• Gastroesophageal reflux disease
• Dysplasia
• Biomarkers
• Endoscopic imaging

• Barrett's esophagus
• dysplasia
• endoscopy
• high definition
• surveillance

Esophageal carcinoma affects more than 450000 people worldwide and the incidence is rapidly increasing. In the United States and Europe, esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence. Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages. Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett’s esophagus. These risk factors include chronic gastroesophageal reflux disease, hiatal hernia, advanced age, male sex, white race, cigarette smoking, and obesity. The annual risk of esophageal cancer is approximately 0.25% for patients without dysplasia and 6% for patients with high-grade dysplasia. Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa. The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option. The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia. Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation, photodynamic therapy and cryoablation. Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion. Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor, positive lymph node and submucosal invasion. Surgical resection should be offered to patients with deep submucosal invasion.

• Esophageal adenocarcinoma
• High grade dysplasia, endoscopic ultrasound
• Gastroesophageal reflux
• Barrett’s esophagus
• Chromoendoscopy
• Narrow band imaging
• Endoscopic mucosal resection
• Radiofrequency ablation

AIM: To evaluate the diagnostic value of digital chrome endoscopy (I-Scan) in Barrett's esophagus (BE).

METHODS: From August 2012 to March 2013, a total of 420 patients with reflux esophageal disease were enrolled. The patients were randomized into two groups: one group (n = 220) received I-Scan and the other received ordinary endoscopy. Those suspected to have BE were observed closely and underwent biopsy. The detection rate and diagnostic accuracy were compared between the two endoscopic modes.

RESULTS: Suspected BE was diagnosed in 35 patients (15.91%) by I-Scan and in 24 (12.00%) by ordinary endoscopy. There was no significant difference in the detection rate for BE between the two methods (P > 0.05). The coincidence rate of diagnosis between I-Scan and pathology was 87.10%, and was 70.83% for the ordinary endoscopy, with a significant difference between the two groups (P < 0.05). The image score of paliform blood vessels was significant difference between squamoucolumnar junction (SCJ) and gastroesophageal junction (GEJ) (P < 0.05).

CONCLUSION: I-Scan could play an important role in the observation of paliform blood vessels between SCJ and GEJ in BE. The dignostic rate of I-Scan might be better than that of ordinary endoscopy. I-Scan can improve the detection rate for BE.

• Barrett's esophagus
• Diagnosis
• Pathology
• Digital chrome endoscopy

Ideally, endoscopists should be able to detect, characterize, and confirm the nature of a lesion at the bedside, minimizing uncertainties and targeting biopsies and resections only where necessary. However, under conventional white-light inspection – at present, the sole established technique available to most of humanity – premalignant conditions and early cancers can frequently escape detection. In recent years, a range of innovative techniques have entered the endoscopic arena due to their ability to enhance the contrast of diseased tissue regions beyond what is inherently possible with standard white-light endoscopy equipment. The aim of this review is to provide an overview of the state-of-the-art advanced endoscopic imaging techniques available for clinical use that are impacting the way precancerous and neoplastic lesions of the gastrointestinal tract are currently detected and characterized at endoscopy. The basic instrumentation and the physics behind each method, followed by the most influential clinical experience, are described. High-definition endoscopy, with or without optical magnification, has contributed to higher detection rates compared with white-light endoscopy alone and has now replaced ordinary equipment in daily practice. Contrast-enhancement techniques, whether dye-based or computed, have been combined with white-light endoscopy to further improve its accuracy, but histology is still required to clarify the diagnosis. Optical microscopy techniques such as confocal laser endomicroscopy and endocytoscopy enable in vivo histology during endoscopy; however, although of invaluable assistance for tissue characterization, they have not yet made transition between research and clinical use. It is still unknown which approach or combination of techniques offers the best potential. The optimal method will entail the ability to survey wide areas of tissue in concert with the ability to obtain the degree of detailed information provided by microscopic techniques. In this respect, the challenging combination of autofluorescence imaging and confocal endomicroscopy seems promising, and further research is awaited.

• autofluorescence imaging
• confocal laser endomicroscopy
• fluorescence lifetime imaging
• image-enhanced endoscopy
• narrowband imaging

• Barrett's esophagus
• diagnosis
• meta-analysis
• narrow band imaging

• Barrett's Esophagus
• Endoscopic Imaging
• Endoscopic Therapy
• Neoplasia

• AFI
• Confocal Endomicroscopy
• FICE
• HD Endoscopy
• NBI
• i-scan

• Endoscopy/methods
• Endoscopy/trends
• Gastrointestinal Diseases/diagnosis
• Humans
• Image Processing, Computer-Assisted/methods
• Image Processing, Computer-Assisted/trends
• Optical Imaging/methods
• Optical Imaging/trends