Efficacy of radiologic studies in the detection of Barrett's esophagus

Esophageal radiography using two different air-contrast techniques was used to examine 30 patients with Barrett's esophagus and 18 controls. All patients had upper gastrointestinal endoscopy and biopsy of the esophagus. The radiographs were randomized, masked, and then interpreted by two radiologists blinded to the endoscopic and biopsy diagnosis. Depending upon the diagnostic strategy of the radiologist, sensitivity varied from 0.36 to 0.83 and specificity from 0.56 to 1.00. A typical receiver-operating-characteristic curve was generated. Esophageal radiography is effective in identifying those patients who have stricture and ulceration as a complication beyond the epithelial transformation. However, because of low sensitivity, it is not a satisfactory method for identifying most cases of Barrett's esophagus.