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Updated: Jul 19, 2025
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Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
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Endoscopic features of low-grade dysplastic Barrett's.
Tony He1,2, Kiran Gopinath Iyer1, Mark Lai1
1Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia.
Endoscopy International Open
|August 11, 2023
Summary
Barrett's esophagus with low-grade dysplasia (BE-LGD) is often invisible, but this study found over 50% were visible, especially at specialized centers. Improving community endoscopy surveillance is key for early detection of BE-LGD.
Area of Science:
- Gastroenterology
- Endoscopy
- Oncology
Background:
- Barrett's esophagus with low-grade dysplasia (BE-LGD) is often considered endoscopically invisible.
- The endoscopic features of BE-LGD are not well-described, leading to challenges in detection.
Purpose of the Study:
- To determine the frequency of visible BE-LGD.
- To compare BE-LGD detection rates between community settings and a Barrett's referral unit (BRU).
- To characterize the endoscopic features of BE-LGD.
Main Methods:
- Retrospective analysis of 497 patients with dysplastic BE referred to a BRU (2008-2022).
- Review of endoscopy reports, images, and histology to identify visible BE-LGD and its features.
- Definition of BE-LGD confirmed by expert gastrointestinal pathologists.
Main Results:
- 135 patients (27.2%) had confirmed BE-LGD; only 11.1% were visible in the community.
- BRU assessment identified visible LGD in 50.4% of cases.
- Visible LGD predominantly comprised flat lesions (64.7%) with abnormal mucosal/vascular patterns; detection rates increased over time.
Conclusions:
- Over 50% of BE-LGD is endoscopically visible, with higher detection rates at BRUs compared to the community.
- Endoscopic recognition of BE-LGD has improved over time.
- While BRU assessment is crucial, enhancing community endoscopy surveillance quality is vital for effective BE-LGD management.
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