Related Experiment Video For Adenocarcinoma of esophagus
Updated: Jul 16, 2026
Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
Diagnostic Accuracy of Optical Endoscopic Evaluation and EUS for Differentiating T1a and T1b Barrett's
Rinrada Worapongpaiboon1, Suchapa Arayakarnkul2, Kasenee Tiankanon1,3
1Division of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, MD, USA.
Background And Aims:
Accurate differentiation between T1a and T1b Barrett's adenocarcinoma (BAC) is essential for selecting endoscopic resection (ER) versus surgery. The diagnostic reliability of optical endoscopic evaluation (OEE) and endoscopic ultrasound (EUS) remains inconsistent. We performed a systematic review and meta-analysis to assess their diagnostic performance.
Methods:
PubMed, Embase, Scopus, and Cochrane were searched through December 2025. Studies evaluating OEE or EUS for differentiating T1a from T1b BAC were included. Pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated using random-effects models. Heterogeneity was assessed with I2. Hierarchical summary receiver operating characteristic (HSROC) analysis compared modalities. Secondary analyses evaluated Paris morphology and Barrett's segment length (BSL) using diagnostic odds ratios (DORs).
Results:
Nineteen studies (2,292 patients) were included. OEE showed pooled sensitivity of 55.3% and specificity of 75.1%, with accuracy of 63.1%. EUS demonstrated sensitivity of 66.1%, specificity of 89.3%, and accuracy of 82.8%. HSROC analysis showed no significant difference between modalities (AUC 0.69 vs 0.87; P = 1). Paris 0-I, 0-IIa, lesions with 0-IIc components, and BSL ≥ 3 cm were not associated with T1b invasion. Paris 0-IIb lesions were significantly less likely to harbor T1b disease (DOR 0.17, 95% CI 0.07-0.38).
Conclusions:
Both OEE and EUS demonstrate modest accuracy for differentiating T1a from T1b BAC. Endoscopic morphology is not a reliable predictor of submucosal invasion, except for flat lesions being less likely T1b. ER remains essential for definitive staging.
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