High-resolution endoscopy may improve the detection of early neoplasia in Barrett's esophagus.
Indigo carmine chromoendoscopy and narrow-band imaging may be useful techniques to complement high-resolution endoscopy.
Dr Kara and colleagues from the Netherlands assessed high-resolution endoscopy combined with indigo carmine chromoendoscopy or narrow-band imaging.
The researchers compared the 2 techniques for the detection of high-grade dysplasia or early cancer in patients with Barrett's esophagus.
In a randomized sequence separated by 6 to 8 weeks, 28 patients underwent the 2 therapies.
The 2 procedures were performed by two different endoscopists, who were blinded to the findings of the other examination.
The researchers took targeted biopsies from all detected lesions, followed by 4-quadrant biopsies at 2-cm intervals.
|Sensitivity for early cancer was 93 % for high-resolution endoscopy-indigo carmine chromoendoscopy|
Biopsy evaluation was supervised by a single expert pathologist, who was blinded to the imaging technique used.
The research team reported that 14 patients were diagnosed with high grade dysplasia or early cancer.
The researchers found that the sensitivity for high grade dysplasia or early cancer was 93 % for high-resolution endoscopy-indigo carmine chromoendoscopy.
Sensitivity for high grade dysplasia or early cancer was 86 % with high-resolution endoscopy-narrow-band imaging.
The team observed that targeted biopsies had a sensitivity of 79 % with high-resolution endoscopy alone.
The research team noted that high grade dysplasia was diagnosed from random biopsies alone in only 1 patient.
Indigo carmine chromoendoscopy and narrow-band imaging detected a limited number of additional lesions occult to high-resolution endoscopy.
However, the team noted that these lesions did not alter the sensitivity for identifying patients with high grade dysplasia or early cancer.
Dr Kara's team concluded, “In most patients with high-grade dysplasia or early cancer in Barrett's esophagus, subtle lesions can be identified with high-resolution endoscopy.”
“Indigo carmine chromoendoscopy and narrow-band imaging are comparable as adjuncts to high-resolution endoscopy.”