Light-induced fluorescence endoscopy may improve the detection of high-grade dysplasia and early stage cancer in Barrett's esophagus.
Dr Bergman and colleagues from the Netherlands compared light-induced fluorescence endoscopy with standard endoscopy in a randomized crossover study.
The researchers randomized 50 patients with Barrett’s esophagus to undergo standard endoscopy and light-induced fluorescence endoscopy with 4 to 6-week intervals between procedures.
The 2 procedures were performed by 2 different endoscopists who were blinded to the findings of the other examination.
| Overall sensitivity of all biopsy specimens was 85% for standard endoscopy|
The investigators took targeted biopsy specimens from detected lesions, followed by random biopsy specimens with a 2-cm interval, 4-quadrant protocol.
Biopsy specimens were routinely evaluated and subsequently reviewed by a single, blinded expert GI Pathologist.
The researchers reported that targeted biopsy specimens had a sensitivity for the diagnosis of high-grade dysplasia/early stage cancer of 62% for both techniques.
The overall sensitivity of all biopsy specimens was 85% for standard endoscopy and 69% for light-induced fluorescence endoscopy.
All targeted biopsy specimens had a positive predictive value for high-grade dysplasia/early stage cancer of 41% for standard endoscopy and 28% for light-induced fluorescence endoscopy.
The research team reported that autofluorescence-targeted biopsy specimens had a positive predictive value of 13%.
False-positive lesions had a significantly higher rate of acute inflammation than random biopsy specimens.
Dr Bergman concludes, “In this study, light-induced fluorescence endoscopy did not improve the detection of high-grade dysplasia or early stage cancer in patients with Barrett’s esophagus compared with standard endoscopy.”