Endoscopic techniques for recognizing neoplasia in Barrett's esophagus: which should the clinician use?

Abstract

Purpose of review: The key to prevention and cure of esophageal adenocarcinoma is the detection and eradication of neoplasia in patients with Barrett's esophagus. Multiple tools and technologies are emerging for this purpose.

Recent findings: A detailed white light examination with high-resolution endoscopy and recognition of lesions is paramount. A variety of imaging modalities are being studied for the detection of neoplasia in Barrett's esophagus. Chromoendoscopy, narrow band imaging, and autofluorescence provide a way to target suspicious areas. Confocal endomicroscopy and optical coherence tomography are means to pinpoint imaging to obtain information about the tissue microarchitecture.

Summary: The key to detection of neoplasia is a careful white light examination with high-resolution endoscopy and recognition of lesion characteristics. Additional imaging modalities may enhance targeting of lesions or provide more information at a focused level. Many of these modalities have yet to be validated in prospective randomized, multicenter trials.