Optical detection and eradication of dysplastic Barrett's esophagus

Louis Michel Wong Kee Song, Kenneth Ke Ning Wang

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Dysplastic Barrett's esophagus is a condition that offers multiple diagnostic and therapeutic challenges. The diagnosis of dysplasia within Barrett's esophagus currently relies on periodic endoscopic surveillance with multiple biopsies, a methodology limited by random sampling error, inconsistent histopathologic interpretation and delay in diagnosis. Optical spectroscopic and imaging techniques have the potential to identify dysplastic or early neoplastic lesions in real-time. These diagnostic modalities are needed to enhance the endoscopic surveillance of Barrett's esophagus in the future as well as help to define lesions for endoscopic therapy. Esophagectomy has been the standard of care for Barrett's esophagus with high-grade dysplasia although it is a procedure associated with significant morbidity and mortality. Minimally invasive endoscopic ablative therapies are attractive and less morbid alternatives to esophagectomy, with promising results obtained from the use of light-activated drugs (i.e., photodynamic therapy). The combination of novel optical diagnostic techniques and therapies will provide the endoscopist with much needed tools that can considerably enhance the management of patients with Barrett's esophagus. This article reviews the current status and future prospects of optical-based modalities for diagnosis and therapy of dysplastic Barrett's esophagus.

Original languageEnglish (US)
Pages (from-to)289-302
Number of pages14
JournalTechnology in Cancer Research and Treatment
Volume2
Issue number4
StatePublished - Aug 2003

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Keywords

  • Barrett's esophagus
  • Dysplasia
  • Fluorescence
  • Light scattering
  • Optical coherence tomography
  • Optical imaging
  • Optical spectroscopy
  • Photodynamic therapy
  • Raman
  • Reflectance

ASJC Scopus subject areas

  • Cancer Research
  • Radiology Nuclear Medicine and imaging

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