Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Advanced endoscopic imaging for detection of Barrett's esophagus

  • Netanel Zilberstein (Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center) ;
  • Michelle Godbee (Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center) ;
  • Neal A. Mehta (Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center) ;
  • Irving Waxman (Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center)
  • Received : 2023.01.22
  • Accepted : 2023.08.29
  • Published : 2024.01.30
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Abstract

Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

Keywords

Acknowledgement

Thank you to Dr. Douglas K. Pleskow from Beth Israel Deaconess Medical Center for providing the endomicroscopy images.

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