Medical device company NinePoint Medical (Bedford, MA), which specializes in optical coherence tomography (OCT) for gastrointestinal applications, presented new clinical data at the World Congress of Gastroenterology at the American College of Gastroenterology Annual Scientific Meeting (ACG 2017) in Orlando, FL. This data highlights clinical results achieved using the company's NvisionVLE imaging system with Real-time Targeting, which enables volumetric laser endomicroscopy (VLE) scanning of the esophagus and subsequent laser marking of concerning regions for pathological examination.
From 2011-2017, Arvind Trindade, MD, director of endoscopy at the Long Island Jewish Medical Center (Queens, NY), and colleagues from the Northwell Health System (Great Neck, NY) studied 369 consecutive patients that received endoscopic surveillance for Barrett's esophagus. These patients fell into three categories: one group that received Seattle protocol random biopsies, one that received VLE scanning without laser marking, and one that received VLE with laser marking. Patients with raised lesions on high-definition white light endoscopy and lesions seen on electronic chromoendoscopy were excluded from analysis. The surveillance strategy was dictated by available technology at the time. The esophageal dysplasia (pre-cancer) detection rates for the three groups, respectively, were 19.6%, 24.8%, and 33.7%. The differences were statistically significant. Both VLE with laser marking and VLE without laser marking had statistically significant differences in neoplasia (high-grade dysplasia and intramucosal cancer) detection compared to the Seattle protocol groups (14% vs. 1% and 11% vs. 1%).
"When compared to a standard random biopsy protocol, VLE with laser marking yielded a statistically significant increase in the detection of dysplasia," Trindade states. "In addition, VLE with laser marking may enable more accurate targeting for biopsies and endoscopic resection, which should allow pathologists to detect more dysplasia. These promising results support the use of VLE with laser marking for the surveillance of Barrett's esophagus in academic centers, and should be further studied prospectively for validation, as well as in the community hospital setting."
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