Imaging and Advanced TechnologyEndoscopic Tri-Modal Imaging Is More Effective Than Standard Endoscopy in Identifying Early-Stage Neoplasia in Barrett's Esophagus
Section snippets
Setting
This multicenter randomized cross-over study was performed in 5 centers with a tertiary referral function for the detection and treatment of patients with early BE neoplasia: Academic Medical Center, Amsterdam, Netherlands; St Antonius Hospital, Nieuwegein, Netherlands; Mayo Clinic, Jacksonville, Florida; Mayo Clinic, Rochester, Minnesota; and Queens Medical Center, Nottingham, United Kingdom. The study was approved by the institutional review boards of all participating centers
Patients
Between January 2007 and September 2009, 111 eligible patients (age mean ± SD age, 68.0 ± 9.0 yeas; 92 males [83%]; median circumferential Barrett's extent, 4.0 cm [IQR. 2.0–8.0]; median maximal Barrett's extent, 7.0 cm [IQR, 4.0–9.0]) were included in the participating centers. Twenty-four patients were excluded after the first procedure (Supplementary Figure 1): 17 patients exhibited a type 0–I or type 0–III lesion that did not allow a delay in intervention, 4 patients had Barrett's length
Discussion
This is the first randomized cross-over study to compare ETMI with SVE in patients referred for endoscopic evaluation of early BE neoplasia. The randomized cross-over design ensured that each patient acted as his or her own control, allowing pairwise comparison of the 2 techniques investigated. Although expensive and labor intensive, this is considered the optimal method for endoscopic imaging studies. The study was performed in 5 centers with a tertiary referral function for early Barrett's
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Conflicts of interest The authors disclose the following: Louis-Michel Wong Kee Song has received research support from Olympus and Fujinon. Krish Ragunath has received research support, educational grants, and speaker honorarium from Olympus-Keymed, United Kingdom. Ganapathy Prasad has received funding from Takeda Pharmaceuticals, NIH/NCI, and the American College of Gastroenterology. Wouter Curvers, Lorenza Alvarez Herrero, Michael B. Wallace, Herbert Wolfsen, Kenneth Wang, Venkataraman Subramanian, Bas Weusten, Fiebo ten Kate, and Jacques Bergman have no conflict of interest to disclose.
Funding This study was supported by an unrestricted research grant from Olympus Inc, Tokyo, Japan.
The work of Wouter Curvers and Lorenza Alvarez Herrero is supported by an unrestricted research grant from Astra-Zeneca Netherlands.
This trial was registered at www.trialregister.nl as ISRCTN 68328077; NTR945.