Volumetric Laser Endomicroscopy Used In Combination With Other Advanced Modalities Can Increase Dysplasia Detection During Surveillance Of Non-Treated Barrett'S Esophagus

Endoscopic surveillance of Barrett’s esophagus (BE) is performed to identify progression of disease which requires a change in a patient’s management strategy. Prior studies have shown the value of advanced imaging techniques such as narrow band imaging (NBI) and confocal laser endomicroscopy (CLE) in augmenting the diagnostic yield for focal dysplasia and neoplasia within a BE segment. Enhanced detection systems such as wide area transepithelial brush sampling with 3 dimensional computer-assisted analysis (WATS3D) also have been described. Volumetric laser endomicroscopy (VLE) is a second-generation optical coherence tomography system capable of rapidly imaging the esophageal wall to a depth of 3 mm at a resolution of 7 microns. Recent data highlights a similar capability of VLE to increase detection of advanced disease. Our aim was to evaluate the benefit of using multi-modal advanced imaging and tissue sampling techniques, including VLE, when assessing known BE segments for progression of disease.