Barrett's Esophagus is the only known precursor of Esophageal Adenocarcinoma.1
Barrett’s Esophagus (BE) is the only known precursor of Esophageal Adenocarcinoma (EAC)1, which is currently the fastest growing cancer2 where 4 out of 5 patients die within 5 years of their diagnosis.3 The unfortunate statistics are the result of only 1 in 4 cases of EAC being diagnosed within 1 year of normal index endoscopy in patients with BE.4
Cellvizio® Clinical Value
Compared to the standard 4-quadrant biopsy (Seattle) protocol, using Cellvizio® doubles the detection rate of Barrett's Esophagus.5
This allows physicians to better target biopsies within focused areas of concern, augmenting conventional technologies and techniques and improving the ability to detect and monitor cellular changes which cannot be observed with HD-WLE or Narrow Band Imaging (NBI).6,7
For surgeons, this technology has the potential to reduce inappropriate endoluminal therapy for non-neoplastic conditions, thus improving overall procedure-related complications, optimizing surveillance intervals, and limiting histological analysis of insignificant lesions.11
This helps improve diagnostic yield and increase the detection of dysplastic lesions from 34% to 68%.6
Cellvizio is part of routine clinical practice
See how Dr. Joseph Burnette, a general surgeon with special interest in reflux uses Cellvizio on all his chronic reflux patients.
"Cellvizio® adds 3-5 minutes, while more than doubling detection of Barrett's Esophagus vs. conventional biopsies."
Dr. A. McNair Jr., New Gulf Coast Surgery Center
using Cellvizio® GastroFlex UHD Miniprobe
Criteria: squamous epithelium with flat and scale-like cells, intrapapillary loops
Criteria: regular columnar-lined epithelium, dark mucin in goblet cells easily identified, equidistant and regular cells, glands equal in size and shape
Criteria: epithelial surface appearing saw-toothed, non equidistant glands, glands unequal in size and shape, pleomorphic and enlarged cells
Cellvizio® leads to better informed patient management by providing additional advanced imaging, enabling real-time tissue assessment and early detection.
Physicians are able to rule-in or rule-out intestinal metaplasia when there are Gastroesophageal Reflux Disease (GERD) symptoms8, allowing early detection of BE5 and then, they can monitor disease progression for BE.6,7
Physicians also are able to define the location and lateral extent of neoplasia inducing clinical intervention9, as well as differentiate lesions that are not amenable to EMR and determine the margins of a lesion before endoscopic resection11. Therefore, pCLE can lead to positive redirection of therapy.10
1. Bhardwaj A. et al. Barrett’s Esophagus: Emerging Knowledge and Management Strategies. Pathology Research International, 2012.
2. Chai J. et al. Esophageal malignancy: A growing concern, World Journal of Gastroenterology, 2012.
3. Desai M. et al. Prevalence of HGD and adenocarcinoma on index endoscopy in BE, Gastrointest Endosc, 2018.
4. Visrodia K. et al. Magnitude of Missed Esophageal Adenocarcinoma After Barrett’s Esophagus Diagnosis: A Systematic Review and Meta-analysis. Gastroenterology, 2016.
5. Richardson C. et al. Real-time diagnosis of Barrett’s Esophagus: a prospective, multicenter study comparing confocal laser endomicroscopy with conventional histology for the identification of intestinal metaplasia in new users, Surgical Endoscopy, 2018.
6. Sharma P. et al. Real-time increased detection of Neoplastic tissue in Barrett’s Esophagus with pCLE; Final results of a multi-center prospective international randomized controlled trial, Gastrointest Endosc, 2011.
7. Canto M. et al. In vivo endomicroscopy improves detection of Barrett’s Esophagus related neoplasia: a multicenter international randomized controlled trial, GIE, 2013.
8. Kiesslich R. et al. In vivo histology of Barrett’s Esophagus and Associated Neoplasia by CLE, Clinical Gastro and Hepatology, 2006.
9. Wang K. et al. Use of probe-based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence. UEGW Journal, 2015.
10. Caillol et al. Probe confocal laser endomicroscopy in the therapeutic endoscopic management of Barrett’s dysplasia. Annals of Gastroenterology, 2017.
11. Al-Mansour. et al. SAGES TAVAC safety and efficacy analysis confocal laser endomicroscopy. Surg Endosc, 2020.