1. Articles from Arvind J. Trindade

    1-7 of 7
    1. Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol

      Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol

      Background and Aims Volumetric laser endomicroscopy (VLE) is a new wide-field advanced imaging technology for Barrett’s esophagus (BE). No data exist on incremental yield of dysplasia detection. Our aim is to report the incremental yield of dysplasia detection in BE using VLE. Methods This is a retrospective study from a prospectively maintained database from 2011 to 2017 comparing the dysplasia yield of 4 different surveillance strategies in an academic BE tertiary care referral center. The groups were (1) random biopsies (RB), (2) Seattle protocol random biopsies (SP), (3) VLE without laser marking (VLE), and (4) VLE with laser marking ...

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    2. Optical coherence tomography in gastroenterology: a review and future outlook

      Optical coherence tomography in gastroenterology: a review and future outlook

      Optical coherence tomography (OCT) is an imaging technique optically analogous to ultrasound that can generate depth-resolved images with micrometer-scale resolution. Advances in fiber optics and miniaturized actuation technologies allow OCT imaging of the human body and further expand OCT utilization in applications including but not limited to cardiology and gastroenterology. This review article provides an overview of current OCT development and its clinical utility in the gastrointestinal tract, including disease detection/differentiation and endoscopic therapy guidance, as well as a discussion of its future applications.

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    3. Volumetric laser endomicroscopy in the management of Barrett's esophagus

      Volumetric laser endomicroscopy in the management of Barrett's esophagus

      Purpose of review: The incidence of esophageal adenocarcinoma is on the rise despite widespread appreciation that the precursor lesion is Barrett's esophagus. Studies have shown that some patients known to have Barrett's esophagus develop cancer despite their enrollment in conventional endoscopic surveillance programs. This highlights the need for advanced endoscopic imaging to help identify early neoplasia and prevent its progression to esophageal cancer. Recently, a wide-field, second-generation optical coherence tomography endoscopic platform called volumetric laser endomicroscopy (VLE) was cleared by the Food and Drug Administration and made commercially available for advanced imaging in Barrett's esophagus. Recent findings ...

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    4. Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users

      Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users

      Abstract Background and Aims Targeting neoplasia in Barrett’s esophagus (BE) is challenging. Volumetric laser endomicroscopy (VLE) is a new imaging technique that allows for real time cross-sectional microstructure imaging that can detect BE neoplasia. The interobserver agreement among users in practice is unknown. Methods Eight high-volume users of VLE from different academic centers in the United States evaluated 120-stored VLE images blinded to the endoscopic and clinical findings. There were 30 images for each tissue type: gastric cardia, esophageal squamous mucosa, non-neoplastic BE, and neoplastic BE. Each image with BE had corresponding histology confirming the tissue diagnosis. Each normal ...

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    5. The new kid on the block for advanced imaging in Barrett’s esophagus: a review of volumetric laser endomicroscopy

      The new kid on the block for advanced imaging in Barrett’s esophagus: a review of volumetric laser endomicroscopy

      Advanced imaging techniques used in the management of Barrett’s esophagus include electronic imaging enhancement (e.g. narrow band imaging, flexible spectral imaging color enhancement, and i-Scan), chromoendoscopy, and confocal laser endomicroscopy. Electronic imaging enhancement is used frequently in daily practice, but use of the other advanced technologies is not routine. High-definition white light endoscopy and random four quadrant biopsy remain the standard of care for evaluation of Barrett’s esophagus; this is largely due to the value of advanced imaging technologies not having been validated in large studies or in everyday practice. A new advanced imaging technology called volumetric ...

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    6. Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus

      Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus

      Methods and study aims: The incidence of esophageal cancer is rising despite increased surveillance efforts. Volumetric laser endomicroscopy (VLE) is a new endoscopic imaging tool that can allow for targeted biopsy of neoplasia in Barrett’s esophagus. We report a series of 6 patients with long-segment Barrett’s esophagus ( > 3 cm), who underwent a session of endoscopy with volumetric laser endomicroscopy, after a separate prior session of standard high-definition endoscopy with narrow band imaging (NBI) and random biopsies that did not reveal neoplasia. In all six patients, the first endoscopy was the index endoscopy diagnosing the Barrett’s esophagus. All ...

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    7. Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus

      Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus

      A 64-year-old man underwent esophagoscopy 15 months earlier, which diagnosed long-segment Barrett’s esophagus. Examination of random biopsy specimens yielded a diagnosis of intestinal metaplasia, with 1 biopsy specimen as indefinite for dysplasia. Two subsequent esophagoscopies were performed 6 months apart, and random biopsy specimens were negative for dysplasia. The patient was referred for volumetric laser endomicroscopy (VLE) (NVisionVLE, NinePoint Medical, Cambridge, Mass). At esophagoscopy, high-definition white-light endoscopy showed a 7-cm segment of flat salmon-colored mucosa (Prague class C6M7) ( A ).

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    1-7 of 7
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