Navigation Links
New form of endoscopic scanning improves detection of precancerous condition
Date:4/12/2010

BOSTON Cancer of the lower esophagus develops almost exclusively in patients with Barrett's esophagus, an otherwise benign complication of esophageal reflux that affects approximately 3 million Americans. Although the prognosis of patients diagnosed with esophageal cancer is poor, the chances of successful treatment increase significantly if the disease is detected at an early dysplastic stage.

Now, a new endoscopic scanning technique developed by scientists in the Biomedical Imaging and Spectroscopy Laboratory (BISL) at Beth Israel Deaconess Medical Center (BIDMC) has proven successful in the early detection of dysplasia in Barrett's esophagus. The results of the study, which appear in the April 11 on-line issue of the journal Nature Medicine, could help clinicians to diagnose esophageal cancer at an earlier stage, when the condition is still treatable.

"We have established that this multispectral scanning technique, which we have named endoscopic polarized scanning spectroscopy [EPSS] offers great promise for the early detection of dysplasia in patients with Barrett's esophagus," explains inventor and senior author Lev Perelman, PhD, Director of the BISL at BIDMC and Associate Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School. "When used to guide the endoscopist, EPSS appears to not only help to avoid unnecessary biopsies, but also to help the endoscopist to locate suspicious dysplastic areas that might otherwise be missed."

The esophagus is the muscular tube that connects the throat to the stomach, allowing food to enter the stomach for digestion. Although cancer of the esophagus remains relatively rare, it is currently the fastest increasing cancer in the U.S., possibly due to an increased incidence of obesity. Furthermore, the symptoms of esophageal cancer including difficulty swallowing, chest pain, or choking generally do not appear until advanced stages of the disease.

"Barrett's esophagus often develops in individuals who suffer from heartburn and gastrointestinal reflux disease [GERD] which occurs when stomach acid flows backward into the esophagus," explains Ram Chuttani, MD, Director of Interventional Gastroenterology and Endoscopy at BIDMC and a coauthor of the study. "Over time, repeated exposure to stomach contents can result in further progression of the precancerous nature of Barrett's. Known as dysplasia, these precancerous changes occur on a cellular scale, and can currently only be diagnosed by staining numerous cell samples taken from multiple biopsies of different parts of the esophagus," he adds, noting that in spite of multiple biopsies, dysplasia and even cancer may be missed due to inherent sampling errors that can occur when tiny samples are obtained from large surface areas.

The new EPSS instrument, developed by Perelman, enables the endoscopist to more thoroughly search for these dysplastic changes on a subcellular scale. EPSS works by using light-scattering spectroscopy, an optical method that relates color of reflected light to the size, shape and refractive index of the illuminated particle.

"The idea behind light scattering spectroscopy is rooted in the same principles as the formation of a rainbow," explains Perelman. "In a rainbow, white light from the sun is refracted and reflected by tiny water droplets in the atmosphere, which form a colorful spectrum which you see with your eyes. Light scattering spectroscopy employs a bright arc lamp in place of the sun, targets epithelial cells and cell nuclei instead of water droplets, and is viewed through a spectrometer rather than just the human eye. In the case of EPSS, instead of viewing a beautiful arc, the information obtained from these spectra tells us whether or not the esophageal cells we are viewing are dysplastic.

A clinically useful technique in the detection of dysplasia in Barrett's esophagus must rapidly survey a comparatively large area while simultaneously detecting changes on a cellular scale, explains Perelman, and by combining polarized light scattering spectroscopy with an endoscopically compatible scanning approach, he and his scientific team were able to achieve both goals.

In its first pilot clinical test, conducted at the BIDMC Interventional Endoscopy Center, the EPSS instrument successfully guided the endoscopist in performing biopsies of the esophagus, detecting and mapping sites of numerous invisible dysplasia which would have been missed by the currently used biopsy standards.

"The detection of the signal related to precancerous epithelial cellular changes is made possible through the use of polarized light," explains Perelman. "Since light reflected from sub-epithelial tissue will become 'depolarized,' while light that is backscattered from epithelial cells will preserve its polarization, the technique of polarization subtraction or polarized light scattering spectroscopy retains and conveys only the diagnostically important information."


'/>"/>

Contact: Bonnie Prescott
bprescot@bidmc.harvard.edu
617-667-7306
Beth Israel Deaconess Medical Center
Source:Eurekalert

Related medicine news :

1. Why does percutaneous endoscopic gastrostomy fail to eliminate gastroesophageal reflux?
2. ASGE issues guidelines on management of antithrombotic agents for endoscopic procedures
3. Chronic sinusitis patients experience improved quality of life after endoscopic sinus surgery
4. New endoscopic treatment may spare Barretts esophagus patients from surgery
5. Endoscopic resection of a large ileal lipoma
6. A new endoscopic technique for gastrointestinal perforations: the over-the-scope-clip
7. New e-Forms Management Tools from Access Bridge the Gap Between MEDITECH Magic and Scanning and Archiving for Hospitals
8. SecureWorks Extends PCI Approved Scanning Vendor Solutions
9. Scanning for skin cancer: Infrared system looks for deadly melanoma
10. News brief: Contrast agent with MRI improves detection of lymph nodes metastases
11. Nuclear Power Plant Improves Site Security with Blast Resistant Guard Booth
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... Florida (PRWEB) , ... February 05, 2016 , ... Steven ... event he has completed every year since it started in 2003. This year, he ... the attention of fellow runners and NBA team the Miami Heat. , This Sunday, ...
(Date:2/5/2016)... ... February 05, 2016 , ... ... company's lighter, sleeker next generation LYNX VR Indoor Trainer with multi-rider capability to ... design and manufacturing not only reduce the weight of the unit, they also ...
(Date:2/5/2016)... ... 2016 , ... Successful recruitment and retention efforts, new collaborations ... have all marked the last 12 months at Roswell Park Cancer Institute (RPCI). ... oldest cancer center, Candace S. Johnson, PhD, outlined the many accomplishments of her ...
(Date:2/5/2016)... ... February 05, 2016 , ... The Muscular ... Louisiana Kitchen restaurants, launched the 14th annual “Appetite for a Cure” campaign on ... muscular dystrophy, ALS and related diseases that severely limit strength and mobility. ...
(Date:2/5/2016)... York, New York (PRWEB) , ... February 05, 2016 , ... ... life? The answer may be at the tips of your toes. Foot massage, whether ... as well as pure comfort and relaxation. The American Board of Multiple Specialties ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... 2016 Amgen (NASDAQ: AMGN ) will present ... Conference at 9:15 a.m. ET on Wednesday, Feb. 10, 2016, ... W. Meline , executive vice president and chief financial officer ... the presentation can be accessed from the Events Calendar on ... the webcast will also be available on Amgen,s website for ...
(Date:2/5/2016)... Feb. 5, 2016  ivWatch, a medical devices company, is ... Award granted by Governor Terry McAuliffe,s office. ivWatch ... February 25th at an event to be held at the ... award honors professionals and business that have made significant contributions ... Logo - http://photos.prnewswire.com/prnh/20160205/330117LOGO ...
(Date:2/5/2016)... MILTON, Ontario , Feb. 5, 2016  Aralez ... business combination of POZEN Inc. ("POZEN") and Tribute Pharmaceuticals Canada ... of POZEN and shareholders of Tribute. The combined company ... specialty pharmaceutical company with operations in Canada ... the United States . Under the terms ...
Breaking Medicine Technology: