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

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

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