Review
Medicine, General & Internal
Francesco Maione, Alessia Chini, Rosa Maione, Michele Manigrasso, Alessandra Marello, Gianluca Cassese, Nicola Gennarelli, Marco Milone, Giovanni Domenico De Palma
Summary: Barrett's Esophagus is a common condition associated with chronic gastroesophageal reflux disease and has a higher risk of developing esophageal adenocarcinoma. Low and high-grade dysplasia precede neoplastic transformation in this condition. The evaluation of low-grade dysplastic esophageal mucosa is still controversial, but endoscopic surveillance and minimally invasive endoscopic treatments such as endoscopic mucosal resection and radiofrequency ablation are available options. Cryotherapy ablation and argon plasma coagulation are novel endoscopic treatments with high eradication rates and fewer complications and post-procedural pain.
Review
Medicine, General & Internal
Peter M. M. Stawinski, Karolina N. N. Dziadkowiec, Lily A. A. Kuo, Juan Echavarria, Shreyas Saligram
Summary: Barrett's esophagus (BE) is a premalignant mucosal transformation characterized by the replacement of esophageal squamous epithelium with metaplastic columnar epithelium. It is associated with an increased risk of esophageal adenocarcinoma and is often caused by gastroesophageal reflux disease. Screening for BE is selective based on risk factors and is not recommended for the general population. Diagnosis involves endoscopic recognition, targeted biopsies, and histologic confirmation of columnar metaplasia. This review provides a comprehensive overview of the epidemiology, pathogenesis, screening, and advanced techniques for detecting and eradicating Barrett's esophagus.
Article
Gastroenterology & Hepatology
Mate Knabe, Torsten Beyna, Thomas Roesch, Jacques Bergman, Hendrik Manner, Andrea May, Guido Schachschal, Horst Neuhaus, Jennis Kandler, Bas Weusten, Oliver Pech, Siegbert Faiss, Mario Anders, Michael Vieth, Susanne Sehner, Raf Bisschops, Pradeep Bhandari, Christian Ell, Hanno Ehlken
Summary: This study evaluated a potential alternative treatment for neoplastic Barrett's esophagus, called hybrid argon plasma ablation. The results showed that this technique achieved the expected eradication and recurrence rates of Barrett's intestinal metaplasia and neoplasia within 2 years. However, a randomized comparative trial is needed to provide final evidence compared to radiofrequency ablation.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Sanne N. van Munster, Charlotte N. Frederiks, Esther A. Nieuwenhuis, Lorenza Alvarez Herrero, Auke Bogte, Alaa Alkhalaf, Boudewijn E. Schenk, Erik J. Schoon, Wouter L. Curvers, Arjun D. Koch, Steffi E. M. van de Ven, Pieter J. F. de Jonge, Thjon J. Tang, Wouter B. Nagengast, Frans T. M. Peters, Jessie Westerhof, Martin H. M. G. Houben, Jacques J. G. H. M. Bergman, Roos E. Pouw, Bas L. A. M. Weusten
Summary: In patients with Barrett's esophagus undergoing radiofrequency ablation therapy, poor healing and poor squamous regeneration were associated with higher risk of treatment failure and progression to advanced disease. However, additional time and acid suppression can lead to normal squamous regeneration and excellent treatment outcomes in patients with poor healing.
Article
Gastroenterology & Hepatology
Prashanthi N. Thota, Jalil Nasibli, Prabhat Kumar, Madhusudhan R. Sanaka, Amitabh Chak, Xuefeng Zhang, Xiuli Liu, Shikhar Uttam, Yang Liu
Summary: Nanoscale nuclear architecture mapping (nanoNAM) is a method for detecting structural alterations in the chromatin of epithelial cell nuclei. This study demonstrates that nanoNAM can be used to identify patients with Barrett's esophagus (BE) at risk for developing high-grade dysplasia or esophageal adenocarcinoma (EAC), and a prediction model based on nanoNAM features was developed.
GASTROINTESTINAL ENDOSCOPY
(2022)
Article
Gastroenterology & Hepatology
Rajesh Krishnamoorthi, Ian Hargraves, Naveen Gopalakrishnan, Christopher H. Blevins, Harshith Priyan, Michele L. Johnson, Kristyn A. Maixner, Kenneth K. Wang, David A. Katzka, Jayant A. Talwalkar, Annie LeBlanc, Prasad G. Iyer
Summary: The study aimed to develop an encounter decision aid for managing BE-LGD and evaluate its impact on patient-important outcomes. Divided into two phases, the research showed that BE-Choice significantly improved patient knowledge, decisional comfort, and patient involvement compared to usual care. Further multicenter trials are needed to confirm and promote the widespread use of BE-Choice.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Vani Konda, Rhonda F. Souza, Kerry B. Dunbar, Jason C. Mills, Daniel S. Kim, Robert D. Odze, Stuart J. Spechler
Summary: This study aimed to characterize the early endoscopic and histologic features of radiofrequency ablation (RFA) wound healing in patients with Barrett's esophagus (BE). The results showed that squamous re-epithelialization of RFA wounds not only progressed through squamous cells extending from the proximal wound edge, but also through islands of squamous epithelium sprouting throughout the ablated segment. Additionally, subepithelial glandular structures associated with the squamous islands were found to increase post-RFA. Furthermore, subsquamous intestinal metaplasia (SSIM) was detected in biopsies of patients during the healing process. This study provides insights into the mechanisms of esophageal metaplasia and the healing of RFA wounds.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Review
Biochemistry & Molecular Biology
David Kessel
Summary: Photodynamic therapy (PDT) is capable of eradicating neoplastic cells accessible to sufficient light and oxygen. Despite adequate information available for assessing the conditions where PDT might be the therapy of choice, limited access to clinical facilities and barriers to regulatory approval of new agents have restricted its clinical usage.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Oncology
Yizi Wang, Bin Ma, Shize Yang, Wenya Li, Peiwen Li
Summary: Radiofrequency ablation (RFA) reduces the risk of progression from low-grade dysplasia (BE-LGD) to high-grade dysplasia (BE-HGD). RFA treatment is associated with a higher rate of complete eradication of dysplasia and intestinal metaplasia, but also a slightly higher rate of adverse events.
FRONTIERS IN ONCOLOGY
(2022)
Review
Gastroenterology & Hepatology
Muhannad Sarem, Francisco J. Martinez Cerezo, Maria Lujan Salvia Favieres, Rodolfo Corti
Summary: The diagnosis of low-grade dysplasia (LGD) in Barrett's esophagus (BE) poses challenges and can lead to unnecessary follow-up or high-risk disease progression. This article focuses on the re-confirmation of LGD diagnosis, interobserver agreement, persistent confirmed LGD, and the risk of progression to high-grade dysplasia and esophageal adenocarcinoma.
GASTROENTEROLOGIA Y HEPATOLOGIA
(2023)
Article
Gastroenterology & Hepatology
Nicholas J. Shaheen, Gary W. Falk, Prasad G. Iyer, Rhonda F. Souza, Rena H. Yadlapati, Bryan G. Sauer, Sachin Wani
Summary: Barrett's esophagus is a common condition associated with chronic gastroesophageal reflux disease and is a precursor to esophageal adenocarcinoma. The revised guidelines propose recommendations for the definition, diagnosis, screening, surveillance, and treatment of Barrett's esophagus, including important changes such as expanding acceptable screening methods and volume criteria for treatment centers.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Oncology
Yue Chen, Chenyu Sun, Yile Wu, Xin Chen, Sujatha Kailas, Zeid Karadsheh, Guangyuan Li, Zhichun Guo, Hongru Yang, Lei Hu, Qin Zhou
Summary: The use of PPI is negatively associated with the risk of progression to HGD/EAC in BE patients, and the risk of HGD/EAC can be reduced with the prolonged use of PPI. Sensitivity analysis showed the stable results of this meta-analysis, and no publication bias was detected.
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
(2021)
Article
Oncology
Dale J. Waterhouse, Wladyslaw Januszewicz, Sharib Ali, Rebecca C. Fitzgerald, Massimiliano di Pietro, Sarah E. Bohndiek
Summary: The study demonstrates the potential of spectral endoscopy technology to improve detection efficiency of Barrett's esophagus, and the ability to accurately classify disease stages using deep learning, enhancing the contrast of endoscopic examination.
Article
Gastroenterology & Hepatology
Edward H. Tsoi, Puneet Mahindra, Georgina Cameron, Richard Williams, Richard Norris, Paul Desmond, Spiro Raftopoulos, Darren Pavey, Arti Rattan, Luke F. Hourigan, Richard Lee, Michael J. Bourke, Naaz Sidhu, Rajvinder Singh, Andrew Chan, Sudarshan Krishnamurthi, Andrew C. F. Taylor
Summary: This study aimed to determine the proportion of prevalent HGD or EAC detected in Barrett's esophagus (BE) patients referred from the community with a recent diagnosis of low-grade dysplasia (LGD). The results showed that BERU assessment endoscopy identified more visible lesions than community referral endoscopy and identified HGD or EAC in 27% of patients referred from the community with a recent diagnosis of LGD. Reported progression rates from LGD to HGD or EAC may be overestimated.
GASTROINTESTINAL ENDOSCOPY
(2021)
Article
Gastroenterology & Hepatology
Theresa H. Nguyen, Aaron P. Thrift, Rollin George, Daniel G. Rosen, Hashem B. El-Serag, Gyanprakash A. Ketwaroo
Summary: This study aimed to evaluate the proportion of missed dysplasia within 18 months of the initial diagnosis of Barrett's esophagus (BE). The results showed a decrease in the occurrence of missed dysplasia over time. Patients with long segment BE were more likely to have missed dysplasia and could benefit from dysplasia surveillance within 18 months of diagnosis.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Sravanthi Parasa, Michael B. Wallace, Sachin Srinivasan, Suneha Sundaram, Kevin F. Kennedy, Lucas J. Williams, Prateek Sharma
Summary: This study confirms the effectiveness of structured educational intervention in improving the quality of upper endoscopy for Barrett's esophagus and knowledge of standards of care, but it does not significantly impact dysplasia detection rate.
GASTROINTESTINAL ENDOSCOPY
(2022)
Article
Gastroenterology & Hepatology
Alessandro Repici, Marco Spadaccini, Giulio Antonelli, Loredana Correale, Roberta Maselli, Piera Alessia Galtieri, Gaia Pellegatta, Antonio Capogreco, Sebastian Manuel Milluzzo, Gianluca Lollo, Dhanai Di Paolo, Matteo Badalamenti, Elisa Ferrara, Alessandro Fugazza, Silvia Carrara, Andrea Anderloni, Emanuele Rondonotti, Arnaldo Amato, Andrea De Gottardi, Cristiano Spada, Franco Radaelli, Victor Savevski, Michael B. Wallace, Prateek Sharma, Thomas Roesch, Cesare Hassan
Summary: Artificial intelligence assistance during colonoscopy can increase adenoma detection rate (ADR) and related polyp parameters in less experienced examiners compared to the control group. The level of examiner experience does not play a significant role in determining ADR, as shown in this study.
Article
Gastroenterology & Hepatology
Marco Spadaccini, Cesare Hassan, Ludovico Alfarone, Leonardo Da Rio, Roberta Maselli, Silvia Carrara, Piera Alessia Galtieri, Gaia Pellegatta, Alessandro Fugazza, Glenn Koleth, James Emmanuel, Andrea Anderloni, Yuichi Mori, Michael B. Wallace, Prateek Sharma, Alessandro Repici
Summary: The aim of this study was to validate a previously developed classification of false-positive (FP) activations and compare the performances of different brands of approved computer-aided detection (CADe) systems. The results showed that there was no significant difference in the number and causes of false activations between the two different brands of CADe systems. The use of standardized nomenclature provided comparable results.
GASTROINTESTINAL ENDOSCOPY
(2022)
Review
Gastroenterology & Hepatology
Pujan Kandel, Murtaza Hussain, Deepesh Yadav, Santosh K. Dhungana, Bhaumik Brahmbhatt, Massimo Raimondo, Frank J. Lukens, Ghassan Bachuwa, Michael B. Wallace
Summary: The application of snare tip soft coagulation (STSC) at the margins of mucosal defects can significantly reduce adenoma recurrence at the first surveillance colonoscopy and decrease the risk of bleeding complications, according to the findings of a systematic review and meta-analysis.
ENDOSCOPY INTERNATIONAL OPEN
(2022)
Editorial Material
Gastroenterology & Hepatology
Michael B. Wallace, Stephanie Kinnan
Review
Oncology
Raefa Abou Khouzam, Jean-Marie Lehn, Hemma Mayr, Pierre-Alain Clavien, Michael Bradley Wallace, Michel Ducreux, Perparim Limani, Salem Chouaib
Summary: Hypoxia is a crucial characteristic of the tumor microenvironment in pancreatic ductal adenocarcinoma (PDAC) and plays a significant role in its pathogenesis. This review focuses on the impact of hypoxia on genomic instability and the tumor immune microenvironment in PDAC. Strategies for alleviating hypoxia and their potential applications for diagnosis and therapy in PDAC patients will also be discussed.
Article
Radiology, Nuclear Medicine & Medical Imaging
Sanne A. Hoogenboom, Megan M. L. Engels, Anthony Chuprin, Jeanin E. van Hooft, Jordan D. LeGout, Michael B. Wallace, Candice W. Bolan
Summary: This study aims to characterize the prevalence of missed pancreatic masses and PDAC-related findings on CT and MRI scans among pre-diagnostic patients and healthy individuals. The results show that radiological features such as pancreatic duct dilation and interruption, and focal atrophy are common first signs of PDAC and are often missed or unrecognized. Therefore, further investigation with dedicated pancreas imaging is recommended for patients with PDAC-related radiological findings.
ABDOMINAL RADIOLOGY
(2022)
Review
Gastroenterology & Hepatology
Babu P. Mohan, Antonio Facciorusso, Shahab R. Khan, Deepak Madhu, Lena L. Kassab, Suresh Ponnada, Saurabh Chandan, Stefano F. Crino, Gursimran S. Kochhar, Douglas G. Adler, Michael B. Wallace
Summary: Based on rigorous systematic review and meta-analysis, this study found that artificial intelligence performs well in the analysis of EUS-images of pancreatic lesions, with good accuracy, sensitivity, and specificity.
ENDOSCOPIC ULTRASOUND
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Marco Spadaccini, Ludovico Alfarone, Leonardo Da Rio, Roberta Maselli, Silvia Carrara, Piera Alessia Galtieri, Gaia Pellegatta, Alessandro Fugazza, Glenn Koleth, James Emmanuel, Andrea A. Anderloni, Yuichi Mori, Michael B. Wallace, Prateek Sharma, Alessandro Repici, Cesare Hassan
GASTROINTESTINAL ENDOSCOPY
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Michael B. Wallace, Prateek Sharma, Pradeep Bhandari, James E. East, Giulio Antonelli, Roberto Lorenzetti, Michael Vieth, Ilaria Speranza, Marco Spadaccini, Madhav Desai, Frank Lukens, Genci Babameto, Daisy D. Batista, William C. Palmer, Tisha Lunsford, Kevin C. Ruff, Elizabeth L. Bird-Liebermann, Victor Ciofoaia, Sophie Arndtz, David Cangemi, Kristy Puddick, Gregory Derfus, Amitpal S. Johal, Mohammed Barawi, Luigi Longo, Alessandro Repici, Cesare Hassan
GASTROINTESTINAL ENDOSCOPY
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Marc Monachese, Jennifer M. Kolb, Kenneth J. Chang, Alyssa Choi, Sagar Shah, Thomas J. Wang, Ahmad Bazarbashi, Ali Zakaria, Pushpak Taunk, Ali M. Abbas, Pedro Cortes, Michael B. Wallace, Bhaumik Brahmbhatt, Natalie D. Cosgrove, Wenjing Cai, David P. Lee, Prashant Kedia, Marvin Ryou, Jason B. Samarasena
GASTROINTESTINAL ENDOSCOPY
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Pujan Kandel, Nischit Baral, Murtaza Hussain, Trisandhya Sharma, Bhaumik Brahmbhatt, Ghassan Bachuwa, Michael B. Wallace
GASTROINTESTINAL ENDOSCOPY
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Maryam Alahmad, Noora Alhosani, Khaled Alnuaimi, Colleen T. Ball, Julia E. Crook, Talha A. Malik, Michael B. Wallace
GASTROINTESTINAL ENDOSCOPY
(2022)
Meeting Abstract
Gastroenterology & Hepatology
M. Spadaccini, C. Hassan, L. Alfarone, L. Da Rio, R. Maselli, S. Carrara, P. A. Galtieri, G. Pellegatta, A. Fugazza, G. Koleth, J. Emmanuel, A. Anderloni, Y. Mori, M. B. Wallace, P. Sharma, A. Repici
DIGESTIVE AND LIVER DISEASE
(2022)
Article
Gastroenterology & Hepatology
Muhammad Aziz, Chandra S. Dasari, Tarun Rai, Benjamin Alsop, Neil Gupta, Prashanth Vennalaganti, Viveksandeep Thoguluva Chandrasekar, Kelsey Able, Kevin Kennedy, Michael B. Wallace, Kenneth K. Wang, Herbert C. Wolfsen, Prateek Sharma, Cadman L. Leggett
Summary: This study aimed to investigate the feasibility of incorporating volumetric laser endomicroscopy (VLE) training into a gastroenterology (GI) fellowship curriculum. The results showed that a brief training session was insufficient for GI trainees to accurately interpret VLE images, and additional experience is required.
TRANSLATIONAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)