Abstract
Background and study aims Endoscopic surveillance for Barrett’s esophagus (BE) is limited by long procedure
times and sampling error. Near-infrared (NIR) fluorescence imaging minimizes tissue
autofluorescence and optical scattering. We assessed the feasibility of a topically
applied NIR dye-labeled lectin for the detection of early neoplasia in BE in an ex
vivo setting.
Methods Consecutive patients undergoing endoscopic mucosal resection (EMR) for BE-related
early neoplasia were recruited. Freshly collected EMR specimens were sprayed at the
bedside with fluorescent lectin and then imaged. Punch biopsies were collected from
each EMR under NIR light guidance. We compared the fluorescence intensity from dysplastic
and nondysplastic areas within EMRs and from punch biopsies with different histological
grades.
Results 29 EMR specimens were included from 17 patients. A significantly lower fluorescence
was found for dysplastic regions across whole EMR specimens (P < 0.001). We found a 41 % reduction in the fluorescence of dysplastic compared to
nondysplastic punch biopsies (P < 0.001), with a sensitivity and specificity for dysplasia detection of 80 % and
82.9 %, respectively.
Conclusion Lectin-based NIR imaging can differentiate dysplastic from nondysplastic Barrett’s
mucosa ex vivo.