Advanced endoscopic imaging in Barrett's esophagus

The goal of surveillance in Barrett's esophagus is the detection and treatment of early neoplasia. It has been shown that patients with early lesions (intraepithelial neoplasia or intramucosal cancer) can be cured with a high success rate. This is in contrast to advanced esophageal adenocarcinoma, which has a poor prognosis. Currently, many authorities regard endoscopic treatment for early neoplasia as equivalent, if not superior, to radical surgery because the cure rates are comparable with less mortality and morbidity. With the rising popularity of, and the expanding experience with, endoscopic treatment, principally endoscopic resection, precise localization of the neoplastic lesions within the Barrett's segment has become important for precise staging and successful resection. This localization results in low rates of residual and recurrent neoplasia. In recent years, many developments in the field of endoscopic imaging and treatment of Barrett's esophagus have greatly advanced the field. When it comes to endoscopic detection of early neoplastic lesions in Barrett's esophagus, the 21st century has brought several paradigm shifts. (C) 2010 Elsevier Inc. All rights reserved.