New Tool for the Detection of Dysplasia in Barrett's Esophagus

Researchers at Beth Israel Deaconess Medical Center have developed an endoscopic scanning technique that successfully detects dysplasia in Barrett's esophagus early in the disease's progression, which is a crucial step in detecting esophageal cancer early and therefore improving prognosis.

, led by Lev Perelman, PhD, director of the Biomedical Imaging and Spectroscopy Laboratory, have developed an endoscopic scanning technique that successfully detects dysplasia in Barrett’s esophagus early in the disease’s progression, which is a crucial step in detecting esophageal cancer early and therefore improving prognosis.

endoscopic polarized scanning spectroscopy, uses light-scattering spectroscopy to identify dysplastic changes on a sub-cellular scale. According to the researchers, it also allows for a more thorough examination of the esophagus.

The scanning technique, which the researchers have named

“The idea behind light scattering spectroscopy is rooted in the same principles as the formation of a rainbow,” said 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.”

In the first test, performed at the BIDMC Interventional Endoscopy Center, the EPSS instrument successfully guided the endoscopist as a biopsy was performed, detecting and mapping sites of numerous invisible dysplasia that current biopsy standards would have missed, according to the researchers.

“The detection of the signal related to precancerous epithelial cellular changes is made possible through the use of polarized light,” Perelman said. “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.”

The results of the EPSS pilot study were published in Nature Medicine

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Researchers at Beth Israel Deaconess Medical Center (BIDMC)