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United European Gastroenterol J. 2018 Jul;6(6):838-845. doi: 10.1177/2050640618761701. Epub 2018 Feb 22.

Use of volumetric laser endomicroscopy for determining candidates for endoscopic therapy in superficial esophageal squamous cell carcinoma.

Author information

1
Division of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
2
Department of Pathology, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
3
Columbia University Medical Center, Division of Gastroenterology, New York, NY, USA.
4
Division of Gastroenterology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
5
Department of Gastroenterology, Weill Cornell Medical College, New York, NY, USA.

Abstract

Background:

Accurate staging of superficial esophageal squamous cell cancer (ESCC) for endoscopic therapy is challenging. Optical coherence tomography (OCT) has been shown to be superior to high-resolution endoscopic ultrasound (EUS). Volumetric Laser Endomicroscopy (VLE), a second-generation OCT, has recently become commercially available.

Objective:

To assess if VLE can determine which patients with superficial ESSC can undergo endoscopic therapy.

Methods:

This is a multi-center retrospective study. Patients were included if (a) they had visible ESCC, (b) they underwent VLE and EUS for staging, and c) if superficial disease was suspected then endoscopic resection had to be performed to have accurate histology to compare the VLE scan to. VLE scans were then compared to the gold standard: histology for superficial disease and EUS for disease T1b and greater.

Results:

Seventeen patients were included with the following disease: squamous intraepithelial neoplasia (4 patients), T1a disease (6 patients), T1b (2 patients), T2 disease (2 patients) and T3 disease (3 patients). VLE was able to distinguish superficial disease, defined as disease limited up to the lamina propria, from non-superficial disease in all cases.

Conclusions:

VLE may be able to determine which ESCC patients are candidates for endoscopic therapy. Prospective studies are needed to confirm this.

KEYWORDS:

Esophagus; advanced imaging; cancer; staging; volumetric laser endomicroscopy

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