Information for Physicians

Diagnosis

  • State-of-the-art Olympus high definition endoscopes with enhanced optical imaging are being used to detect Barrett’s esophagus.

  • Wide Area Transepithelial Sample with 3D Analysis (WATS 3D) system (CDx Diagnostics, Suffern, NY, USA) is being utilized to help increase detection of precancerous areas of the esophagus. Studies have shown that the addition of WATS increased the overall detection of Barrett’s esophagus by almost 40%. In a multicenter prospective study, the addition of WATS to standard biopsy protocol increased the detection of dysplasia by 42%.

  • Volumetric Laser Endomicroscopy (VLE) is a new endoscopic imaging technology (NinePoint Medical Inc., Bedford, MA, USA) using optical coherence tomography with infrared light and balloon-centered imaging probes that scans areas of the esophagus to reveal surface and subsurface abnormalities that can be targeted for endoscopic treatment in Barrett’s esophagus. This technology allows detection of subsquamous areas of Barrett’s esophagus (or buried Barrett’s).

Treatment

  • Endoscopic mucosal resection (EMR) – Focal areas of abnormal mucosa (Barrett’s esophagus with dysplasia and early esophageal cancer) can be resected endoscopically by EMR.

  • Endoscopic submucosal dissection (ESD) – Larger areas of abnormal tissue including early esophageal cancer that has not invaded the muscularis propria, can be resected en-bloc using ESD. This involves lifting the abnormal area by injecting saline or other viscous solution, cutting the surrounding mucosa, and dissecting the submucosa beneath the lesion.

  • Radiofrequency ablation (RFA) – The Barrx RFA (Medtronic, Minneapolis, MN, USA) system includes a state-of-the-art generator with multiple endoscopic ablation devices that allow delivery of ablative thermal energy in a focal or circumferential manner to treat Barrett’s esophagus with low grade or high grade dysplasia.
  • Cryotherapy – Spray and balloon-based focal cryotherapy are available. The technology uses extremely cold liquid nitrogen to provide targeted ablation of Barrett’s esophagus with dysplasia.
  • Surgery – The interventional gastroenterology team has partnered with the highly skilled surgeons at the Cancer Institute of New Jersey (CINJ) to provide comprehensive care to patients who develop esophageal cancer. Cases are discussed in a multidisciplinary fashion at weekly tumor board meetings and surgery is only recommended for those patients that truly need it.

Surveillance

To refer a patient who may benefit from RWJ’s comprehensive Barrett’s program, please call 732-235-8970.

Patient Stories

  • Since the procedure, Mitchell has been able to enjoy food again, as well as increased energy and overall well-being.

    Mitch
    Read More

Patient Stories

  • Watch Testimonial