Fluorescence, reflectance, and light-scattering spectroscopy for evaluating dysplasia in patients with Barrett's esophagus

(Background & Aims) under bar: The aim of this study was to assess the pote ntial of 3 spectroscopic techniques (fluorescence, reflectance, and light-s cattering spectroscopy) individually and in combination, for evaluating low - and high-grade dysplasia In patients with Barrett's esophagus (BE), (Meth ods) under bar: Fluorescence spectra at 11 excitation wavelengths and a ref lectance spectrum were acquired in approximately 1 second from each site be fore biopsy using an optical fiber probe. The measured fluorescence spectra were combined with the reflectance spectra to extract the intrinsic tissue fluorescence. The reflectance spectra provided morphologic information abo ut the bulk tissue, whereas light-scattering spectroscopy was used to deter mine cell nuclear crowding and enlargement in Barrett's epithelium. (Result s) under bar: Significant differences were observed between dysplastic and non-dysplastic BE in terms of intrinsic fluorescence, bulk scattering prope rties, and levels of epithelial cell nuclear crowding and enlargement. The combination of all 3 techniques resulted In superior sensitivity and specif icity for separating high-grade from non-high-grade and dysplastic from non dysplastic epithelium. (Conclusions) under bar: Intrinsic fluorescence, ref lectance, and light-scattering spectroscopies provide complementary informa tion about biochemical and morphologic changes that occur during the develo pment of dysplasia, The combination of these techniques (Tri-Modal Spectros copy) can serve as an excellent tool for the evaluation of dysplasia in BE.