New diagnostic platform offers hope for early detection of cancer in patients with Barrett’s esophagus

As part of a mission to increase the early detection of esophageal cancer, University of Colorado (CU) Cancer Center member Sachin Wani, MD, is leading a study to determine if a new plate – form of diagnosis can help endoscopists better identify disease in patients with a disease called Barrett’s. esophagus.

Barrett’s esophagus, a premalignant condition of esophageal adenocarcinoma, occurs when the flat wall of the esophagus is damaged by acid reflux. The condition is diagnosed in 7% to 10% of people with chronic gastroesophageal reflux disease (GERD) and is estimated to be present in 1% to 2% of the general adult population.

Because Barrett’s esophagus is associated with an increased risk of developing esophageal cancer, people with the disease should have regular biopsies to look for precancerous cells (called dysplasia) or esophageal cancer at a early stage. When caught early, esophageal cancer is much more treatable by endoscopy than it is at later stages. Early treatment can often be done endoscopically, where advanced stage cancers usually require surgery (esophagectomy) with or without chemotherapy and radiation therapy.

Esophageal adenocarcinoma is a highly lethal cancer with a five-year survival rate of less than 20%. What’s really disappointing is that despite all the advances we’ve made, the vast majority of esophageal cancer patients still have advanced disease.”

Sachin Wani, MD, CU Cancer Center Member

An AI-based diagnostic platform

With sponsorship from medical technology company CDx Diagnostics Inc., Wani is the principal investigator of a four-year study to test the effectiveness of CDx’s advanced diagnostic platform –; WATS3D, or Wide-Area Transepithelial Sampling with computer-assisted three-dimensional analysis -; compared to the current standard of care known as the Seattle biopsy protocol. When the latter method involves obtaining random four-quadrant biopsies of the esophagus, the CDx’s unique brush instrument contains long, stiff bristles that result in the acquisition of more risky mucous membranes. Specimens will be examined at the company’s CLIA-certified laboratory with its patented extended depth-of-field imaging system and artificial intelligence-based platform that aid pathologists in diagnostic accuracy. The trial will be conducted at approximately 14 centers across the United States, including the University of Colorado Division of Gastroenterology and the CU Cancer Center. The main objective of this study is to compare the diagnostic yield of dysplasia or cancer between these two sampling methods.

“It’s a three-dimensional computer-assisted analysis of samples that we get during endoscopy of Barrett’s segment,” Wani says of the new sampling technique. “Instead of using forceps biopsies, it’s a brush device that allows you to broadly sample Barrett’s segment. Then, using the synthesized 3D images and neural network analyses, those samples are evaluated and abnormal cells are reported to the pathologist The goal is to find patients early in their progression, so they can avoid having to undergo chemotherapy, radiation therapy and esophagectomy, which are treatments we reserve for cancers at an advanced stage.

New hope for early detection

It’s important to study Barrett’s esophagus, Wani says, because it’s the only identifiable precancerous condition for esophageal adenocarcinoma. Traditional endoscopy with biopsies can miss up to 30% of patients with Barrett’s esophageal dysplasia or early esophageal adenocarcinoma. This study will hopefully set the stage for future studies aimed at predicting the progression of esophageal cancer in patients with Barrett’s esophagus, he says.

“We are thrilled to embark on such an important study that will truly impact the thousands of patients diagnosed with Barrett’s esophagus and esophageal cancer,” Wani said. “If the study shows that this sampling method detects more patients with dysplasia and early esophageal cancer and improves outcomes, this could have important ramifications for how we perform endoscopy at the hospital. future for this patient population.”

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