Endoscopic Tri-Modal Imaging in Patients With Barrett's Esophagus (ETMI)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00586989
Recruitment Status : Completed
First Posted : January 7, 2008
Last Update Posted : January 7, 2016
Information provided by (Responsible Party):
Louis-Michel Wong Kee Song, Mayo Clinic

December 21, 2007
January 7, 2008
January 7, 2016
December 2007
February 2010   (Final data collection date for primary outcome measure)
1. The number of patients and the number of lesions with HGD or early ACA detected with WLE and ETMI 2. The number of patients with HGD and early ACA detected with targeted biopsies only with ETMI and WLE [ Time Frame: 2 years ]
Same as current
Complete list of historical versions of study NCT00586989 on Archive Site
1. The positive predictive value (PPV) of HRE and AFI 2. The reduction of false-positive findings after NBI (both the initial in vivo NBI assessment as well as later assessment based on still images) [ Time Frame: 2 years ]
Same as current
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Endoscopic Tri-Modal Imaging in Patients With Barrett's Esophagus
Endoscopic Tri-Modal Imaging for the Detection of High-Grade Dysplasia and Early Adenocarcinoma in Patients With Barrett's Esophagus: A Randomized Crossover Multi-center Study
This study is being done to determine if a new endoscope will help doctors identify pre-cancer or early cancer lesions in patients who have Barrett's esophagus. This new endoscope allows the doctor to look at the lining of the esophagus in 3 different ways by modifying light.
Patients with Barrett's esophagus are advised to undergo periodic endoscopic surveillance with random biopsies in an attempt to identify high-grade dysplasia (HGD) or early adenocarcinoma (ACA) at a time when intervention can be curative. This approach, however, can be time-consuming and is hindered by low sampling yield and random sampling error. Endoscopic Tri-Modal Imaging (ETMI) is a novel diagnostic modality that encompasses three advanced imaging features in one system: high-resolution endoscopy (HRE), autofluorescence imaging (AFI) and narrow-band imaging (NBI). HRE and AFI provide a bird's-eye view of 'red flag' areas which are then assessed by NBI for focused and more specific tissue characterization. The aim of this prospective, multi-center study is to compare the diagnostic performance of ETMI with that of standard white-light endoscopy (WLE) for identifying high-grade dysplasia (HGD) and early adenocarcinoma (ACA) in BE. A total of 84 BE patients will be recruited for the study and they will undergo both ETMI and WLE examinations in a randomized, crossover fashion. Standard surveillance biopsies and ETMI-targeted biopsies will be performed. The primary outcome will compare the number of patients and lesions with HGD or early ACA detected with WLE and ETMI. It is anticipated that ETMI will enhance the detection of high-grade Barrett's lesions relative to WLE.
Observational Model: Cohort
Time Perspective: Prospective
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Retention:   Samples Without DNA
esophageal biopsies
Probability Sample
patients with barrett's esophagus or esophageal cancer referred for endoscopy
  • Barretts Esophagus
  • High Grade Dysplasia
  • Early Esophageal Adenocarcinoma
Procedure: Upper endoscopy with biopsy
Endoscopy with biopsy 6 weeks after the initial endoscopy
Other Name: ETMI system (Olympus, Tokyo, Japan)
Patient with Barrett's Esophagus with a history of High grade dysplasia or early esophageal adenocarcinoma
Intervention: Procedure: Upper endoscopy with biopsy
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*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Same as current
September 2010
February 2010   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  1. Age > 18 years
  2. Prior diagnosis of BE, defined as the presence of columnar-lined epithelium in the distal tubular esophagus with specialised intestinal metaplasia on histological investigation
  3. Prior diagnosis of HGD or early ACA that was endoscopically inconspicuous according to the referring source
  4. A minimum Barrett's length of C>2M>2 or C<2M>4 according to the Prague C&M classification for the endoscopic appearance of BE
  5. Ability to provide written informed consent

Exclusion Criteria:

  1. Description of a visibly suspicious lesion within the Barrett's segment according to the referring source
  2. Presence of a type 0-I or type 0-III lesion, or a lesion that, according to the discretion of the endoscopist, does not allow delay in intervention for a period of 6 weeks (minimum interval between the two crossover endoscopies)
  3. Prior endoscopic therapy for Barrett's lesions, such as photodynamic therapy or endoscopic mucosal resection (EMR)
  4. Presence of esophagitis > Los Angeles grade A classification
  5. Presence of conditions precluding histological sampling of the esophagus (e.g., esophageal varices, coagulation disorders, anticoagulant therapy)
  6. Pregnancy
Sexes Eligible for Study: All
18 Years to 85 Years   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
Netherlands,   United States
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Louis-Michel Wong Kee Song, Mayo Clinic
Mayo Clinic
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Principal Investigator: Louis M WongKeeSong, MD Mayo Clinic
Mayo Clinic
September 2010