Utility of WATS3D for Barrettʼs Esophagus in Community Practice

Abstract

Introduction: Early detection is vital in determining a patient's risk for development of esophageal carcinoma. WATS3D (CDx Diagnostics, Suffern, NY) testing has been shown to increase the detection of Barrett's esophagus (BE) and low or high grade dysplasia by up to 40% when compared to the standard histological protocol. Methods: To determine the utility of WATS3D testing our community referral practice performed a retrospective review of patients over one year. The histological specimen result and the WATS3D result were recorded and compared. Patients previously diagnosed with BE as well as new patients were reviewed. We recorded BE, non- BE, dysplasia and indefinite dysplasia. The incremental increased detection rates for BE and dysplasia were noted for each patient. Results: One hundred and five patients underwent esophagogastroduodenoscopy with both WATS3D sampling and histologic testing. Eighty seven patients, or 83%, had surveillance exams for a previous BE diagnosis. Eighteen or 12.5% of the patients were new suspected BE. In the surveillance group, the original BE diagnosis was based on interpretation by pathologists with varied backgrounds and institutions. Fifty nine patients, or 68%, were confirmed to have BE by our testing. Eight of the 59 patients, or 13.6%, had BE detection by WATS3D only. Twenty eight patients, or 32%, of the surveillance group were negative for BE by both histology and WATS3D sampling. One surveillance patient had dysplasia findings noted on both histology and WATS3D sampling. One surveillance patient had indefinite dysplasia findings by WATS3D sampling only. In the newly suspected BE group 8 patients had a new diagnosis of BE made. Six diagnoses were made by histology and WATS3D sampling, 1 histology positive only and 1 WATS3. WATS3 sampling gave a 12.5% increase in detection. No dysplasia was noted on any newly diagnosed patients. No cancers were identified. Conclusion: WATS3D is a new technology that has the potential to increase diagnosis of BE with or without dysplasia. Utility in various populations is still being established. We report a 12.5% to 13.6% increase in BE detection in our community referral practice using WATS3D. The patient cost benefit ratio may vary in different patient populations and should be investigated further.