Esophageal Screening Research Articles

Sa1692 - Esophageal Dysphagia Screening: Improving the Diagnostic Capability of the Modified Barium Swallow Study Through Standardization of an Esophageal Sweep Protocol Performed by the Speech Pathologist

Sa1692 - Esophageal Dysphagia Screening: Improving the Diagnostic Capability of the Modified Barium Swallow Study Through Standardization of an Esophageal Sweep Protocol Performed by the Speech Pathologist

Conditional Reprogramming of Pediatric Human Esophageal Epithelial Cells for Use in Tissue Engineering and Disease Investigation.

Identifying and expanding patient-specific cells in culture for use in tissue engineering and disease investigation can be very challenging. Utilizing various types of stem cells to derive cell types of interest is often costly, time consuming and highly inefficient. Furthermore, undesired cell types must be removed prior to using this cell source, which requires another step in the process. In order to obtain enough esophageal epithelial cells to engineer the lumen of an esophageal construct or to screen therapeutic approaches for treating esophageal disease, native esophageal epithelial cells must be expanded without altering their gene expression or phenotype. Conditional reprogramming of esophageal epithelial tissue offers a promising approach to expanding patient-specific esophageal epithelial cells. Furthermore, these cells do not need to be sorted or purified and will return to a mature epithelial state after removing them from conditional reprogramming culture. This technique has been described in many cancer screening studies and allows for indefinite expansion of these cells over multiple passages. The ability to perform esophageal screening assays would help revolutionize the treatment of pediatric esophageal diseases like eosinophilic esophagitis by identifying the trigger mechanism causing the patient's symptoms. For those patients who suffer from congenital defect, disease or injury of the esophagus, this cell source could be used as a means to seed a synthetic construct for implantation to repair or replace the affected region.

Screening for Barrett's esophagus.

Barrett's esophagus is the only known esophageal precursor for the development of esophageal adenocarcinoma. However, screening for Barrett's esophagus remains controversial. Although screening is advocated in selected populations, it is unclear how it should be implemented. In this review, the current definition of Barrett's esophagus will be discussed. There will be a review of the emerging evidence supporting the cost-effectiveness of screening and surveillance for Barrett's esophagus in preventing esophageal adenocarcinoma. The known risk factors for Barrett's esophagus and the development of esophageal adenocarcinoma, currently utilized to determine the appropriate populations to screen, will be reviewed. Finally we will review the standard techniques utilized to screen for Barrett's esophagus and examine new technologies that might improve the efficacy and availability of Barrett's esophagus screening.

Inter-rater reliability for speech-language therapists' judgement of oesophageal abnormality during oesophageal visualization.

Oesophageal abnormalities are common findings in a speech-language therapy videofluoroscopy clinic. Fluoroscopic screening involving oropharynx alone fails to identify these patients. Oesophageal screening as an adjunct to videofluoroscopy is gaining popularity. Yet currently, little is known about the reliability of speech and language therapists' judgement of the oesophageal phase. To measure the inter-rater reliability of oesophageal abnormality judgement in speech and language therapists during upright videofluoroscopy. Seventy-four speech and language therapists were trained in oesophageal physiology and oesophageal visualization. Participants were asked to provide a rating of bolus transit (> or <15 s) for 10 segments of videofluoroscopy with oesophageal visualization showing ingestion of one 20 ml fluid barium bolus. Participants then provided a binary judgement of (1) the presence of stasis, (2) the presence of redirection and (3) the need for referral for further investigation. If stasis were present, they then rated the level of stasis as cervical, aortic or thoracic. Participants achieved substantial agreement for bolus transit time, presence of stasis, presence of redirection and need for referral (K = 1.0.63.63 and .61 respectively). The level of stasis achieved only fair agreement (K = .22) with disagreement primarily between aortic, thoracic or aortic/thoracic across clinicians. Speech and language therapists demonstrated substantial agreement in judging oesophageal abnormality during videofluoroscopy. Oesophageal screening as an adjunct to videofluoroscopy can be used reliably in trained clinicians.

Predicting Barrett's Esophagus in Families: An Esophagus Translational Research Network (BETRNet) Model Fitting Clinical Data to a Familial Paradigm.

Barrett's esophagus is often asymptomatic and only a small portion of Barrett's esophagus patients are currently diagnosed and under surveillance. Therefore, it is important to develop risk prediction models to identify high-risk individuals with Barrett's esophagus. Familial aggregation of Barrett's esophagus and esophageal adenocarcinoma, and the increased risk of esophageal adenocarcinoma for individuals with a family history, raise the necessity of including genetic factors in the prediction model. Methods to determine risk prediction models using both risk covariates and ascertained family data are not well developed. We developed a Barrett's Esophagus Translational Research Network (BETRNet) risk prediction model from 787 singly ascertained Barrett's esophagus pedigrees and 92 multiplex Barrett's esophagus pedigrees, fitting a multivariate logistic model that incorporates family history and clinical risk factors. The eight risk factors, age, sex, education level, parental status, smoking, heartburn frequency, regurgitation frequency, and use of acid suppressant, were included in the model. The prediction accuracy was evaluated on the training dataset and an independent validation dataset of 643 multiplex Barrett's esophagus pedigrees. Our results indicate family information helps to predict Barrett's esophagus risk, and predicting in families improves both prediction calibration and discrimination accuracy. Our model can predict Barrett's esophagus risk for anyone with family members known to have, or not have, had Barrett's esophagus. It can predict risk for unrelated individuals without knowing any relatives' information. Our prediction model will shed light on effectively identifying high-risk individuals for Barrett's esophagus screening and surveillance, consequently allowing intervention at an early stage, and reducing mortality from esophageal adenocarcinoma. Cancer Epidemiol Biomarkers Prev; 25(5); 727-35. ©2016 AACR.

Predictive Value of Serum miR-10b, miR-29c, and miR-205 as Promising Biomarkers in Esophageal Squamous Cell Carcinoma Screening

Predictive Value of Serum miR-10b, miR-29c, and miR-205 as Promising Biomarkers in Esophageal Squamous Cell Carcinoma Screening

Predictive Value of Serum miR-10b, miR-29c, and miR-205 as Promising Biomarkers in Esophageal Squamous Cell Carcinoma Screening.

Esophageal squamous cell carcinoma (ESCC) is a leading cause of cancer-related deaths worldwide. The high mortality of ESCC is mainly due to late diagnosis. Current detection methods have their own weakness, including high costs and invasive procedures. MicroRNA assays are shown to have great potential to be accurate and noninvasive methods for ESCC screening. In this study, we selected 3 microRNAs, miR-10b, miR-29c, and miR-205, to assess their diagnostic value in ESCC screening. Fifty ESCC patients and 50 healthy controls are recruited in our study. Blood samples are collected from the total 100 participants. MicroRNAs were extracted from serum and quantified by qRT-PCR, which their relative expressions were normalized by internal control, U6 snRNA. Statistical analyses were conducted to compare microRNAs level as well as other clinical characteristics between 2 groups. The levels of serum miR-29c and miR-205 were significantly downregulated in ESCC patients compared with healthy volunteers. In contrast, ESCC patients appeared to have a higher level of miR-10b than healthy controls. ROC curve analyses revealed that the AUC value for miR-10b, miR-29c, and miR-205 were 0.85 (95% CI: 0.79–0.93; sensitivity = 76%; specificity = 84%), 0.72 (95% CI: 0.62–0.82; sensitivity = 68%; specificity = 68%), and 0.72 (95% CI: 0.62–0.83; sensitivity = 70%; specificity = 64%), respectively, suggesting that miR-10b, miR-29c, and miR-205 have great potential to be noninvasive screening tools for ESCC detection.

Facility- and Patient-Level Factors Associated with Esophageal Variceal Screening in the USA.

The American Association for the Study of Liver Disease (AASLD) recommends screening for esophageal varices (EV) by esophagoduodenoscopy (EGD) in patients with cirrhosis to guide decisions regarding primary prophylaxis for EV hemorrhage. We aimed to identify patient and facility factors associated with EV screening in veterans with hepatitis C (HCV)-associated cirrhosis. This was a population-based cohort study. Veterans with HCV and newly diagnosed cirrhosis between 1/1/2004 and 12/31/2005 and followed until 12/31/2011 were included. The primary outcome was receipt of EGD within 1 year of cirrhosis diagnosis. Patient- and facility-level factors associated with EV screening were determined. A total of 4230 patients with HCV cirrhosis were identified. During median follow-up of 6.1 years (IQR: 4.0-8.0), 21.5 % developed a decompensating event, and 38.3 % died. Fifty-four percent received an EGD, and 33.8 % had an EGD within guidelines. Median time from cirrhosis diagnosis to EGD was 72 days (IQR: 12-176). Factors independently associated with receipt of EV screening were a decompensation event (OR 1.16, CI 1.01-1.32) and gastroenterology/hepatology clinic access (OR 2.1, CI 1.73-2.46), whereas cardiovascular (OR 0.81, CI 0.69-0.95), mental health (OR 0.79, CI 0.68-0.91), and respiratory (OR 0.85, CI 0.72-0.99) comorbidities were associated with reduced likelihood of EV screening. EV screening per AASLD guidelines occurs in only one-third of patients. This missed opportunity was strongly associated with access to gastroenterology/hepatology specialty care. Additionally, providers may be relying on clinical cues (i.e., decompensation) to prompt referral for endoscopy suggesting education to improve compliance with guidelines is needed.

Cost-effectiveness analysis of esophageal cancer once-in-a-lifetime endoscopic screening in high-risk areas of rural China

To estimate the cost-effectiveness of esophageal cancer endoscopic screening once-in-a-lifetime and to predict the optimal screening age for people in high-risk areas of rural China. A Markov model was constructed to predict and compare the effect of four esophageal cancer endoscopic screening modalities which varied with different screening ages. Long-term epidemiological effectiveness and cost-effectiveness were predicted by simulation of the model. Compared with the control group, strategies starting at 40, 45, 50 and 55 year-old had saved life-years of 629.51, 769.88, 738.98 and 533.21 years per 100 000 people, respectively, of which the strategy starting at 45 year-old saved the maximum life years. All strategies were cost-effective and starting at 40 year-old cost the most per life-year saved. Among all alternatives, strategies starting age at 45 year-old and 50 year-old were incremental cost-effective, and the incremental cost-effective ratios were 34 962.87 and 3 346.43 RMB per life year saved, respectively. The strategy starting at 40 year-old implemented at present and other strategies were cost-effective in high-risk areas of rural China. However, the 45-year-old group is more aligned with the principle of cost-effectiveness. Considering the cost-effectiveness of different strategies and social economic status, 45 year-old is regarded as the optimal starting age of esophageal cancer once-in-a-lifetime endoscopic screening and is recommended in areas lacking health resources. The strategy of starting age at 40 year-old which could obtain better screening effects would be preferable in wealthy regions.

Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial

Esophageal squamous cell neoplasia has a high mortality rate as a result of late detection. In high-risk regions such as China, screening is performed by Lugol's chromoendoscopy (LCE). LCE has low specificity, resulting in unnecessary tissue biopsy with a subsequent increase in procedure cost and risk. The purpose of this study was to evaluate the accuracy of a novel, low-cost, high-resolution microendoscope (HRME) as an adjunct to LCE. In this prospective trial, 147 consecutive high-risk patients were enrolled from 2 US and 2 Chinese tertiary centers. Three expert and 4 novice endoscopists performed white-light endoscopy followed by LCE and HRME. All optical images were compared with the gold standard of histopathology. By using a per-biopsy analysis, the sensitivity of LCE vs LCE + HRME was 96% vs 91% (P = .0832), specificity was 48% vs 88% (P < .001), positive predictive value was 22% vs 45% (P < .0001), negative predictive value was 98% vs 98% (P = .3551), and overall accuracy was 57% vs 90% (P < .001), respectively. By using a per-patient analysis, the sensitivity of LCE vs LCE + HRME was 100% vs 95% (P = .16), specificity was 29% vs 79% (P < .001), positive predictive value was 32% vs 60%, 100% vs 98%, and accuracy was 47% vs 83% (P < .001). With the use of HRME, 136 biopsies (60%; 95% confidence interval, 53%-66%) could have been spared, and 55 patients (48%; 95% confidence interval, 38%-57%) could have been spared any biopsy. In this trial, HRME improved the accuracy of LCE for esophageal squamous cell neoplasia screening and surveillance. HRME may be a cost-effective optical biopsy adjunct to LCE, potentially reducing unnecessary biopsies and facilitating real-time decision making in globally underserved regions. ClinicalTrials.gov, NCT 01384708.

Sa1071 Direct and Indirect Costs Associated With Barrett's Esophagus Screening: Results From a Community Randomized Controlled Trial

Background and Aims: Real costs associated with screening for Barrett's esophagus (BE) are not known. Modeling studies concluding that screening for BE is cost effective have used estimates based on several assumptions. As part of a prospective randomized controlled trial assessing the comparative effectiveness of unsedated transnasal endoscopy (uTNE) and sedated endoscopy (sEGD), real direct and indirect costs associated with BE screening were prospectively collected and compared. Methods: Patients were randomly allocated to three screening techniques: sEGD or uTNE in a hospital setting (huTNE) versus uTNE in a mobile research van (muTNE). Following the procedure, patients were called at 1 and 30 days by a research coordinator to assess adverse effects, loss of work (for the screening procedure) and medical care sought after the BE screening procedure. Direct medical (initial screening test and medical costs within 30 days of test), indirect (loss of work for subject and caregiver) and total medical costs were extracted using the Olmsted County Healthcare Expenditure and Utilization Database (OCHEUD). This claims-based database contains details on healthcare utilization, associated charges, and inflation adjusted economic costs for patients in Olmsted County. Costs were analyzed descriptively and compared using multivariate regression. Covariates in the model included age, sex and comorbidities (measured using the Hwang method). To test whether the assumed cost affects results, sensitivity analyses were performed by varying costs from 50% to 300%. Results: 209 patients (46% males, mean age 65 years) were screened (61 with sEGD, 72 with huTNE and 76 with muTNE), out of 459 who were invited (participation rate 46%). Clinical effectiveness of uTNE screening was comparable to that of sEGD (Sami, AmJGastro 2014). 4 sEGD and 4 muTNE patients did not have follow-up interviews and were excluded from analyses. 30 day direct medical costs and indirect costs were higher in the sEGD than in huTNE and muTNE groups. Total costs (direct medical + indirect costs) were significantly higher in the sEGD group than in the uTNE groups (Table 1). muTNE had significantly lower costs than the huTNE group on univariate and multivariate analysis. (Table 2). Sensitivity analyses still resulted in significantly higher costs for sEGD compared to muTNE for both low and high values (results not shown). Conclusions: In our prospective randomized comparative effectiveness trial, we demonstrate for the first time that real short term direct medical, indirect and total costs of BE screening are significantly lower with uTNE compared with sEGD. Costs associated with mobile uTNE were lower than with huTNE, raising the possibility of mobile screening (which has comparable clinical effectiveness to sEGD and huTNE) as a novel method of screening for BE and esophageal adenocarcinoma. Table 1. Total costs (30 day direct medical + indirect costs) over the one-month period following screening, by study group. (Costs in US$)

Sa1892 Barrett's Esophagus Screening and Surveillance Criteria May Not Target Many Patients at Risk for Gastroesophageal Junction Tumors

Sa1892 Barrett's Esophagus Screening and Surveillance Criteria May Not Target Many Patients at Risk for Gastroesophageal Junction Tumors

Comparative acceptability of transnasal esophagoscopy and esophageal capsule esophagoscopy: a randomized, controlled trial in veterans

EGD screening for Barrett's esophagus (BE) is costly, with insufficient evidence to support its effectiveness. To compare acceptance and tolerability of 2 novel, office-based, endoscopic screening techniques done on nonsedated patients. Randomized block study design with allocation concealment. Outpatient clinic setting at a Veterans Affairs medical center. A total of 184 veterans with or without GERD symptoms. Transnasal esophagoscopy (TNE) or esophageal capsule esophagoscopy (ECE). Acceptance and tolerability of TNE and ECE and effectiveness of BE screening. Esophageal screening was accepted by 184 of 1210 (15.2%) veterans. The majority were men (96%) and African American (58%), with a mean (± standard deviation) age of 58.9 (± 8.1) years. Five TNE participants (5%) and 2 ECE participants (2%) refused the assigned procedure after randomization (P = .25). Eleven patients (12.6%) randomized to TNE crossed the minimal clinically important threshold for overall procedure tolerability, as opposed to no patients randomized to ECE (P = .001). Effectiveness of BE screening was not significantly different in both procedures (TNE vs ECE = 3.2% vs 5.4%; P = .47). Overall, BE was present in 8 of 75 white participants (10.6%) and in 0 of 107 African American participants (P < .001). The general veteran population may not reflect the screening population for BE. Despite a small proportion of veterans expressing interest in esophageal screening, both TNE and ECE were feasible in the outpatient clinic setting and were accepted by >95% of participants who did express an interest. Screening was effective only in white participants. Moderate differences in tolerability between TNE and ECE notwithstanding, cost considerations along with availability of equipment and trained personnel should guide the modality to be used for BE screening.

PTU-052 Does Use Of Sedation Affect The Speed At Which Endoscopy Is Performed And Number Of Biopsies Obtained In Barrett’s Oesophagus?

IntroductionGuidelines for Barrett’s oesophagus (BE) screening recommend 2 yearly endoscopies with 4 quadrant biopsies every 2cm for BE without dysplasia. There is increasing evidence that longer inspection time of BE...

OC-020 Comparative Effectiveness Of Novel Techniques For Barrett’s Oesophagus (bo) Screening In The Community: A Prospective Randomised Trial

IntroductionBO is the strongest precursor of oesophageal adenocarcinoma. Participation patterns and effectiveness of BO community screening using unsedated transnasal endoscopy (uTNE) is unknown. Feasibility of mobile van screening closer to...

Interobserver variability in transient elastography analysis of patients with chronic hepatitis C

Transient elastography based on liver stiffness measurement is a non-invasive method to assess hepatic fibrosis. However, interobserver variability has led to controversy over its use in fibrosis evaluation. To evaluate the interobserver variation in transient elastography in chronic hepatitis C. We performed a cross-sectional study, analysing findings from two experienced operators who each assessed 195 patients by transient elastography on the same day. Liver stiffness measurement used to define fibrosis stages, based on METAVIR score, was: <7.1 as F0F1, 7.1-9.4 as F2, 9.5-12.4, as F3 and >12.4kPa as F4. We also assessed interobserver variation in identification of potential oesophageal varices screening based on transient elastography. The interobserver intraclass correlation coefficient was 0.940 (95% CI 0.863-0.967) and measurements made by operators correlated [Spearman's ρ=0.924; P<0.001]. However, the median liver stiffness measurement assessed by first operators was higher (11.5 vs 9.8kPa; P<0.001). The discordance between operators was 35% for at least one stage of fibrosis and 5% for two or more stages. Interobserver reliability values were κ=0.61 for fibrosis stages F≥2 and κ=0.80 for cirrhosis. Among the 74 patients determined to have cirrhosis by at least one operator, there was considerable discordance in identification of those with indication for oesophageal varices screening (κ values from 0.13 to 0.61) according to several cut-offs. Although a high correlation of liver stiffness measurement between operators, interobserver variability in transient elastography was not negligible. This method should not be used as the only screening tool for oesophageal varices in chronic hepatitis C.

160 Comparative Effectiveness of Novel Techniques for Barrett's Esophagus Screening in the Community: a Prospective Randomized Trial

160 Comparative Effectiveness of Novel Techniques for Barrett's Esophagus Screening in the Community: a Prospective Randomized Trial

Detection of Esophageal Squamous Cell Carcinoma by Cathepsin B Activity in Nude Mice

Background and ObjectiveDespite great progress in treatment, the prognosis for patients with esophageal squamous cell carcinoma (ESCC) remains poor, highlighting the importance of early detection. Although upper endoscopy can be used for the screening of esophagus, it has limited sensitivity for early stage disease. Thus, development of new diagnosis approach to improve diagnostic capabilities for early detection of ESCC is an important need. The aim of this study was to assess the feasibility of using cathepsin B (CB) as a novel imaging target for the detection of human ESCC by near-infrared optical imaging in nude mice.MethodsInitially, we examined specimens from normal human esophageal tissue, intraepithelial neoplasia lesions, tumor in situ, ESCC and two cell lines including one human ESCC cell line (Eca-109) and one normal human esophageal epithelial cell line (HET-1A) for CB expression by immunohistochemistry and western blot, respectively. Next, the ability of a novel CB activatable near-infrared fluorescence (NIRF) probe detecting CB activity presented in Eca-109 cells was confirmed by immunocytochemistry. We also performed in vivo imaging of tumor bearing mice injected with the CB probe and ex vivo imaging of resected tumor xenografts and visceral organs using a living imaging system. Finally, the sources of fluorescence signals in tumor tissue and CB expression in visceral organs were identified by histology.ResultsCB was absent in normal human esophageal mucosa, but it was overexpressed in ESCC and its precursor lesions. The novel probe for CB activity specifically detected ESCC xenografts in vivo and in vitro.ConclusionsCB was highly upregulated in human ESCC and its precursor lesions. The elevated CB expression in ESCC allowed in vivo and in vitro detection of ESCC xenografts in nude mice. Our results support the usefulness of CB activity as a potential imaging target for the detection of human ESCC.

Measuring telomere length for the early detection of precursor lesions of esophageal squamous cell carcinoma

BackgroundEsophageal cancer is the sixth leading cause of cancer death worldwide; current early detection screening tests are inadequate. Esophageal balloon cytology successfully retrieves exfoliated and scraped superficial esophageal epithelial cells, but cytologic reading of these cells has poor sensitivity and specificity for detecting esophageal squamous dysplasia (ESD), the precursor lesion of esophageal squamous cell carcinoma (ESCC). Measuring telomere length, a marker for chromosomal instability, may improve the utility of balloon cytology for detecting ESD and early ESCC.MethodsWe examined balloon cytology specimens from 89 asymptomatic cases of ESD (37 low-grade and 52 high-grade) and 92 age- and sex-matched normal controls from an esophageal cancer early detection screening study. All subjects also underwent endoscopy and biopsy, and ESD was diagnosed histopathologically. DNA was extracted from the balloon cytology cells, and telomere length was measured by quantitative PCR. A receiver operating characteristic (ROC) curve was plotted for telomere length as a diagnostic marker for high-grade dysplasia.ResultsTelomere lengths were comparable among the low- and high-grade dysplasia cases and controls, with means of 0.96, 0.96, and 0.92, respectively. The area under the ROC curve was 0.55 for telomere length as a diagnostic marker for high-grade dysplasia. Further adjustment for subject characteristics, including sex, age, smoking, drinking, hypertension, and body mass index did not improve the use of telomere length as a marker for ESD.ConclusionsTelomere length of esophageal balloon cytology cells was not associated with ESCC precursor lesions. Therefore, telomere length shows little promise as an early detection marker for ESCC in esophageal balloon samples.

Volumetric Laser Endomicroscopy (VLE): An OFDI Case Study of Barrettʼs Esophagus with Dysplasia

Figure: No Caption available.Purpose: Optimal diagnosis and surveillance of patients with Barrett's esophagus (BE) is complex, given that few patients undergoing resection of esophageal adenocarcinoma have a prior diagnosis of Barrett's esophagus (BE) and, among those who have been screened and diagnosed with BE, >90% never develop adenocarcinoma. Surveillance of patients with BE is further complicated by variability in the distribution of dysplasia and cancer within the esophagus. Random sampling of esophageal biopsies can result in missed regions of interest with pathology. Thus, a significant need exists for more accurate methods of identifying areas of dysplasia in the endoscopic screening and surveillance of BE. Volumetric laser endomicroscopy uses the principles of optical coherence tomography to generate high-resolution, cross-sectional, and longitudinal images of tissue microstructures simultaneously in real time. Methods: The console generates the near infrared light and transmits the light into the VLE catheter. The console includes the swept light source, optical receiver and interferometer, data acquisition computer and control electronics, and user interface and display. The catheter is a long catheter (2.5 m) plugs into the console and has a polymer, noncompliant balloon with soft tip. Results: In this case, a 64-year-old man with long standing acid reflux and a family history esophageal carcinoma had undergone endoscopy documenting long segment BE with areas suspicious for HGD and/or carcinoma. At our institution, he underwent video endoscopy with VLE imaging documenting abnormal crypt formation and surface maturation consistent with BE HGD and focal mass treated with endoscopic resection. Conclusion: Optical coherence tomography (OCT) is an imaging modality that has the ability to improve the current paradigm for endoscopic screening and surveillance. The benefit of OCT over ultrasound is that it is capable of generating cross-sectional images of tissues with an axial-resolution of up to 10 microns, which is comparable to low-power microscopy. Original OCT systems or time-domain OCT were limited to discrete locations or ‘point' sampling due to slow acquisition rates. However, with the development of second-generation OCT, termed optical frequency domain Imaging (OFDI) now called VLE, it is now possible to perform high-speed acquisition of large luminal surfaces in three-dimensions. Due to its high-resolution and high-acquisition rates, utilizing this technique for screening and surveillance of Barrett's esophagus may provide a means to evaluate pathologic states of the esophageal lumen in real-time. Disclosure - Leslie Blackshear, E Aranda-Michel, Mayo Clinic Florida: None MB Wallace, HC Wolfsen, Mayo Clinic Florida and G Tearney Massachusetts General Hospital: Grant/Research Support. This research was supported by an industry grant from Nine Point Medical, Cambridge MA.