Optical molecular imaging for detection of Barrett’s-associated neoplasia

Table 1 Advantages and disadvantages of optical technologies for identification of neoplasia in Barrett’s esophagus

Technology	Advantages	Disadvantages	Stage of clinical translation
Standard WLE	Capable of scanning wide area, widely available outside of tertiary care centers, no exogenous contrast	Limited sensitivity and specificity	Commercially available
High-definition WLE	Capable of scanning wide area, increased image contrast, no exogenous contrast	Performance evaluated in moderate-sized studies	Commercially available
AFI	Capable of scanning wide area, consistently high sensitivity, no exogenous contrast	High rate of false positives, performance evaluated only in small pilot studies	Commercially available
NBI	Capable of scanning wide area, consistently high sensitivity, no exogenous contrast	Performance evaluated in small pilot studies	Commercially available
OCT	Resolves subsurface structure, no exogenous contrast	Technology still under development	Clinical studies
Endocytoscopy	Histology-like imaging, high specificity	Low sensitivity, limited field of view, requires exogenous contrast	Commercially available
CME	Nuclear morphology can be viewed, high sensitivity and specificity	Limited field of view, high cost, uses IV exogenous contrast	Commercially available
High-resolution microendoscopy	Some nuclear morphology can be viewed, lower cost, adaptable to any endoscope	Limited field of view, requires exogenous contrast, technology still in development	Clinical studies

AFI: Autofluorescence imaging; OCT: Optical coherence tomography; CME: Confocal microendoscopy; WLE: White-light endoscopy; NBI: Narrow-band imaging.