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Computer aided-image recognition in Barrett’s oesophagus

Most of the oesophageal cancers in the Western world arise from Barrett’s oesophagus. This is a condition where inflammation triggered by longstanding reflux induces an intestinal epithelium with metaplasia that is genetically instable and premalignant. Barrett’s oesophagus is detected endoscopically by colour changes from light pink to salmon-red. Dysplastic areas and early cancers are seen as subtle alterations in surface and microvasculature pattern. However, up to 25% of cases of early oesophageal Barrett’s cancer are missed at endoscopy.1,2

In a joined project with the Ludwig Institute and medical engineering, we work on computer-aided automated recognition of dysplastic and neoplastic lesions in Barrett’s oesophagus.

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                   Figure: Principle of narrow band imaging. (Source: www.olympus-europa.com)

Frequency ablation of Barrett’s oesophagus

We participate in the national UK Halo registry, a longterm study on outcome of radiofrequency ablation to prevent dysplastic Barrett’s epithelium from progressing  to cancer. Unsolved questions are predictors of treatment failure, surveillance intervals and outcome of this method in dysplastic squamous epithelium.

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Figure: Using optical filters such as narrow band
imaging we can bring out subtle changes in the
microvasculature that indicate the presence of
intramucosal cancer in Barrett's epithelium

Figure: Radiofrequency ablation in the oesophagus

Collaborators:

Prof. Xin Lu, Ludwig Institute for Cancer Research, Oxford

Prof. Jens Rittscher, Ludwig Institute and  Oxford Insitute for Biomedical Engineering

Prof. Christoph Dietrich, Caritas Hospital, Bad Mergentheim, Germany

Prof. Stefan Zeuzem, University Frankfurt/Main, Germany