Probe-based Volumetric Laser Endomicroscopy (pVLE) of Endoscopic Mucosal Resection (EMR) Tissue in Patients With Barrett's Dysplasia

Study Overview
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Brief Summary
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This study is to assess the diagnostic accuracy and precision of the Probe-based Volumetric Laser Endomicroscopy (pVLE) imaging system in detecting dysplasia in BE in both in vivo and ex vivo imaging of Endoscopic Mucosal Resection (EMR) tissue, as compared to standard histopathology

Detailed Description
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To assess the ability of pVLE to visualize subsurface architecture of EMR tissue, as compared to histology in both in vivo and ex vivo imaging.

Official Title
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Probe-based Volumetric Laser Endomicroscopy (pVLE) of Endoscopic Mucosal Resection (EMR) Tissue in Patients With Barrett's Dysplasia

Conditions
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Barrett's Esophagus With High Grade Dsyplasia, Early Esophageal Cancer

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Males and females over the age of 18 years. Patients with either suspected or confirmed Barrett's-associated high grade dysplasia (HGD) or intramucosal cancer (IMC) presenting for endoscopy possibly requiring EMR. Ability to provide written, informed consent. Females must be willing to take a pregnancy test if still capable of bearing a child. Exclusion Criteria: Patients on anticoagulation undergoing high risk procedures in accordance to ASGE guideline for the management of antithrombotic agents for endoscopic procedures (2009)*. Patients with esophageal varices that preclude biopsies. Presence of an esophageal mass/cancer that precludes full distention of the balloon from the Nvision balloon guide sheath. Patients with esophageal strictures that would prevent adequate expansion of the balloon from the Nvision guide sheath. Patients with known inflammatory disease, esophageal tears or ulcers, which prohibit full distention of the balloon from the Nvision balloon guide sheath. Patients with known eosinophilic esophagitis. Patients who are pregnant. Patients with a history of hemostasis disorders*. Patients on anticoagulation undergoing low risk procedures are not excluded. ** Hemostasis disorders will include, but will not be limited to: patients with hemophilia or other congenitally acquired clotting factor deficiencies, patients with cirrhosis with coagulopathy, patients known to have thrombocytopenia (<100,000 plt/ul) and individuals with von Willebrand's disease or other known platelet malfunction disorders.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| EMR<br>patients undergoing clinically indicated endoscopic mucosal resection as standard of care will be asked to participate for this observational study | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| distinguishing between normal esophageal squamous mucosa and Barrett's dysplasia | We will assess descriptive and diagnostic performance (accuracy, sensitivity, specificity, positive and negative predictive values) of the Nvision pVLE device in visualizing dysplasia as compared to standard histopathology | at time of endoscopic mucosal resection |