caa a22 4500 445795026 CHVBK 20180317145122.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s10620-010-1497-6 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1497-6 Computer-Assisted Analysis of Abrasive Transepithelial Brush Biopsies Increases the Effectiveness of Esophageal Screening: A Multicenter Prospective Clinical Trial by the EndoCDx Collaborative Group [Elektronische Daten] [J. Johanson, J. Frakes, D. Eisen] Background: The sensitivity of screening for Barrett's esophagus (BE) and esophageal dysplasia (ED) is hampered by the limited amount of tissue that can be sampled by forceps biopsy (FB). Aim: The aim of this study was to evaluate computer assisted analysis of an abrasive, transepithelail brush biopsy as an adjunct to FB to increase detection of BE and ED. Methods: This was a multicenter prospective trial of patients being screened for BE and ED. Each patient had two brush biopsies (BB) and then random four-quadrant FB every 1-2cm of the esophagus. All BB were examined with computer assistance by pathologists at CDx Laboratories (Suffern, NY), and all FB were examined by the investigators' local pathologists. Results: Of 1,266 patients enrolled, 363 were diagnosed with BE by FB alone and 146 additional cases of BE were identified by adding BB. The addition of BB to FB increased the overall detection of BE by 39.8% (95% CI 32-48%). This added detection of BE in 11.5% of all patients tested with the BB (146/1266) resulted in a number of patients needed to test (NNT) to obtain each additional positive finding of Barrett's esophagus of 8.7. Among a subset of 848 patients with gastroesophageal reflux disease and no prior history of BE, the addition of BB to FB identified an additional 105 patients with BE increasing the overall detection of BE by 70.5% (95% CI 54-90%). Dysplasia was diagnosed in 16 patients by FB alone, with an additional 14 cases detected by adding BB. The addition of BB to FB thus increased the detection of ED by 87.5%. Conclusion: These results suggest that adjunctive computer-assisted analysis of an abrasive brush biopsy has the potential to substantially improve the detection of Barrett's esophagus and dysplasia in screening populations. Springer Science+Business Media, LLC, 2010 GERD nationallicence Barrett's esophagus nationallicence EGD nationallicence Surveillance nationallicence Brush biopsy nationallicence Johanson J. Rockford Gastroenterology Associates, Ltd., Rockford, IL, USA aut Frakes J. Rockford Gastroenterology Associates, Ltd., Rockford, IL, USA aut Eisen D. CDx Laboratories, Suffern, NY, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/3(2011-03-01), 767-772 0163-2116 56:3<767 2011 56 10620 https://doi.org/10.1007/s10620-010-1497-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1497-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Johanson J. Rockford Gastroenterology Associates, Ltd., Rockford, IL, USA aut NATIONALLICENCE 700 1- Frakes J. Rockford Gastroenterology Associates, Ltd., Rockford, IL, USA aut NATIONALLICENCE 700 1- Eisen D. CDx Laboratories, Suffern, NY, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/3(2011-03-01), 767-772 0163-2116 56:3<767 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer