Use of volumetric laser endomicroscopy for dysplasia detection at the gastroesophageal junction and gastric cardia

Table 1 Validated criteria for interpretation of volumetric laser endomicroscopy Images of gastroesophageal tissue[12]

Diagnosis	Imaging criteria on volumetric laser endomicroscopy
Squamous epithelium	Layered horizontal architecture
	Absence of glands
Gastric cardia	Vertical pit architecture
	Regular glandular architecture
	Poor image penetration
	Homogeneous scattering
	Regular, broad gastric rugae
Metaplasia	Lack of layered or vertical pit architecture
	Heterogeneous scattering
	Irregular surface
	Atypical glandular structure

Table 2 Frequency of volumetric laser endomicroscopy imaging features in histologic subgroups n (%)

	IMC/HGD (n = 1)	LGD (n = 6)	NDBE (n = 6)	Inflamed cardia (n = 9)	No diagnostic abnormality (n = 12)	Neoplastic1 (n = 7)	Non-neoplastic2 (n = 27)	P-value3
Gastric rugae	1 (100)	6 (100)	6 (100)	9 (100)	12 (100)	7 (100)	27 (100)	NS
Gastric pit architecture	1 (100)	6 (100)	6 (100)	9 (100)	12 (100)	7 (100)	27 (100)	NS
Poor penetration	1 (100)	6 (100)	6 (100)	9 (100)	12 (100)	7 (100)	27 (100)	NS
Loss of normal gastric pit architecture	1 (100)	6 (100)	5 (83)	8 (89)	7 (58)	7 (100)	20 (74)	NS
Irregular surface	1 (100)	6 (100)	2 (33)	1 (11)	2 (20)	7 (100)	5 (19)	< 0.0001
Heterogeneous scattering	1 (100)	5 (83)	5 (83)	6 (67)	3 (25)	6 (86)	14 (52)	< 0.005
Epithelial glands	1 (100)	6 (100)	6 (100)	9 (100)	12 (100)	7 (100)	27 (100)	NS
Anomalous glands	1 (100)	6 (100)	5 (83)	6 (67)	5 (42)	7 (100)	16 (59)	< 0.05

¹Neoplastic: HGD + IMC;

²Non-neoplastic: NDBE + IGC + NL;

³P value: Neoplastic vs non-neoplastic. IMC: Intramucosal carcinoma; HGD: High-grade dysplasia; LGD: Low grade dysplasia; NDBE: Barrett’s without no dysplasia; IGC: Inflamed gastric cardia; NL: Normal mucosa; NS: Not significant.