Page 99 - GTM-3-2

Global Translational Medicine Targeted detection in Barrett’s neoplasia

minimal overlap with WL illumination. By comparison heterodimer used in the study. Eric J. Seibel is an inventor
with alternate detection methods, our integrated imaging on patents filed by the University of Washington on the
methodology allows for the simultaneous use of both mmSFE. The remaining authors declare that they have no
WL and fluorescence imaging. This innovative approach conflicts of interest.
enabled the identification of residual neoplasia in a BE
patient who had undergone an incomplete EMR. This Author contributions
technology can also be used to improve visualization Conceptualization: Tse-Shao Chang, Jing Chen, Eric J.
of flat and subtle pre-malignant lesions in BE patients Seibel, D. Kim Turgeon, Thomas D. Wang
who are at an increased risk of developing EAC. A larger Investigation: Tse-Shao Chang, Jing Chen, Richard S. Kwon
clinical study of 31 human subjects showed that the mean Data analysis: Tse-Shao Chang, Yang Jiang, Eric J. Seibel
T/B ratio for Barrett’s neoplasia (HGD and EAC) was Writing – original draft: Tse-Shao Chang, Thomas D. Wang
significantly greater than that for non-dysplastic BE, LGD, Writing – review & editing: Tse-Shao Chang, Thomas D. Wang
and squamous epithelium. The T/B ratio was determined
13
using a deep learning algorithm. This methodological Ethics approval and consent to participate
17
advantage provided high levels of sensitivity and specificity The research study was approved by the Michigan
for the detection of Barrett’s neoplasia, thus overcoming Medicine IRB (HUM00158121) and was registered online
many shortcomings of conventional detection approaches.
at ClinicalTrials.gov (NCT03852576). The enrolled subject
Our findings contribute not only to the expanding provided written informed consent.
endoscopic arsenal for the detection of Barrett’s neoplasia but
also advance targeted detection methods for other imaging Consent for publication
methodologies. Peptide heterodimers can also be radiolabeled Permission was obtained from the subject to publish
to stage metastatic Barrett’s neoplasia using positron emission results.
tomography-computed tomography to aid in identifying
optimal treatment strategies for these patients. A future Availability of data
clinical study with a larger number of subjects studied at
multiple clinical sites can be performed to further validate the The datasets used and/or analyzed during the current
initial findings and explore the full potential of this targeted study are available from the corresponding author upon
approach for early detection of Barrett’s neoplasia. reasonable request.

4. Conclusion References
1. Prasad GA, Bansal A, Sharma P, Wang KK. Predictors of
A peptide heterodimer was used to visualize the expression progression in Barrett’s esophagus: Current knowledge and
of EGFR and HER2 concurrently to identify early EAC future directions. Am J Gastroenterol. 2010;105:1490-1502.
(stage T1a) in a region of nodular Barrett’s mucosa
following a prior incomplete EMR. A flexible fiber-coupled doi: 10.1038/ajg.2010.2
mmSFE was used to capture in vivo images. This integrated 2. Arnold M, Abnet CC, Neale RE, et al. Global burden of 5
imaging strategy demonstrates a promising approach for major types of gastrointestinal cancer. Gastroenterology.
early detection of Barrett’s neoplasia. Patient outcomes may 2020;159:335-349.e15.
be improved by earlier and more accurate identification of doi: 10.1053/j.gastro.2020.02.068
pre-malignant lesions.
3. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics,
Acknowledgments 2023. CA Cancer J Clin. 2023;73:17-48.
We thank C. Olivo for fabricating the mmSFE and E. Brady doi: 10.3322/caac.21763
and C. Nolan for their clinical support. 4. He H, Chen N, Hou Y, et al. Trends in the incidence and
survival of patients with esophageal cancer: A SEER database
Funding analysis. Thorac Cancer. 2020;11:1121-1128.

This work is supported by the National Institutes of Health doi: 10.1111/1759-7714.13311
(CA163059). 5. Shaheen NJ, Falk GW, Iyer PG, Souza RF, Wani S. Guideline
to practice: Diagnosis and management of Barrett’s
Conflict of interest esophagus: An updated ACG guideline. Am J Gastroenterol.
Jing Chen and Thomas D. Wang are inventors on patents 2022;117:1177-1180.
filed by the University of Michigan on the peptide doi: 10.14309/ajg.0000000000001788

Volume 3 Issue 2 (2024) 4 doi: 10.36922/gtm.2223