Image-Enhanced Technologies for Barrett Esophagus Surveillance and Therapy: An American Gastroenterological Association White Paper

Experts recommend that image-enhanced endoscopic technologies should be limited to endoscopists who meet PIVI thresholds for their use.

The PIVI (Preservation and Incorporation of Valuable endoscopic Innovations) initiative was developed by the American Society of Gastrointestinal Endoscopy to establish a priori diagnostic and therapeutic thresholds for endoscopic technologies in order to avoid their widespread use before clinical effectiveness is adequately demonstrated. For Barrett esophagus (BE), the suggested thresholds for use of imaging enhancement to target direct biopsy and eliminate the need for random biopsy (done with high-definition white-light endoscopy; HDWLE), are a per-patient sensitivity ≥90%, negative-predictive value ≥98%, and specificity ≥80% for detecting high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC).

In an industry-sponsored workshop, ex…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors