Acetowhitening Time as a Novel Objective Tool for the Diagnosis of High Risk Neoplasia in Barrett's Oesophagus
This is a prospective pilot study. It is standard practice within our unit to use acetic
acid for the detection of neoplasia. No patient would receive any additional intervention
that would not normally be performed.
We will record the surface and vascular patterns before and after acetic acid spray. As
usual we will then apply acetic acid spray to the Barrett's epithelium and time how long it
takes for the aceto whitening to disappear. It is the timing of the disappearance that is
the key study intervention. We will biopsy these areas to confirm the diagnosis. Again this
is standard practice and no patient will be denied an intervention that is normally
performed, and no extra interventions will be performed over and above the standard clinical
We will correlate the histology to the aceto-whitening disappearance time to identify a
threshold time which can serve as a cut off between neoplastic and non-neoplastic tissue.
We hypothesise that the aceto-whitening reaction lasts much longer in the normal epithelium
of Barrett's oesophagus and colon. This reaction will be much shorter in areas with abnormal
pathology like dysplasia or cancer.
Observational Model: Cohort, Time Perspective: Prospective
Timing of disappearance of aceto-whitening for Barrett's metaplasia, HGD and cancer
To quantify the differential in the timing of the disappearance of the aceto-whitening reaction between metaplastic tissue, dysplastic tissue and invasive cancer after acetic acid dye spray in the oesophagus and colon.
Pradeep Bhandari, MD, FRCP
Portsmouth Hospitals NHS Trust
United Kingdom: Research Ethics Committee