Red flag imaging techniques in Barrett's esophagus.

The key to detection and treatment of early neoplasia in Barrett's esophagus (BE) is thorough and careful inspection of the Barrett's segment. The greatest role for red flag techniques is to help identify neoplastic lesions for targeted biopsy and therapy. High-definition white light endoscopy (HD-WLE) can potentially improve endoscopic imaging of BE compared with standard endoscopy, but little scientific evidence supports this. The addition of autofluorescence imaging to HD-WLE and narrow band imaging increases sensitivity and the false-positive rate without significantly improving overall detection of BE-related neoplasia.