Detection of palisade vessels as a landmark for Barrett’s esophagus in a Western population

Background In Japan, palisade vessels (PV) are used to distinguish the esophagogastric junction (EGJ). Elsewhere, the EGJ is defined by the upper end of the gastric folds (GF) and PV are considered difficult to detect. This study evaluated the detection rate of PV in Western patients with Barrett’s esophagus (BE) using white light imaging (WLI) and narrow band imaging (NBI), and quantified any discordance between Western and Japanese criteria for the EGJ. Methods In 25 BE patients, the presence and location of PV and GF were determined and biopsies were obtained. High-quality images of the EGJ were collected under different conditions (insufflations–desufflation, WLI–NBI, forward-retroflex approach), resulting in eight different images per patient. The presence of PV on each still image was assessed by a panel of six Western and Japanese endoscopists with expertise in BE. Results PV were observed in ≥ 1 images by a majority of the panel (≥ 4 raters) in 100 % of patients during insufflation versus 60 % during desufflation ( p