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Patients undergoing ablative therapy for management of dysplastic Barrett's Esophagus (BE) will have decreased distensibility over the course of treatment, but improvement in mucosal impedance as BE epithelia is replaced by neosquamous epithelia. This information may lead to further research in predicting therapeutic response and complications. The purpose of this research is to collect information while measuring changes related to the esophagus in patients that receive radiofrequency ablation (RFA) for dysplastic Barrett's Esophagus (BE) or esophageal cancer. Study participation includes measurements of the esophagus with the use of two different devices. This takes place during clinically indicated upper endoscopies during the timeframe the participant is receiving RFA treatments. This process will take up to an additional 10 minutes during the upper endoscopy and be done while the participant is sedated.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Radiofrequency ablation alone | Diagnostic Test | If there is no evidence of nodularity, these patients will undergo RFA. Clinical biopsies utilizing a large-capacity biopsy forceps (Radial Jaw 4, Boston Scientific, Marlborough, MA) are obtained. RFA may be delivered through several devices under the BarrX RFA System (Medtronic USA, Minnetonka, MN), including a circumferential balloon catheter (Halo 360; figure 1), or over the scope focal catheter (Halo 90 or 60). The Halo 360 treats a circumferential 4 cm segment at a time, whereas the focal catheters treat a 1.3x2 cm (Halo 90) or 1.0x1.5 cm (Halo 60) area. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in distensibility index (DI) | Change in DI will be measured by functional luminal impedance planimetry (FLIP) during RFA procedure. | Every 12 weeks, up to 1 year (4 visits) |
| Changes in diameter | Change in esophageal diameter will be measured by functional luminal impedance planimetry (FLIP) during RFA procedure. | Every 12 weeks, up to 1 year (4 visits) |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in mucosal impedance | Damage to the mucosal lining of the esophagus and measurement of esophageal leakiness will be assessed by sensors used during RFA procedure. | Every 12 weeks, up to 1 year (4 visits) |
| Measure | Description | Time Frame |
|---|---|---|
| GERD-Q Questionnaire | The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) IS a 6-item questionnaire used to help diagnose GERD and assess the impact of symptoms on a patient's daily life. Scores range from 0-18 with higher scores indicating greater GERD symptoms. | Every 12 weeks, up to 1 year (4 visits) |
| Reflux symptom index (RSI) |
Inclusion Criteria:
Exclusion Criteria:
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Subjects will be recruited from the Mayo Clinic Rochester Barrett's Esophagus practice. Clinic and upper endoscopy lists will be screened on a daily basis to identify patients who meet inclusion criteria. These patients will then be invited to participate in the study and screened by the study team.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mariah J Robran | Contact | (507)266-3595 | robran.mariah@mayo.edu | |
| Michele L Johnson | Contact | johnson.michele@mayo.edu |
| Name | Affiliation | Role |
|---|---|---|
| Chamil C Codipilly, M.D. | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic | Recruiting | Rochester | Minnesota | 55905 | United States |
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| Label | URL |
|---|---|
| Mayo Clinic Clinical Trials | View source |
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| ID | Term |
|---|---|
| D001471 | Barrett Esophagus |
| ID | Term |
|---|---|
| D011230 | Precancerous Conditions |
| D009369 | Neoplasms |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
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Esophageal biopsies
The RSI is used to measure impact of GERD symptoms over the past month. It consists of 9 symptoms which are rated on a scale of 0-5 where 0=no problem and 5=significant problem. Higher scores indicate greater impact of symptoms. |
| Every 12 weeks, up to 1 year (4 visits) |
| D004066 |
| Digestive System Diseases |