A less invasive method for testing patients suspected of having Barrett’s esophagus, a potentially cancerous change in the lining of the esophagus due to acid reflux, has been developed and successfully tested. Acid reflux occurs when stomach acid splashes, or refluxes, up into the esophagus. Long periods of acid reflux can change the cells that line the esophagus, making them appear more like intestinal than esophageal cells. These cellular changes could be a precursor to cancer and, as in most cancers, early detection often leads to better outcomes for patients. Biomedical engineers at Duke University discovered that a tiny light source and sensors at the end of an endoscope might provide a more accurate way to identify precancerous cells in the esophagus. Using an endoscope to reach the esophagus via the nose, physicians can shine short bursts of light at locations suspected of disease, while sensors capture and analyze the light as it is reflected back. The method enables doctors to spot characteristic changes within the layer of cells known as the epithelium, which lines cavities and surfaces throughout the body. Because most cancers begin within this layer, the system could also detect cancers in the colon, trachea, cervix and bladder. The technology developed by the researchers for cancer detection is known as angle-resolved low-coherence interferometry. It can separate the unique patterns of the nucleus from the other parts of the cell to provide real-time representations of its changes in shape. A clinical trial of the system is planned, and commercial availability of the device could be as early as 2012. Supported by the National Institutes of Health, the National Science Foundation and Oncoscope Inc., the research was published online in the January 2011 issue of Gastroenterology (Vol. 140, pp. 42-50, 2011).