Becker's ASC Review

October 2022 Issue of Becker's ASC Review

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16 EXECUTIVE BRIEFING 3 EXECUTIVE BRIEFING Dr. Boss has found that some patients with stomach ulcers also have silent acid reflux. In addition, many other patients with damaging acid reflux have no symptoms. "Regardless of the indication for the EGD, if I see changes raising a concern for Barrett's, I perform a biopsy and WATS 3D ," he explained. Once Dr. Boss diagnoses a patient with Barrett's esophagus without dysplasia, he conducts follow-up surveillance every three years. If the results are indefinite, he doubles the proton pump inhibitors and brings the patient back within six months. This is often the case with low-grade dysplasia. "Even with indefinite or low-grade dysplasia, I'll bring patients back within six months and repeat the WATS 3D procedure. I do four quadrant biopsies every one centimeter to see what that shows. That dictates what we do next. If the patient has high-grade dysplasia, they will need radiofrequency ablation which we don't do in the ASC setting," Dr. Boss said. "When you start looking at missed high-grade dysplasia, WATS 3D is a no-brainer," Dr. Boss said. "It's easy to use and it adds just a small amount of time to procedures. In addition, it is very easy to learn, and all of my nurses and techs know how to use it." WATS 3D is a quick process in and out of the procedure room. The physician and staff will sample with the brushes, place the samples in prepared vials, and ship them to the CDx Diagnostics Lab in the prepaid boxes provided by CDx. A WATS 3D expert pathologist will make diagnoses, and the attending physician will have results within 5 days. CDx Diagnostics has designed WATS 3D to be an easy-to-adopt technology that can be integrated into ASC workflows. "We provide WATS 3D kits to ASCs at no charge and no purchase order is required," Mr. Huffnagle said. "We include the kits as part of our service, so centers have everything they need with no hassle. It costs ASCs nothing to use this technology." "We've been using WATS 3D for eight years, and given the results and benefits for patients, it's become a routine part of our prevention protocol. There is no burden associated with the sample preparation and we share the yield results with the staff at least once or twice a year. They buy into why we are doing this," Mr. Mann said. Artificial intelligence in gastroenterology Artificial intelligence is being applied in a variety of ways to assist gastroenterologists. Technologies like Medtronic's GI Genius are used in the colon to assist endoscopists in detecting polyps during live colonoscopies. At CDx Diagnostics, WATS 3D utilizes AI technology to detect cellular changes in the tissue that is acquired during an endoscopy in order to assist pathologists in rendering diagnoses. "When people hear the term 'AI,' they assume that a machine is replacing human intellect, but that couldn't be further from the truth," Dr. Odze said. "A highly trained pathologist on staff at CDx Diagnostics makes the final diagnosis. The WATS 3D tools merely enhance the overall diagnostic process." "These technologies are making a difference. One is used during live colonoscopies to aid in visualization, and the other is used by the pathologist to increase diagnostic precision," Dr. Odze said. "Ultimately, both are using artificial intelligence to help endoscopists more reliably detect pre-cancer and save patient lives." Gastroenterologists recognize WATS 3D as an effective tool for screening and monitoring Barrett's esophagus patients In recent years, 15 peer-reviewed publications have highlighted the effectiveness and the overall utility of WATS 3D . "Based on that body of evidence, WATS 3D has been recognized by four major gastrointestinal societies," Mr. Huffnagle said. "Their members are becoming much more aware of the value of WATS 3D ." The American Society for Gastrointestinal Endoscopy (ASGE) included WATS 3D as a recommendation in its 2019 guidelines for the screening and surveillance of Barrett's esophagus. In July 2022, the American Gastroenterological Association's (AGA) Clinical Practice Update included WATS 3D in their Best Practice Advise Statements. Both the American Foregut Society (AFS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recommended WATS 3D for routine use. Conclusion Millions of people are walking around with GERD and Barrett's esophagus, and they might not even know it. "The key to detecting these conditions is by screening patients as a first line of defense," Dr. Odze said. "The faster you can screen patients at the grassroots level in ASCs, the easier it is to recognize precursors to cancers." The good news is that with WATS 3D , effective biopsies can be performed in any ASC by any endoscopist. "Employees at CDx Diagnostics get up each day with the desire to execute on our mission," Mr. Huffnagle said. "Every sample is critically important to us. We empower physicians with innovative technology to prevent esophageal cancer, one patient at a time." n 1 National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases, niddk.nih.gov/health-information/digestive-diseases/ acid-reflux-ger-gerd-adults/definition-facts#:~:text=see%20your%20doctor.- ,How%20common%20is%20GERD%3F,the%20United%20States%20have%20 GERD. 2 Johns Hopkins Medicine, The Sidney Kimmel Comprehensive Cancer Center, www.hopkinsmedicine.org/kimmel_cancer_center/cancers_we_treat/ esophageal_cancer/prevention/barretts-esophagus.html#:~:text=Barrett's%20 esophagus%20is%20a%20complication,GERD%20will%20develop%2. 3 National Institutes of Health, National Cancer Institute, www.cancer.gov/ pediatric-adult-rare-tumor/rare-tumors/rare-digestive-system-tumors/ esophageal#:~:text=Doctors%20estimate%20esophageal%20cancer%20 survival,from%205%25%20to%2047%25. CDx Diagnostics, provider of WATS 3D , is a pioneer in the detection of dysplastic cells to help prevent the development of cancer. The company's mission of Empowering Physicians with Innovative Technology to Prevent Esophageal Cancer, One Patient at a Time is accomplished by a proprietary diagnostic platform that combines unique tissue sampling and artificial intelligence (AI) enabled tissue analysis and 3D imaging to reliably detect precancerous cells. This aids CDx's expert pathologists in diagnostic precision. Routine clinical use of CDx testing has already identified thousands of precancers that would otherwise have been missed in time for effective treatment.

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