Figure 3.

The Multi-scale nature of screening in Barrett’s esophagus (BE). The standard screening protocol for BE involves scales from stem cells in the crypt (left) to the BE cylindrical segment of the esophagus depicted (right) with rectangles representing biopsy samples taken during endoscopy. The BE segment may have dysplasia and/or malignant tissue patches that may be missed. During histological preparation, portions of each biopsy are sliced by microtome and placed on slides for pathologic assessment. A diagnosis is made by microscopic interpretation of crypt and cellular architecture, reflecting the most severe tissue grade found from all slides. Given the multi-scale nature of the problem, it is natural that a multi-scale-based screening model would have great clinical utility. (EAC = Esophageal Adenocarcinoma; HGD = High Grade Dysplsia.)