Barrett’s oesophagus is an acquired metaplastic condition that predisposes patients to the development of
oesophageal adenocarcinoma, prompting the use of surveillance regimes to detect early malignancy for endoscopic
therapy with curative intent. The currently accepted surveillance regime uses white light endoscopy together with
random biopsies, but suffers poor sensitivity and discards information from numerous light-tissue interactions that
could be exploited to probe structural, functional and molecular changes in the tissue. Advanced optical methods are
now emerging that are exquisitely sensitive to these changes and hold significant potential to improve surveillance of
Barrett’s oesophagus if they can be applied endoscopically. The next decade will see some of these exciting new
methods applied to Barrett’s surveillance in new device architectures for the first time, potentially leading to a longawaited
improvement of the standard of care
