Dr Massimiliano di Pietro

University of Cambridge
Cambridge University Hospitals NHS Foundation Trust

University departments
Department of Oncology
NHS or other affiliations
Addenbrookes Hospital

Position: Senior Clinical Investigator Scientist and Consultant Gastroenterologist
Personal home page:

PubMed journal articles - click here

Research description

I have an interest in early detection of upper gastro-intestinal cancer, with particular attention to oesophageal and gastric cancer and risk stratification of patients with Barrett's oesophagus. My research focuses on novel imaging modalities and clinical utility of molecular biomarkers.

I am a Senior Clinical Investigator Scientist at the University of Cambridge and Honorary Consultant Gastroenterology at Cambridge University. I completed my medical and specialty training at the University of Naples in Italy and completed a postdoc at the Institute of Molecular Cancer Research at the University of Zurich (Switzerland) to study colon cancer biology. I have been in Cambridge UK since 2007, first as clinical lecturer and research fellow, and then as Clinician Scientist and Gastroenterology consultant.

Over the last few years in Cambridge I have developed a strong research interest in pre-malignant conditions of the oesophagus and stomach. In particular I focus on Barrett's oesophagus, which I believe is an extraordinary research model to study epithelial carcinogenesis and new technologies for early detection. My research has embraced key aspects of the disease from molecular pathogenesis, to tissue biomarkers for patient stratification and advanced endoscopic imaging for the diagnosis of dysplasia and cancer. My early studies in Barrett's oesophagus have elucidated the role of Homeobox genes in the development and progression of Barrett's neoplasia. More recently I have invested time and resources on advanced endoscopic imaging and molecular biomarkers. For the first time, I have developed a novel diagnostic approach based on the integration of endoscopic imaging and biomarkers, which used Barrett's neoplasia as research model, but it is applicable to all pre-malignant diseases. Two recent multi-centre studies led by our group (TIME and ACE-B trials) have demonstrated that it is possible to increase diagnostic accuracy for early cancer by combining image-enhance endoscopy and molecular biomarkers. We are also currently investigating novel imaging modalities including multispectral and hyperspectral endoscopy, optoacustic imaging and fluorescence endoscopy.

We are also active in the field of gastric cancer, with particular focus on early detection in patients with hereditary diffuse gastric cancer and non-endoscopic diagnosis of individuals at risk gastric cancer.

We have active collaborations within the University of Cambridge with the Department of Physics (Prof. Sarah Bohndiek) and the Department of Veterinary Medicine (Dr Tim Williams) and we are part of two large European Consortia (ESOTRAC and Immune Image) to investigate novel imaging techniques for early detection and molecular characterization of oesophageal cancer

Research Programme or Virtual Institute
Early Cancer Institute
Methods and technologies
Clinical trials
Confocal microscopy
Fluorescence microscopy
Tumour type interests
Barrett's oesophagus
Oesophageal Cancer
Endoscopic Imaging
Molecular Biomarkers
Recent publications:
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Key publications

Image enhanced endoscopy and molecular biomarkers vs Seattle protocol to diagnose dysplasia in Barrett's esophagus. Vithayathil M, Modolell I, Ortiz-Fernandez-Sordo J, Oukrif D, Pappas A, Januszewicz W, O'Donovan M, Hadjinicolaou A, Bianchi M, Blasko A, White J, Kaye P, Novelli M, Wernisch L, Ragunath K, di Pietro M*. Clin Gastroenterol Hepatol. 2022 Feb

Use of a Cytosponge biomarker panel to prioritise endoscopic Barrett's oesophagus surveillance: a cross-sectional study followed by a real-world prospective pilot. Pilonis ND, Killcoyne S, Tan WK, O'Donovan M, Malhotra S, Tripathi M, Miremadi A, Debiram-Beecham I, Evans T, Phillips R, Morris DL, Vickery C, Harrison J, di Pietro M, Ortiz-Fernandez-Sordo J, Haidry R, Kerridge A, Sasieni PD, Fitzgerald RC*. Lancet Oncol. 2022 Feb

First-in-human pilot study of snapshot multispectral endoscopy for early detection of Barrett's-related neoplasia.
Waterhouse DJ, Bano S, Januszewicz W, Stoyanov D, Fitzgerald RC, di Pietro M*, Bohndiek SE*. J Biomed Opt. 2021 Oct;26(10):106002

Cytosponge-TFF3 Testing can Detect Precancerous Mucosal Changes of the Stomach. Hadjinicolaou AV, Azizi AA, O'Donovan M, Debiram I, Fitzgerald RC, Di Pietro M*. Clin Gastroenterol Hepatol. 2021 Aug

Spectral Endoscopy Enhances Contrast for Neoplasia in Surveillance of Barrett's Esophagus. Waterhouse DJ, Januszewicz W, Ali S, Fitzgerald RC, di Pietro M*, Bohndiek SE*. Cancer Res. 2021 Jun 15;81(12):3415-3425

Cytosponge-trefoil factor 3 versus usual care to identify Barrett's oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial. Fitzgerald RC, di Pietro M, O'Donovan M, Maroni R, Muldrew B, Debiram-Beecham I, Gehrung M, Offman J, Tripathi M, Smith SG, Aigret B, Walter FM, Rubin G; BEST3 Trial team, Sasieni P. Lancet. 2020 Aug 1;396(10247):333-344

Single-bite versus double-bite technique for mapping biopsies during endoscopic surveillance for hereditary diffuse gastric cancer: a single-center, randomized trial. Pappas A, Tan WK, Waldock W, Richardson S, Tripathi M, Januszewicz W, Roberts G, O'Donovan M, Fitzgerald RC, di Pietro M*.
Endoscopy. 2021 Mar;53(3):246-253.

Aneuploidy in targeted endoscopic biopsies outperforms other tissue biomarkers in the prediction of histologic progression of Barrett's oesophagus: A multi-centre prospective cohort study. Hadjinicolaou AV, van Munster SN, Achilleos A, Santiago Garcia J, Killcoyne S, Ragunath K, Bergman JJGHM, Fitzgerald RC, di Pietro M*. EBioMedicine. 2020 Jun;56:102765

Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic. di Pietro M, Modolell I, O'Donovan M, Price C, Pilonis ND, Debiram-Beecham I, Fitzgerald RC*. Lancet Gastroenterol Hepatol. 2020 Sep;5(9):805-806

The utility of a methylation panel in the assessment of clinical response to radiofrequency ablation for Barrett's esophagus.
Januszewicz W, Subhash VV, Waldock W, Fernando DI, Bartalucci G, Chettouh H, Miremadi A, O'Donovan M, Fitzgerald RC, di Pietro M*.
EBioMedicine. 2020 Aug;58:102877

Development and Validation of Confocal Endomicroscopy Diagnostic Criteria for Low-Grade Dysplasia in Barrett's Esophagus.
di Pietro M*, Bertani H, OʼDonovan M, Santos P, Alastal H, Phillips R, Ortiz-Fernández-Sordo J, Iacucci M, Modolell I, Reggiani Bonetti L, Ragunath K, Wernisch L. Clin Transl Gastroenterol. 2019 Apr;10(4)

Autofluorescence-directed confocal endomicroscopy in combination with a three-biomarker panel can inform management decisions in Barrett?s esophagus. di Pietro M, Bird-Lieberman E, Liu X et al., Am J Gastroenterol 2015 Nov;110(11):1549-58

The combination of autofluorescence endoscopy and molecular biomarkers is a novel diagnostic tool for dysplasia in Barrett's esophagus.di Pietro M, Shariff MK, Boerwinkel DF et al, Gut. 2015 Jan;64(1):49-56

Shariff MK, Varghese S, O'Donovan M, Abdullahi Z, Liu X, Fitzgerald RC, di Pietro, M. Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett?s esophagus. Endoscopy. Endoscopy. 2016 Feb;48(2):110-6

British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus. Fitzgerald RC, di Pietro M, Ragunath K et al, Gut. 2014 Jan;63(1):7-42

Evidence for a functional role of epigenetically regulated midcluster HOXB genes in the development of Barrett?s esophagus. di Pietro M., Lao-Sirieix P., Boyle S., et al. PNAS, 2012 Jun 5;109(23):9077-82