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Endoscopy 2016; 48(02): A1-A13
DOI: 10.1055/s-0034-1392803
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Multimodal endoscope can quantify wide-field fluorescence detection of Barrett’s neoplasia

Bishnu P. Joshi
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
Xiyu Duan
2   Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
,
Richard S. Kwon
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
Cyrus Piraka
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
B. Joseph Elmunzer
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
Shaoying Lu
3   Department of General Surgery, First Affiliated Hospital, Medical School of Xi’an Jiaotong University, People’s Republic of China
,
Emily F. Rabinsky
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
David G. Beer
4   Department of Surgery, Section of Thoracic Surgery, University of Michigan, Ann Arbor, Michigan, USA
,
Henry D. Appelman
5   Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
,
Scott R. Owens
5   Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
,
Rork Kuick
6   University of Michigan Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
,
Nobuyuki Doguchi
7   Olympus Medical Systems Corp., Tokyo, Japan
,
D. Kim Turgeon
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
Thomas D. Wang
1   Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
2   Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
8   Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA
› Author Affiliations
Further Information

Publication History

submitted 06 March 2015

accepted after revision 01 June 2015

Publication Date:
01 October 2015 (online)

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Video Comment on Bishnu P. Joshi et al.Endoscopy 2016; 48(02): v5-v5
DOI: 10.1055/s-0042-101361

Background and study aims: To demonstrate the clinical use of a multimodal endoscope with a targeted fluorescently labeled peptide for quantitative detection of Barrett’s neoplasia.

Patients and methods: We studied 50 patients with Barrett’s esophagus using a prototype multimodal endoscope with a fluorescently labeled peptide. Co-registered fluorescence and reflectance images were converted to ratios to correct for differences in distance and geometry over the image field of view. The ratio images were segmented using a unique threshold that maximized the variance between high and low intensities to localize regions of high grade dysplasia (HGD) and esophageal adenocarcinoma (EAC).

Results: Early neoplasia (HGD and EAC) was identified with 94 % specificity and 96 % positive predictive value at a threshold of 1.49. The mean results for HGD and EAC were significantly greater than those for squamous/Barrett’s esophagus and low grade dysplasia by one-way analysis of variance (ANOVA). The receiver operator characteristic curve for detection of early neoplasia had an area under the curve of 0.884. No adverse events associated with the endoscope or peptide were found.

Conclusion: A multimodal endoscope can quantify fluorescence images from targeted peptides to localize early Barrett’s neoplasia. (ClinicalTrials.gov number NCT01630798.)

Figs. e2 – e5, e9, Supplementary references

 

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