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

Bishnu P. Joshi; Xiyu Duan; Richard S. Kwon; Cyrus Piraka; B. Joseph Elmunzer; Shaoying Lu; Emily F. Rabinsky; David G. Beer; Henry D. Appelman; Scott R. Owens; Rork Kuick; Nobuyuki Doguchi; D. Kim Turgeon; Thomas D. Wang

doi:10.1055/s-0034-1392803

Endoscopy, Inhaltsverzeichnis

Endoscopy 2016; 48(02): A1-A13
DOI: 10.1055/s-0034-1392803

Innovations and brief communications

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

Bishnu P. Joshi

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

,

Xiyu Duan

²Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA

,

Richard S. Kwon

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

,

Cyrus Piraka

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

,

B. Joseph Elmunzer

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

,

Shaoying Lu

³Department of General Surgery, First Affiliated Hospital, Medical School of Xi’an Jiaotong University, People’s Republic of China

,

Emily F. Rabinsky

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

,

David G. Beer

⁴Department of Surgery, Section of Thoracic Surgery, University of Michigan, Ann Arbor, Michigan, USA

,

Henry D. Appelman

⁵Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA

,

Scott R. Owens

⁵Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA

,

Rork Kuick

⁶University of Michigan Cancer Center, University of Michigan, Ann Arbor, Michigan, USA

,

Nobuyuki Doguchi

⁷Olympus Medical Systems Corp., Tokyo, Japan

,

D. Kim Turgeon

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

,

Thomas D. Wang

¹Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA

²Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA

⁸Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA

› Institutsangaben

Abstract

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.)

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Referenzen

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