Eladio Rodriguez-Diaz1,2, Lisa I Jepeal1, György Baffy3,4, Wai-Kit Lo3,4, Hiroshi MashimoMD3,4, Ousama A'amar2, Irving J Bigio2,5, Satish K Singh6,7,8,9,10. 1. Research Service, VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA, 02130, USA. 2. Department of Biomedical Engineering, College of Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA. 3. Department of Medicine, Section of Gastroenterology, VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA, 02130, USA. 4. Department of Medicine, Brigham and Women's Hospital Boston and Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA. 5. Department of Medicine, Boston University School of Medicine, 72 E. Concord St., Boston, MA, 02118, USA. 6. Research Service, VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA, 02130, USA. satish.singh@va.gov. 7. Department of Biomedical Engineering, College of Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA. satish.singh@va.gov. 8. Department of Medicine, Section of Gastroenterology, VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA, 02130, USA. satish.singh@va.gov. 9. Department of Medicine, Brigham and Women's Hospital Boston and Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA. satish.singh@va.gov. 10. Department of Medicine, Boston University School of Medicine, 72 E. Concord St., Boston, MA, 02118, USA. satish.singh@va.gov.
Abstract
BACKGROUND: Colonoscopic screening and surveillance for colorectal cancer could be made safer and more efficient if endoscopists could predict histology without the need to biopsy and perform histopathology on every polyp. Elastic-scattering spectroscopy (ESS), using fiberoptic probes integrated into standard biopsy tools, can assess, both in vivo and in real time, the scattering and absorption properties of tissue related to its underlying pathology. AIMS: The objective of this study was to evaluate prospectively the potential of ESS to predict polyp pathology accurately. METHODS: We obtained ESS measurements from patients undergoing screening/surveillance colonoscopy using an ESS fiberoptic probe integrated into biopsy forceps. The integrated forceps were used for tissue acquisition, following current standards of care, and optical measurement. All measurements were correlated to the index pathology. A machine learning model was then applied to measurements from 367 polyps in 169 patients to prospectively evaluate its predictive performance. RESULTS: The model achieved sensitivity of 0.92, specificity of 0.87, negative predictive value (NPV) of 0.87, and high-confidence rate (HCR) of 0.84 for distinguishing 220 neoplastic polyps from 147 non-neoplastic polyps of all sizes. Among 138 neoplastic and 131 non-neoplastic polyps ≤ 5 mm, the model achieved sensitivity of 0.91, specificity of 0.88, NPV of 0.89, and HCR of 0.83. CONCLUSIONS: Results show that ESS is a viable endoscopic platform for real-time polyp histology, particularly for polyps ≤ 5 mm. ESS is a simple, low-cost, clinically friendly, optical biopsy modality that, when interfaced with minimally obtrusive endoscopic tools, offers an attractive platform for in situ polyp assessment.
BACKGROUND: Colonoscopic screening and surveillance for colorectal cancer could be made safer and more efficient if endoscopists could predict histology without the need to biopsy and perform histopathology on every polyp. Elastic-scattering spectroscopy (ESS), using fiberoptic probes integrated into standard biopsy tools, can assess, both in vivo and in real time, the scattering and absorption properties of tissue related to its underlying pathology. AIMS: The objective of this study was to evaluate prospectively the potential of ESS to predict polyp pathology accurately. METHODS: We obtained ESS measurements from patients undergoing screening/surveillance colonoscopy using an ESS fiberoptic probe integrated into biopsy forceps. The integrated forceps were used for tissue acquisition, following current standards of care, and optical measurement. All measurements were correlated to the index pathology. A machine learning model was then applied to measurements from 367 polyps in 169 patients to prospectively evaluate its predictive performance. RESULTS: The model achieved sensitivity of 0.92, specificity of 0.87, negative predictive value (NPV) of 0.87, and high-confidence rate (HCR) of 0.84 for distinguishing 220 neoplastic polyps from 147 non-neoplastic polyps of all sizes. Among 138 neoplastic and 131 non-neoplastic polyps ≤ 5 mm, the model achieved sensitivity of 0.91, specificity of 0.88, NPV of 0.89, and HCR of 0.83. CONCLUSIONS: Results show that ESS is a viable endoscopic platform for real-time polyp histology, particularly for polyps ≤ 5 mm. ESS is a simple, low-cost, clinically friendly, optical biopsy modality that, when interfaced with minimally obtrusive endoscopic tools, offers an attractive platform for in situ polyp assessment.
Authors: Teaco Kuiper; Yasser A Alderlieste; Kristien M A J Tytgat; Marije S Vlug; Joyce A Nabuurs; Barbara A J Bastiaansen; Mark Löwenberg; Paul Fockens; Evelien Dekker Journal: Endoscopy Date: 2014-09-29 Impact factor: 10.093
Authors: Eladio Rodriguez-Diaz; Christopher Atkinson; Lisa I Jepeal; Adam Berg; Christopher S Huang; Sandra R Cerda; Michael J OʼBrien; Irving J Bigio; Francis A Farraye; Satish K Singh Journal: Inflamm Bowel Dis Date: 2014-06 Impact factor: 5.325
Authors: Barham K Abu Dayyeh; Nirav Thosani; Vani Konda; Michael B Wallace; Douglas K Rex; Shailendra S Chauhan; Joo Ha Hwang; Sri Komanduri; Michael Manfredi; John T Maple; Faris M Murad; Uzma D Siddiqui; Subhas Banerjee Journal: Gastrointest Endosc Date: 2015-01-16 Impact factor: 9.427