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Uno K, Koike T, Hatta W, Saito M, Tanabe M, Masamune A. Development of Advanced Imaging and Molecular Imaging for Barrett's Neoplasia. Diagnostics (Basel) 2022; 12:2437. [PMID: 36292126 PMCID: PMC9600913 DOI: 10.3390/diagnostics12102437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
Barrett esophagus (BE) is a precursor to a life-threatening esophageal adenocarcinoma (EAC). Surveillance endoscopy with random biopsies is recommended for early intervention against EAC, but its adherence in the clinical setting is poor. Dysplastic lesions with flat architecture and patchy distribution in BE are hardly detected by high-resolution endoscopy, and the surveillance protocol entails issues of time and labor and suboptimal interobserver agreement for diagnosing dysplasia. Therefore, the development of advanced imaging technologies is necessary for Barrett's surveillance. Recently, non-endoscopic or endoscopic technologies, such as cytosponge, endocytoscopy, confocal laser endomicroscopy, autofluorescence imaging, and optical coherence tomography/volumetric laser endomicroscopy, were developed, but most of them are not clinically available due to the limited view field, expense of the equipment, and significant time for the learning curve. Another strategy is focused on the development of molecular biomarkers, which are also not ready to use. However, a combination of advanced imaging techniques together with specific biomarkers is expected to identify morphological abnormalities and biological disorders at an early stage in the surveillance. Here, we review recent developments in advanced imaging and molecular imaging for Barrett's neoplasia. Further developments in multiple biomarker panels specific for Barrett's HGD/EAC include wide-field imaging systems for targeting 'red flags', a high-resolution imaging system for optical biopsy, and a computer-aided diagnosis system with artificial intelligence, all of which enable a real-time and accurate diagnosis of dysplastic BE in Barrett's surveillance and provide information for precision medicine.
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Affiliation(s)
- Kaname Uno
- Division of Gastroenterology, Tohoku University Hospital, Sendai 981-8574, Japan
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Hoffman A, Atreya R, Rath T, Neurath MF. Use of Fluorescent Dyes in Endoscopy and Diagnostic Investigation. Visc Med 2020; 36:95-103. [PMID: 32355666 DOI: 10.1159/000506241] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 12/25/2022] Open
Abstract
Background The advancement of innovative endoscopic technology in terms of improving the visualization of the mucosa has been of significant benefit. Summary Advancements in image resolution, software processing, and optical filter technology have resulted in several techniques complemental to traditional white light endoscopy. These new techniques provide a real-time optical diagnosis as well as virtual histology of detected lesions. Optical molecular imaging permits a functional assessment within cells. Key Message Optical molecular imaging provides an understanding of cellular processes and permits validation of the specificity of fluorescent tracers and the possibility of quantifying the signal.
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Affiliation(s)
- Arthur Hoffman
- Department of Internal Medicine III, Clinic Aschaffenburg-Alzenau, Aschaffenburg, Germany
| | - Raja Atreya
- First Department of Medicine, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | - Timo Rath
- First Department of Medicine, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | - Markus F Neurath
- First Department of Medicine, Friedrich Alexander University Erlangen-Nuernberg, Erlangen, Germany
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Abstract
Barrett esophagus is a metaplastic change in the lining of the distal esophageal epithelium, characterized by replacement of the normal squamous epithelium by specialized intestinal metaplasia. The presence of Barrett esophagus increases the risk of esophageal adenocarcinoma several-fold. Esophageal adenocarcinoma is a malignancy with rapidly rising incidence and persistently poor outcomes when diagnosed after the onset of symptoms. Risk factors for Barrett esophagus include chronic gastroesophageal reflux, central obesity, white race, male gender, older age, smoking, and a family history of Barrett esophagus or esophageal adenocarcinoma. Screening for Barrett esophagus in those with several risk factors followed by endoscopic surveillance to detect dysplasia or adenocarcinoma is currently recommended by society guidelines. Minimally invasive nonendoscopic tools for the early detection of Barrett esophagus are currently being developed. Multimodality endoscopic therapy-using a combination of endoscopic resection and ablation techniques-for the treatment of dysplasia and early adenocarcinoma is successful in eliminating intestinal metaplasia and preventing progression to adenocarcinoma, with outcomes comparable to those after esophagectomy. Risk stratification of those diagnosed with Barrett esophagus is a challenge at present, with active research focused on identifying clinical and biomarker panels to identify those with low and high risk of progression. This narrative review highlights some of the challenges and recent progress in this field.
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Affiliation(s)
- Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Vivek Kaul
- Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY.
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Waterhouse DJ, Luthman AS, Yoon J, Gordon GSD, Bohndiek SE. Quantitative evaluation of comb-structure correction methods for multispectral fibrescopic imaging. Sci Rep 2018; 8:17801. [PMID: 30542081 PMCID: PMC6290790 DOI: 10.1038/s41598-018-36088-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 11/13/2018] [Indexed: 02/07/2023] Open
Abstract
Removing the comb artifact introduced by imaging fibre bundles, or 'fibrescopes', for example in medical endoscopy, is essential to provide high quality images to the observer. Multispectral imaging (MSI) is an emerging method that combines morphological (spatial) and chemical (spectral) information in a single data 'cube'. When a fibrescope is coupled to a spectrally resolved detector array (SRDA) to perform MSI, comb removal is complicated by the demosaicking step required to reconstruct the multispectral data cube. To understand the potential for using SRDAs as multispectral imaging sensors in medical endoscopy, we assessed five comb correction methods with respect to five performance metrics relevant to biomedical imaging applications: processing time, resolution, smoothness, signal and the accuracy of spectral reconstruction. By assigning weights to each metric, which are determined by the particular imaging application, our results can be used to select the correction method to achieve best overall performance. In most cases, interpolation gave the best compromise between the different performance metrics when imaging using an SRDA.
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Affiliation(s)
- Dale J Waterhouse
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - A Siri Luthman
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Jonghee Yoon
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - George S D Gordon
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
- Department of Engineering, University of Cambridge, Cambridge, CB3 0FA, UK
| | - Sarah E Bohndiek
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK.
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK.
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Luthman AS, Waterhouse DJ, Ansel-Bollepalli L, Yoon J, Gordon GSD, Joseph J, di Pietro M, Januszewicz W, Bohndiek SE. Bimodal reflectance and fluorescence multispectral endoscopy based on spectrally resolving detector arrays. JOURNAL OF BIOMEDICAL OPTICS 2018; 24:1-14. [PMID: 30358334 PMCID: PMC6975231 DOI: 10.1117/1.jbo.24.3.031009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/07/2018] [Indexed: 05/08/2023]
Abstract
Emerging clinical interest in combining standard white light endoscopy with targeted near-infrared (NIR) fluorescent contrast agents for improved early cancer detection has created demand for multimodal imaging endoscopes. We used two spectrally resolving detector arrays (SRDAs) to realize a bimodal endoscope capable of simultaneous reflectance-based imaging in the visible spectral region and multiplexed fluorescence-based imaging in the NIR. The visible SRDA was composed of 16 spectral bands, with peak wavelengths in the range of 463 to 648 nm and full-width at half-maximum (FWHM) between 9 and 26 nm. The NIR SRDA was composed of 25 spectral bands, with peak wavelengths in the range 659 to 891 nm and FWHM 7 to 15 nm. The spectral endoscope design was based on a "babyscope" model using a commercially available imaging fiber bundle. We developed a spectral transmission model to select optical components and provide reference endmembers for linear spectral unmixing of the recorded image data. The technical characterization of the spectral endoscope is presented, including evaluation of the angular field-of-view, barrel distortion, spatial resolution and spectral fidelity, which showed encouraging performance. An agarose phantom containing oxygenated and deoxygenated blood with three fluorescent dyes was then imaged. After spectral unmixing, the different chemical components of the phantom could be successfully identified via majority decision with high signal-to-background ratio (>3). Imaging performance was further assessed in an ex vivo porcine esophagus model. Our preliminary imaging results demonstrate the capability to simultaneously resolve multiple biological components using a compact spectral endoscopy system.
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Affiliation(s)
- A. Siri Luthman
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Center, Robinson Way, Cambridge, United Kingdom
| | - Dale J. Waterhouse
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Center, Robinson Way, Cambridge, United Kingdom
| | - Laura Ansel-Bollepalli
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Center, Robinson Way, Cambridge, United Kingdom
| | - Jonghee Yoon
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Center, Robinson Way, Cambridge, United Kingdom
| | - George S. D. Gordon
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Department of Engineering, Cambridge, United Kingdom
| | - James Joseph
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Center, Robinson Way, Cambridge, United Kingdom
| | - Massimiliano di Pietro
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Wladyslaw Januszewicz
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Sarah E. Bohndiek
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Center, Robinson Way, Cambridge, United Kingdom
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