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Taylor-Williams M, Tao R, Sawyer TW, Waterhouse DJ, Yoon J, Bohndiek SE. Targeted multispectral filter array design for the optimization of endoscopic cancer detection in the gastrointestinal tract. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:036005. [PMID: 38560531 PMCID: PMC10978444 DOI: 10.1117/1.jbo.29.3.036005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024]
Abstract
Significance Color differences between healthy and diseased tissue in the gastrointestinal (GI) tract are detected visually by clinicians during white light endoscopy; however, the earliest signs of cancer are often just a slightly different shade of pink compared to healthy tissue making it hard to detect. Improving contrast in endoscopy is important for early detection of disease in the GI tract during routine screening and surveillance. Aim We aim to target alternative colors for imaging to improve contrast using custom multispectral filter arrays (MSFAs) that could be deployed in an endoscopic "chip-on-tip" configuration. Approach Using an open-source toolbox, Opti-MSFA, we examined the optimal design of MSFAs for early cancer detection in the GI tract. The toolbox was first extended to use additional classification models (k -nearest neighbor, support vector machine, and spectral angle mapper). Using input spectral data from published clinical trials examining the esophagus and colon, we optimized the design of MSFAs with three to nine different bands. Results We examined the variation of the spectral and spatial classification accuracies as a function of the number of bands. The MSFA configurations tested showed good classification accuracies when compared to the full hyperspectral data available from the clinical spectra used in these studies. Conclusion The ability to retain good classification accuracies with a reduced number of spectral bands could enable the future deployment of multispectral imaging in an endoscopic chip-on-tip configuration using simplified MSFA hardware. Further studies using an expanded clinical dataset are needed to confirm these findings.
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Affiliation(s)
- Michaela Taylor-Williams
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - Ran Tao
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - Travis W. Sawyer
- University of Arizona, Wyant College of Optical Sciences, Tucson, Arizona, United States
| | - Dale J. Waterhouse
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
- University College London, Wellcome/EPRSC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Jonghee Yoon
- Ajou University, Department of Physics, Suwon-si, Republic of Korea
| | - Sarah E. Bohndiek
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
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2
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Fu Y, Zhang S, Ma L, Zhao Z, Liao H, Xie T. Comprehensive advancement in endoscopy: optical design, algorithm enhancement, and clinical validation for merged WLI and CBI imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:506-523. [PMID: 38404328 PMCID: PMC10890891 DOI: 10.1364/boe.506134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/16/2023] [Accepted: 12/10/2023] [Indexed: 02/27/2024]
Abstract
As endoscopic imaging technology advances, there is a growing clinical demand for enhanced imaging capabilities. Although conventional white light imaging (WLI) endoscopy offers realistic images, it often cannot reveal detailed characteristics of the mucosa. On the other hand, optical staining endoscopy, such as Compound Band Imaging (CBI), can discern subtle structures, serving to some extent as an optical biopsy. However, its image brightness is low, and the colors can be abrupt. These two techniques, commonly used in clinical settings, have complementary advantages. Nonetheless, they require different lighting conditions, which makes it challenging to combine their imaging strengths on living tissues. In this study, we introduce a novel endoscopic imaging technique that effectively combines the advantages of both WLI and CBI. Doctors don't need to manually switch between these two observation modes, as they can obtain the image information of both modes in one image. We calibrated an appropriate proportion for simultaneous illumination with the light required for WLI and CBI. We designed a new illumination spectrum tailored for gastrointestinal examination, achieving their fusion at the optical level. Using a new algorithm that focuses on enhancing specific hemoglobin tissue features, we restored narrow-band image characteristics lost due to the introduction of white light. Our hardware and software innovations not only boost the illumination brightness of the endoscope but also ensure the narrow-band feature details of the image. To evaluate the reliability and safety of the new endoscopic system, we conducted a series of tests in line with relevant international standards and validated the design parameters. For clinical trials, we collected a total of 256 sets of images, each set comprising images of the same lesion location captured using WLI, CBI, and our proposed method. We recruited four experienced clinicians to conduct subjective evaluations of the collected images. The results affirmed the significant advantages of our method. We believe that the novel endoscopic system we introduced has vast potential for clinical application in the future.
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Affiliation(s)
- Ye Fu
- Department of Biomedical Engineering, College of Future Technology, Peking University, Beijing 100871, China
| | - Shipeng Zhang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Longfei Ma
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Zhe Zhao
- Beijing Tsinghua Changgung Hospital, Beijing 102218, China
- School of Clinical Medicine, Tsinghua University, Beijing 100084, China
| | - Hongen Liao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Tianyu Xie
- Department of Biomedical Engineering, College of Future Technology, Peking University, Beijing 100871, China
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Taylor-Williams M, Spicer G, Bale G, Bohndiek SE. Noninvasive hemoglobin sensing and imaging: optical tools for disease diagnosis. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:JBO-220074VR. [PMID: 35922891 PMCID: PMC9346606 DOI: 10.1117/1.jbo.27.8.080901] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/27/2022] [Indexed: 05/08/2023]
Abstract
SIGNIFICANCE Measurement and imaging of hemoglobin oxygenation are used extensively in the detection and diagnosis of disease; however, the applied instruments vary widely in their depth of imaging, spatiotemporal resolution, sensitivity, accuracy, complexity, physical size, and cost. The wide variation in available instrumentation can make it challenging for end users to select the appropriate tools for their application and to understand the relative limitations of different methods. AIM We aim to provide a systematic overview of the field of hemoglobin imaging and sensing. APPROACH We reviewed the sensing and imaging methods used to analyze hemoglobin oxygenation, including pulse oximetry, spectral reflectance imaging, diffuse optical imaging, spectroscopic optical coherence tomography, photoacoustic imaging, and diffuse correlation spectroscopy. RESULTS We compared and contrasted the ability of different methods to determine hemoglobin biomarkers such as oxygenation while considering factors that influence their practical application. CONCLUSIONS We highlight key limitations in the current state-of-the-art and make suggestions for routes to advance the clinical use and interpretation of hemoglobin oxygenation information.
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Affiliation(s)
- Michaela Taylor-Williams
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom, United Kingdom
| | - Graham Spicer
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom, United Kingdom
| | - Gemma Bale
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom, United Kingdom
- University of Cambridge, Electrical Division, Department of Engineering, Cambridge, United Kingdom, United Kingdom
| | - Sarah E Bohndiek
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom, United Kingdom
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, United Kingdom, United Kingdom
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4
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Tang Y, Hu M, Tang F, Huang R, Wang H, Wu D, Lan P. Easily-injectable shear-thinning hydrogel provides long-lasting submucosal barrier for gastrointestinal endoscopic surgery. Bioact Mater 2021; 15:44-52. [PMID: 35386335 PMCID: PMC8940951 DOI: 10.1016/j.bioactmat.2021.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/22/2022] Open
Abstract
Submucosal injection material has shown protective effect against gastrointestinal injury during endoscopic surgery in clinic. However, the protective ability of existing submucosal injection material is strictly limited by their difficult injectability and short barrier time. Herein, we report a shear-thinning gellan gum hydrogel that simultaneously has easy injectability and long-lasting barrier function, together with good hemostatic property and biocompatibility. Shear-thinning property endows our gellan gum hydrogel with excellent endoscopic injection performance, and the injection pressure of our gellan gum hydrogel is much lower than that of the small molecule solution (50 wt% dextrose) when injected through the endoscopic needle. More importantly, our gellan gum hydrogel shows much stronger barrier retention ability than normal saline and sodium hyaluronate solution in the ex vivo and in vivo models. Furthermore, our epinephrine-containing gellan gum hydrogel has a satisfactory hemostatic effect in the mucosal lesion resection model of pig. These results indicate an appealing application prospect for gellan gum hydrogel utilizing as a submucosal injection material in endoscopic surgery. Submucosal injection materials are widely used in endoscopic surgery to protect against gastrointestinal injury. Gellan gum hydrogel with shear-thinning character is a novel submucosal injection material. Gellan gum hydrogel simultaneously has easy injectability and long-lasting barrier performance in vivo. Epinephrine-containing gellan gum hydrogel has a satisfactory hemostatic effect.
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Waterhouse DJ, Bano S, Januszewicz W, Stoyanov D, Fitzgerald RC, di Pietro M, Bohndiek SE. First-in-human pilot study of snapshot multispectral endoscopy for early detection of Barrett's-related neoplasia. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210159R. [PMID: 34628734 PMCID: PMC8501416 DOI: 10.1117/1.jbo.26.10.106002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/02/2021] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE The early detection of dysplasia in patients with Barrett's esophagus could improve outcomes by enabling curative intervention; however, dysplasia is often inconspicuous using conventional white-light endoscopy. AIM We sought to determine whether multispectral imaging (MSI) could be applied in endoscopy to improve detection of dysplasia in the upper gastrointestinal (GI) tract. APPROACH We used a commercial fiberscope to relay imaging data from within the upper GI tract to a snapshot MSI camera capable of collecting data from nine spectral bands. The system was deployed in a pilot clinical study of 20 patients (ClinicalTrials.gov NCT03388047) to capture 727 in vivo image cubes matched with gold-standard diagnosis from histopathology. We compared the performance of seven learning-based methods for data classification, including linear discriminant analysis, k-nearest neighbor classification, and a neural network. RESULTS Validation of our approach using a Macbeth color chart achieved an image-based classification accuracy of 96.5%. Although our patient cohort showed significant intra- and interpatient variance, we were able to resolve disease-specific contributions to the recorded MSI data. In classification, a combined principal component analysis and k-nearest-neighbor approach performed best, achieving accuracies of 95.8%, 90.7%, and 76.1%, respectively, for squamous, non-dysplastic Barrett's esophagus and neoplasia based on majority decisions per-image. CONCLUSIONS MSI shows promise for disease classification in Barrett's esophagus and merits further investigation as a tool in high-definition "chip-on-tip" endoscopes.
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Affiliation(s)
- Dale J. Waterhouse
- University of Cambridge, Department of Physics and CRUK Cambridge Institute, Cambridge, United Kingdom
- University College London, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Sophia Bano
- University College London, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Wladyslaw Januszewicz
- Medical Centre for Postgraduate Education, Department of Gastroenterology, Hepatology and Clinical Oncology, Warsaw, Poland
| | - Dan Stoyanov
- University College London, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, London, United Kingdom
| | - Rebecca C. Fitzgerald
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Massimiliano di Pietro
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Sarah E. Bohndiek
- University of Cambridge, Department of Physics and CRUK Cambridge Institute, Cambridge, United Kingdom
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6
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Yang Z, Yang F, Yang M, Qi Y, Jiang M, Xuan J, Liu Y, Tao H, Liu Y, Wang F. Prediction of overall survival in patients with Stage I esophageal cancer: A novel web-based calculator. J Surg Oncol 2021; 124:767-779. [PMID: 34263466 DOI: 10.1002/jso.26594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/27/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS In this study, we aimed to develop a convenient web-based calculator to predict the overall survival (OS) of patients with Stage I esophageal cancer (EC). METHODS Data of 1664 patients, between 2004 and 2015, were extracted from the Surveillance, Epidemiology, and End Results database. Least absolute shrinkage and selection operator regression was employed to sift variables; subsequently, Cox proportional hazards regression model was built. We applied the enhanced bootstrap validation to appraise the discrimination and calibration of the model. Clinical benefit was measured using decision curve analysis (DCA). Thereafter, a web-based calculator based on the model, which could be used to predict the 1-, 3-, and 5-year OS rates, was developed. RESULTS Race, age, histologic type, grade, N stage, and therapeutic methods were selected. C-indices of the prediction model in the training and validation groups were 0.726 (95% confidence interval [CI], 0.679-0.773) and 0.724 (95% CI, 0.679-0.769), respectively. Calibration curves showed good agreement between the groups. The DCA demonstrated that the prediction model is clinically useful. CONCLUSIONS The prediction model we developed showed a good performance in calculating the OS rates in patients with Stage I EC. The web-based calculator is available at https://championship.shinyapps.io/dynnomapp/.
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Affiliation(s)
- Zhuoxin Yang
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Fengwu Yang
- Department of Laboratory Medicine, Shandong Guoxin Healthcare Group Zibo Hospital, Zibo, China
| | - Miaofang Yang
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ying Qi
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Mingzuo Jiang
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ji Xuan
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yu Liu
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hui Tao
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuxiu Liu
- Data and Statistics Unit of Department of Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, China.,Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Fangyu Wang
- Department of Gastroenterology and Hepatology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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7
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Waterhouse DJ, Januszewicz W, Ali S, Fitzgerald RC, di Pietro M, Bohndiek SE. Spectral Endoscopy Enhances Contrast for Neoplasia in Surveillance of Barrett's Esophagus. Cancer Res 2021; 81:3415-3425. [PMID: 34039635 PMCID: PMC7611389 DOI: 10.1158/0008-5472.can-21-0474] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/01/2021] [Accepted: 04/16/2021] [Indexed: 12/20/2022]
Abstract
Early detection of esophageal neoplasia enables curative endoscopic therapy, but the current diagnostic standard of care has low sensitivity because early neoplasia is often inconspicuous with conventional white-light endoscopy. Here, we hypothesized that spectral endoscopy could enhance contrast for neoplasia in surveillance of patients with Barrett's esophagus. A custom spectral endoscope was deployed in a pilot clinical study of 20 patients to capture 715 in vivo tissue spectra matched with gold standard diagnosis from histopathology. Spectral endoscopy was sensitive to changes in neovascularization during the progression of disease; both non-dysplastic and neoplastic Barrett's esophagus showed higher blood volume relative to healthy squamous tissue (P = 0.001 and 0.02, respectively), and vessel radius appeared larger in neoplasia relative to non-dysplastic Barrett's esophagus (P = 0.06). We further developed a deep learning algorithm capable of classifying spectra of neoplasia versus non-dysplastic Barrett's esophagus with high accuracy (84.8% accuracy, 83.7% sensitivity, 85.5% specificity, 78.3% positive predictive value, and 89.4% negative predictive value). Exploiting the newly acquired library of labeled spectra to model custom color filter sets identified a potential 12-fold enhancement in contrast between neoplasia and non-dysplastic Barrett's esophagus using application-specific color filters compared with standard-of-care white-light imaging (perceptible color difference = 32.4 and 2.7, respectively). This work demonstrates the potential of endoscopic spectral imaging to extract vascular properties in Barrett's esophagus, to classify disease stages using deep learning, and to enable high-contrast endoscopy. SIGNIFICANCE: The results of this pilot first-in-human clinical trial demonstrate the potential of spectral endoscopy to reveal disease-associated vascular changes and to provide high-contrast delineation of neoplasia in the esophagus. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/81/12/3415/F1.large.jpg.
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Affiliation(s)
- Dale J Waterhouse
- Department of Physics and Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Wladyslaw Januszewicz
- Department of Gastroenterology, Hepatology, and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland
| | - Sharib Ali
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Rebecca C Fitzgerald
- MRC Cancer Unit, Hutchison/MRC Research Center, University of Cambridge, Cambridge, United Kingdom
| | - Massimiliano di Pietro
- MRC Cancer Unit, Hutchison/MRC Research Center, University of Cambridge, Cambridge, United Kingdom.
| | - Sarah E Bohndiek
- Department of Physics and Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom.
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8
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Garg S, Xie J, Inamdar S, Thomas SL, Trindade AJ. Spatial distribution of dysplasia in Barrett's esophagus segments before and after endoscopic ablation therapy: a meta-analysis. Endoscopy 2021; 53:6-14. [PMID: 32503057 DOI: 10.1055/a-1195-1000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dysplasia in Barrett's esophagus (BE) is focal and difficult to locate. The aim of this meta-analysis was to understand the spatial distribution of dysplasia in BE before and after endoscopic ablation therapy. METHODS A systematic search was performed of multiple databases to July 2019. The location of dysplasia prior to ablation was determined using a clock-face orientation (right or left half of the esophagus). The location of the dysplasia post-ablation was classified as within the tubular esophagus or at the top of the gastric folds (TGF). RESULTS 13 studies with 2234 patients were analyzed. Pooled analysis from six studies (819 lesions in 802 patients) showed that before ablation, dysplasia was more commonly located in the right half versus the left half (odds ratio [OR] 4.3; 95 % confidence interval [CI] 2.33 - 7.93; P < 0.001). Pooled analysis from seven studies showed that dysplasia after ablation recurred in 101 /1432 patients (7.05 %; 95 %CI 5.7 % - 8.4 %). Recurrence of dysplasia was located more commonly at the TGF (n = 68) than in the tubular esophagus (n = 34; OR 5.33; 95 %CI 1.75 - 16.21; P = 0.003). Of the esophageal lesions, 90 % (27 /30) were visible, whereas only 46 % (23 /50) of the recurrent dysplastic lesions at the TGF were visible (P < 0.001). CONCLUSION Before ablation, dysplasia in BE is found more frequently in the right half of the esophagus versus the left. Post-ablation recurrence is more commonly found in the TGF and is non-visible, compared with the tubular esophagus, which is mainly visible.
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Affiliation(s)
- Shashank Garg
- Division of Gastroenterology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jesse Xie
- Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sumant Inamdar
- Division of Gastroenterology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sheila L Thomas
- Education and Research Services, UAMS Library, Little Rock, Arkansas, USA
| | - Arvind J Trindade
- Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York, USA
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9
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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: 8] [Impact Index Per Article: 2.0] [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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10
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Gordon GSD, Joseph J, Alcolea MP, Sawyer T, Williams C, Fitzpatrick CRM, Jones PH, di Pietro M, Fitzgerald RC, Wilkinson TD, Bohndiek SE. Quantitative phase and polarization imaging through an optical fiber applied to detection of early esophageal tumorigenesis. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-13. [PMID: 31840442 PMCID: PMC7006047 DOI: 10.1117/1.jbo.24.12.126004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/18/2019] [Indexed: 05/30/2023]
Abstract
Phase and polarization of coherent light are highly perturbed by interaction with microstructural changes in premalignant tissue, holding promise for label-free detection of early tumors in endoscopically accessible tissues such as the gastrointestinal tract. Flexible optical multicore fiber (MCF) bundles used in conventional diagnostic endoscopy and endomicroscopy scramble phase and polarization, restricting clinicians instead to low-contrast amplitude-only imaging. We apply a transmission matrix characterization approach to produce full-field en-face images of amplitude, quantitative phase, and resolved polarimetric properties through an MCF. We first demonstrate imaging and quantification of biologically relevant amounts of optical scattering and birefringence in tissue-mimicking phantoms. We present an entropy metric that enables imaging of phase heterogeneity, indicative of disordered tissue microstructure associated with early tumors. Finally, we demonstrate that the spatial distribution of phase and polarization information enables label-free visualization of early tumors in esophageal mouse tissues, which are not identifiable using conventional amplitude-only information.
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Affiliation(s)
- George S. D. Gordon
- University of Cambridge, Department of Engineering, Cambridge, United Kingdom
| | - James Joseph
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Maria P. Alcolea
- University of Cambridge, Wellcome Trust MRC Stem Cell Institute, Cambridge, United Kingdom
| | - Travis Sawyer
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Calum Williams
- University of Cambridge, Department of Engineering, Cambridge, United Kingdom
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
| | | | - Philip H. Jones
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Massimiliano di Pietro
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Rebecca C. Fitzgerald
- University of Cambridge, MRC Cancer Unit, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | | | - Sarah E. Bohndiek
- University of Cambridge, Department of Physics, Cavendish Laboratory, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, United Kingdom
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11
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Gataric M, Gordon GSD, Renna F, Ramos AGCP, Alcolea MP, Bohndiek SE. Reconstruction of Optical Vector-Fields With Applications in Endoscopic Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:955-967. [PMID: 30334753 PMCID: PMC6456146 DOI: 10.1109/tmi.2018.2875875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/09/2018] [Indexed: 05/03/2023]
Abstract
We introduce a framework for the reconstruction of the amplitude, phase, and polarization of an optical vector-field using measurements acquired by an imaging device characterized by an integral transform with an unknown spatially variant kernel. By incorporating effective regularization terms, this new approach is able to recover an optical vector-field with respect to an arbitrary representation system, which may be different from the one used for device calibration. In particular, it enables the recovery of an optical vector-field with respect to a Fourier basis, which is shown to yield indicative features of increased scattering associated with tissue abnormalities. We demonstrate the effectiveness of our approach using synthetic holographic images and biological tissue samples in an experimental setting, where the measurements of an optical vector-field are acquired by a multicore fiber endoscope, and observe that indeed the recovered Fourier coefficients are useful in distinguishing healthy tissues from tumors in early stages of oesophageal cancer.
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12
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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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