Gastrointestinal tissue diagnosis by laser-induced fluorescence spectroscopy at endoscopy.
An endoscope-compatible, optical fiber system has been developed which can be used to obtain laser-induced fluorescence spectra of mucosal abnormalities during endoscopy in real time. The results of our previous in vitro studies have suggested that laser-induced fluorescence tissue spectra are sufficiently unique that they can be used to accurately diagnose mucosal abnormalities in some systems. To test this hypothesis in vivo, laser-induced fluorescence spectra were obtained during colonoscopy from 31 colonic adenomas, 4 hyperplastic polyps, and 32 examples of normal mucosa in 20 patients. The resulting spectra could be used to correctly differentiate adenomas from normal colonic mucosa and hyperplastic polyps in 97% of the specimens studied with the resulting sensitivity, specificity, and positive predictive value of 100%, 97%, and 94%, respectively. These results, although preliminary in nature, suggest that laser-induced fluorescence spectra can be used in the recognition and differential diagnosis of mucosal abnormalities at endoscopy.
Cothren
R M
RM
Division of Research, Cleveland Clinic Foundation, Ohio 44195.
Richards-Kortum
R
R
Sivak
M V
MV
Fitzmaurice
M
M
Rava
R P
RP
Boyce
G A
GA
Doxtader
M
M
Blackman
R
R
Ivanc
T B
TB
Hayes
G B
GB
D000236:Adenoma / Q000175:diagnosis*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis*; D007417:Intestinal Polyps / Q000175:diagnosis*; D007422:Intestines / Q000473:pathology*; D007834:Lasers; D013050:Spectrometry, Fluorescence / Q000379:methods*