Diagnosis and grading of gastritis by non-invasive optical analysis.
OBJECTIVE
The precise identification of many diseases of the gastrointestinal tract requires the histological analysis of multiple biopsies of the lining mucosae, thus preventing an immediate diagnosis and the safe screening of the entire organ. To address these limitations, we developed a novel spectroscopic procedure for a real-time, non-invasive optical analysis of mucosae.


METHODS
We have used a fibre-optic probe that monitors light propagation through small tissue volumes to evaluate the antral and fundic mucosa of 51 patients that underwent gastroscopy for symptoms of dyspepsia. Several optical coefficients were computed from the recorded light reflectance, and confronted to the diagnosis made by an expert gastroscopist at the time of the clinical examination. Both evaluations were then validated by comparison with the histological diagnosis of a pathologist who screened biopsies taken at the sites of the optical measurements.


RESULTS
We report that the optical procedure discriminated normal and pathological gastric mucosae with a higher sensitivity and specificity than endoscopic diagnosis. We also show that the changes in light-scattering coefficient, which permitted the optical diagnosis of gastritis alterations, were indirectly correlated with the extent of inflammatory infiltration of the mucosa and detected mucosal alterations mild enough to escape endoscopic detection.


CONCLUSIONS
The results show that, in a normal clinical setting, the optical in vivo analysis provided by our system detects alterations typical of gastritis, and allow for their graded scoring with a specificity and sensitivity that compare well with those of standard histology, while avoiding the invasiveness of the latter procedure. The method is adaptable to the screening of other types of lesions and mucosae and, hence, should prove useful in improving available diagnostic approaches.
Department of Cell Physiology and Metabolism, University of Geneva, Medical School, Geneva, Switzerland. charvet9@etu.unige.ch
Igor
I
Charvet
Gaëlle
G
Ory
Philippe
P
Thueler
Marie-Anne
MA
Brundler
Michel
M
Saint-Ghislain
Nadereh
N
Azarpey
Antoine
A
Hadengue
Christian
C
Depeursinge
Bernard
B
Vermeulen
Paolo
P
Meda
D003938:Diagnostic Techniques, Digestive System / Q000295:instrumentation; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods; D005748:Gastric Fundus / Q000473:pathology; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000473:pathology; D012680:Sensitivity and Specificity