Multispectral scanning during endoscopy guides biopsy of dysplasia in Barrett's esophagus.
Esophageal cancer is increasing in frequency in the United States faster than any other cancer. Barrett's esophagus, an otherwise benign complication of esophageal reflux, affects approximately three million Americans and precedes almost all cases of esophageal cancer. If detected as high-grade dysplasia (HGD), most esophageal cancers can be prevented. Standard-of-care screening for dysplasia uses visual endoscopy and a prescribed pattern of biopsy. This procedure, in which a tiny fraction of the affected tissue is selected for pathological examination, has a low probability of detection because dysplasia is highly focal and visually indistinguishable. We developed a system called endoscopic polarized scanning spectroscopy (EPSS), which performs rapid optical scanning and multispectral imaging of the entire esophageal surface and provides diagnoses in near real time. By detecting and mapping suspicious sites, guided biopsy of invisible, precancerous dysplasia becomes practicable. Here we report the development of EPSS and its application in several clinical cases, one of which merits special consideration.
Qiu
Le
L
Biomedical Imaging and Spectroscopy Laboratory, Department of Obstetrics, Harvard University and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Pleskow
Douglas K
DK
Chuttani
Ram
R
Vitkin
Edward
E
Leyden
Jan
J
Ozden
Nuri
N
Itani
Sara
S
Guo
Lianyu
L
Sacks
Alana
A
Goldsmith
Jeffrey D
JD
Modell
Mark D
MD
Hanlon
Eugene B
EB
Itzkan
Irving
I
Perelman
Lev T
LT
D001471:Barrett Esophagus / Q000150:complications / Q000473:pathology*; D001706:Biopsy / Q000379:methods; D003952:Diagnostic Imaging / Q000379:methods; D004724:Endoscopy / Q000379:methods; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D013057:Spectrum Analysis / Q000379:methods
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