title: Endoscopic histological assessment of colonic polyps by using elastic scattering spectroscopy.
abstract: BACKGROUND
  Elastic-scattering spectroscopy (ESS) can assess in vivo and in real-time the scattering and absorption properties of tissue related to underlying pathologies.
  
  
  OBJECTIVE
  To evaluate the potential of ESS for differentiating neoplastic from non-neoplastic polyps during colonoscopy.
  
  
  METHODS
  Pilot study, retrospective data analysis.
  
  
  METHODS
  Academic practice.
  
  
  METHODS
  A total of 83 patients undergoing screening/surveillance colonoscopy.
  
  
  METHODS
  ESS spectra of 218 polyps (133 non-neoplastic, 85 neoplastic) were acquired during colonoscopy. Spectral data were correlated with the classification of biopsy samples by 3 GI pathologists. High-dimensional methods were used to design diagnostic algorithms.
  
  
  METHODS
  Diagnostic performance of ESS.
  
  
  RESULTS
  Analysis of spectra from polyps of all sizes (N = 218) resulted in a sensitivity of 91.5%, specificity of 92.2%, and accuracy of 91.9% with a high-confidence rate of 90.4%. Restricting analysis to polyps smaller than 1 cm (n = 179) resulted in a sensitivity of 87.0%, specificity of 92.1%, and accuracy of 90.6% with a high-confidence rate of 89.3%. Analysis of polyps 5 mm or smaller (n = 157) resulted in a sensitivity of 86.8%, specificity of 91.2%, and accuracy of 90.1% with a high-confidence rate of 89.8%.
  
  
  CONCLUSIONS
  Sample size, retrospective validation used to obtain performance estimates.
  
  
  CONCLUSIONS
  Results indicate that ESS permits accurate, real-time classification of polyps as neoplastic or non-neoplastic. ESS is a simple, low cost, clinically robust method with minimal impact on procedure flow, especially when integrated into standard endoscopic biopsy tools. Performance on polyps 5 mm or smaller indicates that ESS may, in theory, achieve Preservation and Incorporation of Valuable Endoscopic Innovations performance thresholds. ESS may one day prove to be a useful tool used in endoscopic screening and surveillance of colorectal cancer.
authors.affiliation: Department of Medicine, Section of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts, USA; Department of Biomedical Engineering, College of Engineering, Boston University, Boston, Massachusetts, USA.
authors.forename: Eladio
authors.initials: E
authors.lastname: Rodriguez-Diaz
authors.affiliation: Department of Pathology, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Qin
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Cerda
authors.affiliation: Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Department of Medicine, Section of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts, USA; Department of Biomedical Engineering, College of Engineering, Boston University, Boston, Massachusetts, USA.
authors.forename: Irving J
authors.initials: IJ
authors.lastname: Bigio
authors.affiliation: Department of Medicine, Section of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts, USA; Medical Service, Gastroenterology Unit, VA Boston Healthcare System, Boston, Massachusetts, USA; Department of Biomedical Engineering, College of Engineering, Boston University, Boston, Massachusetts, USA.
authors.forename: Satish K
authors.initials: SK
authors.lastname: Singh
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000236:Adenoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D003661:Decision Support Techniques; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis / Q000295:instrumentation / Q000379:methods*