title: Quantitative evaluation of in vivo vital-dye fluorescence endoscopic imaging for the detection of Barrett's-associated neoplasia.
abstract: Current imaging tools are associated with inconsistent sensitivity and specificity for detection of Barrett's-associated neoplasia. Optical imaging has shown promise in improving the classification of neoplasia in vivo. The goal of this pilot study was to evaluate whether in vivo vital dye fluorescence imaging (VFI) has the potential to improve the accuracy of early-detection of Barrett's-associated neoplasia. In vivo endoscopic VFI images were collected from 65 sites in 14 patients with confirmed Barrett's esophagus (BE), dysplasia, oresophageal adenocarcinoma using a modular video endoscope and a high-resolution microendoscope(HRME). Qualitative image features were compared to histology; VFI and HRME images show changes in glandular structure associated with neoplastic progression. Quantitative image features in VFI images were identified for objective image classification of metaplasia and neoplasia, and a diagnostic algorithm was developed using leave-one-out cross validation. Three image features extracted from VFI images were used to classify tissue as neoplastic or not with a sensitivity of 87.8% and a specificity of 77.6% (AUC = 0.878). A multimodal approach incorporating VFI and HRME imaging can delineate epithelial changes present in Barrett's-associated neoplasia. Quantitative analysis of VFI images may provide a means for objective interpretation of BE during surveillance.
authors.affiliation: Rice University, Department of Bioengineering, MS-142, Box 1892, Houston, Texas 77251-1892, United States.
authors.forename: Nadhi
authors.initials: N
authors.lastname: Thekkek
authors.affiliation: Icahn School of Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1069, New York, New York 10029-6574, United States.
authors.forename: Michelle H
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Icahn School of Medicine, Mount Sinai Medical Center, Department of Pathology, One Gustave L. Levy Place, Box 1194, New York, New York 10029-6574, United States.
authors.forename: Alexandros D
authors.initials: AD
authors.lastname: Polydorides
authors.affiliation: Baylor College of Medicine, Department of Pathology, One Baylor Plaza, Cullen 271A, Houston, Texas 77030, United States.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Rosen
authors.affiliation: Baylor College of Medicine, Department of Medicine, One Baylor Plaza, Cullen 271A, Houston, Texas 77030, United States.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Anandasabapathy
authors.affiliation: Rice University, Department of Bioengineering, MS-142, Box 1892, Houston, Texas 77251-1892, United States.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Richards-Kortum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications / Q000473:pathology*; D053705:Capsule Endoscopes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004938:Esophageal Neoplasms / Q000209:etiology / Q000473:pathology*; D004945:Esophagoscopy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation*; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D008297:Male; D008856:Microscopy, Fluorescence / Q000295:instrumentation*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity