title: Beyond endoscopic assessment in inflammatory bowel disease: real-time histology of disease activity by non-linear multimodal imaging.
abstract: Assessing disease activity is a prerequisite for an adequate treatment of inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis. In addition to endoscopic mucosal healing, histologic remission poses a promising end-point of IBD therapy. However, evaluating histological remission harbors the risk for complications due to the acquisition of biopsies and results in a delay of diagnosis because of tissue processing procedures. In this regard, non-linear multimodal imaging techniques might serve as an unparalleled technique that allows the real-time evaluation of microscopic IBD activity in the endoscopy unit. In this study, tissue sections were investigated using the non-linear multimodal microscopy combination of coherent anti-Stokes Raman scattering (CARS), two-photon excited auto fluorescence (TPEF) and second-harmonic generation (SHG). After the measurement a gold-standard assessment of histological indexes was carried out based on a conventional H&E stain. Subsequently, various geometry and intensity related features were extracted from the multimodal images. An optimized feature set was utilized to predict histological index levels based on a linear classifier. Based on the automated prediction, the diagnosis time interval is decreased. Therefore, non-linear multimodal imaging may provide a real-time diagnosis of IBD activity suited to assist clinical decision making within the endoscopy unit.
authors.affiliation: Leibniz Institute of Photonic Technology, Jena, Germany.|Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Olga
authors.initials: O
authors.lastname: Chernavskaia
authors.affiliation: Leibniz Institute of Photonic Technology, Jena, Germany.|Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Sandro
authors.initials: S
authors.lastname: Heuke
authors.affiliation: Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Vieth
authors.affiliation: Institute of Medical Biotechnology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.|Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander University of Erlangen-Nuremberg.
authors.forename: Oliver
authors.initials: O
authors.lastname: Friedrich
authors.affiliation: Institute of Medical Biotechnology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.|Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander University of Erlangen-Nuremberg.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schürmann
authors.affiliation: Medical Department 1, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Raja
authors.initials: R
authors.lastname: Atreya
authors.affiliation: Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stallmach
authors.affiliation: Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander University of Erlangen-Nuremberg.|Medical Department 1, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Markus F
authors.initials: MF
authors.lastname: Neurath
authors.affiliation: Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander University of Erlangen-Nuremberg.|Medical Department 1, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Waldner
authors.affiliation: Institute of Pathology, Jena University Hospital, Jena, Germany.
authors.forename: Iver
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schmitt
authors.affiliation: Leibniz Institute of Photonic Technology, Jena, Germany.|Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bocklitz
authors.affiliation: Leibniz Institute of Photonic Technology, Jena, Germany.|Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Popp
mesh_terms: D001706:Biopsy; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000473:pathology; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D019723:Endoscopes; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D064847:Multimodal Imaging / Q000379:methods*; D017711:Nonlinear Dynamics; D017785:Photons; D013059:Spectrum Analysis, Raman