545 In Situ Rectal Spectral Markers for Colonic Neoplasia Risk Stratification-a Blinded Validation Study

Roy, Hemant K.; Mutyal, Nikhil N.; Goldberg, Michael J.; Du, Hong; Radosevich, Andrew J.; Bianchi, Laura; Rogers, Jeremy D.; Yen, Eugene F.; Tsang, Tat-Kin; Krosnjar, Nela; Jancan, Boris; Upadhye, Sudeep; Parker, Beth A.; Backman, Vadim

doi:10.1016/s0016-5085(12)60410-7

Cited by 2 publications

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“…In the blinded validation set, in vivo LEBS was able to discriminate between patients with no neoplasia vs those with advanced adenomas with 87% sensitivity and 78% specificity. 22 The test was not confounded by patients’ demographic and risk factors or benign lesions and remained accurate regardless of adenoma location (distal vs proximal lesions). 19 …”

Section: Risk Stratification Through Field Carcinogenesis Detectionmentioning

confidence: 92%

Spectroscopic Applications in Gastrointestinal Endoscopy

Roy¹,

Backman²

2012

Clinical Gastroenterology and Hepatology

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One of the major frontiers in biomedical optics has been as an adjunct to gastrointestinal endoscopy. In particular, spectroscopy of elastic light scattering has the potential of addressing many of the vexing challenges confronting endoscopists. This review discusses the principles of spectroscopy and critically evaluates performance in clinically significant scenarios. One of the best established applications is optical biopsy (in situ histological determination), and a number of techniques such as elastic scattering spectroscopy have demonstrated the ability to discriminate between neoplastic and non-neoplastic polyps. For flat dysplasia detection in Barrett's esophagus, some of the most promising spectroscopic technologies are angle-resolved low-coherence interferometry and endoscopic polarized scanning spectroscopy (the next generation light scattering spectroscopy). A new and exciting biological approach involves optical detection of field carcinogenesis. This can be exploited to reduce colonoscopic adenoma miss rate by assessing microcirculatory augmentation in the mucosa in the vicinity of the polyp using polarizationgatedspectroscopy. Furthermore, there are nano/micro-architectural correlates with diffuse field carcinogenesis throughout the colon. Indeed, technologies such as low coherence enhanced backscattering spectroscopy and partial wave spectroscopic microscopy have demonstrated that the detection of the nano-architectural alterations in the rectal mucosa can accurately sense advanced adenomas elsewhere in the colon. This may lend itself to a minimally intrusive risk stratification to identify patients who are most likely to harbor neoplasia and thus benefit from colonoscopy. Bridging these advances into the endoscopy suite requires pragmatic future development. Future studies need to focus on efficacy, cost, practicality (time required, etc), and particularly developing the paradigms that will impact upon clinical decision making. KeywordsSpectroscopy; Endoscopy; Cancer Screening; Biophotonics; Field Carcinogenesis Recently, a number of reports have heralded endoscopic triumphs in the cancer prevention arena. For instance, colonoscopic polypectomy resulted in an approximately 50% reduction in mortality from colorectal cancer (CRC). 1 With regard to Barrett's, radiofrequency ablation showed a remarkable approximately 90% decrease in esophageal adenocarcinoma development in patients harboring high-grade dysplasia. 2 However, there is considerable work remaining as highlighted by the continued toll of CRC (second leading cause of cancer

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Section: Risk Stratification Through Field Carcinogenesis Detectionmentioning

confidence: 92%