Evaluation of quantitative image analysis criteria for the high-resolution microendoscopic detection of neoplasia in Barrett’s esophagus

Abstract

Abstract. Early detection of neoplasia in patients with Barrett's esophagus is essential to improve outcomes. The aim of this ex vivo study was to evaluate the ability of high-resolution microendoscopic imaging and quantitative image analysis to identify neoplastic lesions in patients with Barrett's esophagus. Nine patients with pathologically confirmed Barrett's esophagus underwent endoscopic examination with biopsies or endoscopic mucosal resection. Resected fresh tissue was imaged with fiber bundle microendoscopy; images were analyzed by visual interpretation or by quantitative image analysis to predict whether the imaged sites were non-neoplastic or neoplastic. The best performing pair of quantitative features were chosen based on their ability to correctly classify the data into the two groups. Predictions were compared to the gold standard of histopathology. Subjective analysis of the images by expert clinicians achieved average sensitivity and specificity of 87% and 61%, respectively. The best performing quantitative classification algorithm relied on two image textural features and achieved a sensitivity and specificity of 87% and 85%, respectively. This ex vivo pilot trial demonstrates that quantitative analysis of images obtained with a simple microendoscope system can distinguish neoplasia in Barrett's esophagus with good sensitivity and specificity when compared to histopathology and to subjective image interpretation.

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia

“…Moreover, this dual-scale platform can be adapted to measure other molecular targets that have been used in the gastrointestinal tract with similar excitation and emission properties, 30 such as 2-NBDG or other targeted fluorescence contrast agents. 31,32 Furthermore, the signal associated with these fluorescent contrast agents can be quantified and used to aid in subjective image interpretation, 26,30 thereby further increasing its potential as a surveillance tool.…”

“…Previous studies have shown that these features can be consistently identified in HRME images and correlate with the appearance observed in H&E stained histologic sections. [19][20][21] Moreover, image processing algorithms have been developed for quantitative analysis of digital HRME images; initial pilot studies show high sensitivity and specificity for identifying neoplastic lesions, 26 suggesting the potential to use HRME imaging together with algorithmassisted identification of early cancers and high-grade dysplasia.…”

Quantitative analysis ofex vivocolorectal epithelium using an automated feature extraction algorithm for microendoscopy image data

“…[35][36][37][38][39][40] Quantitative classification based on microendoscopy image texture features in Barrett's esophagus and esophageal squamous cell carcinoma, specifically gray-level co-occurrence matrices, has been previously investigated. [41][42][43] A recent publication on automated selection of high-quality frames in microendoscopic images 44 points to both the need for quality control, as well as the viability of automated extraction of high-quality frames during video-rate acquisition. Ongoing development work with microendoscopic systems may enable spectroscopic data to be used in conjunction with quantitative image features, such as those described in this paper.…”

Synthesis of dye conjugates to visualize the cancer cells using fluorescence microscopy

“…Although there are numerous reports about optical noninvasive and/or less invasive methods for monitoring cancers, random surveillance biopsies are still the current gold standard for the identification of lesions. It was reported that the high-resolution microendoscope (HRME) developed by Richards-Kortum's group can be used to image and identify histopathologic features of metaplasia/ low grade dysplasia, high grade dysplasia, and esophageal adenocarinoma [17,18]. With the help of HRME, optical biopsies will be advanced into the in vivo clinical stage.…”