New method for real-time visualization and quantitative characterization of early colorectal cancer in endoscopy: a pilot study

Abstract

Background: Endoscopic optical diagnosis is crucial to the therapeutic strategy in early gastrointestinal cancer. It accurately (> 85%) predicts pT category based on micro surface (SP) and vascular patterns (VP). However, inter-observer variability is a major problem. We have visualized and digitalized the graded irregularities based on bioinformatically enhanced quantitative endoscopic image analysis (BEE) of high definition white light images. Methods: In a pilot study on 26 large colorectal lesions (LCL, mean diameter 39 mm), we retrospectively compared BEE variables with corresponding histopathology of the resected LCL. Results: We included ten adenomas with low grade intraepithelial neoplasia (LGIN), nine with high grade intraepithelial neoplasia and early adenocarcinoma (HGIN and EAC), and seven deeply submucosal invasive carcinomas. Quantified density (d) and non-uniformity (CU) of vascular and surface structures correlated with histology (rs d VP: -0.77, rs CU VP: 0.13, rs d SP: -0.76, and rs CU SP: 0.45, respectively). A computed BEE-score showed a sensitivity and specifity of 90% and 100% in the group of LGIN, 89% and 41% in the group of HGIN and EAC, and 100% and 95% in the group of deeply invasive carcinoma, respectively. Conclusions: In this pilot study, BEE has shown promise as a tool for endoscopic characterization of LCL during routine endoscopy. Prospective clinical studies are needed.

Bone marrow mesenchymal stromal cell-derived small extracellular vesicles: A novel therapeutic agent in ischemic heart diseases

“…Because in clinical, subjects received allogenic bone marrow transplants detected almost no transfer of the donor mitochondria DNA (mtDNA) to the host mtDNA fraction in epithelial, connective, or skeletal muscle tissues, even exposure to the donor mtDNA in EV fractions for years (Tarnopolsky et al, 2020). In addition, studies showed that mitochondria mainly contain in larger EV (250 nm) rather than sEVs (100 nm), although EV (250 nm) contain all parts of mitochondria, their independent functionality inside EV cannot be confirmed due to methodological deficiencies (Wagner et al, 2022;Zorova et al, 2022).…”

Endoscopic on-site characterization of a large excavated lesion in longstanding ulcerative colitis using a novel bioinformatic tool

“…Despite the suspicious morphology of the 3 × 2 cm lesion, we decided not to resect it following visualization of dense and regular vascular and surface patterns obtained by the BEE variables “density” and “non-uniformity coefficient” ( Fig. 1 ) 1 . Accordingly, multiple targeted biopsies showed chronic inflammation and fibrosis, without dysplasia.…”

“…variables "density" and "non-uniformity coefficient" (▶ Fig. 1) [1]. Accordingly, multiple targeted biopsies showed chronic inflammation and fibrosis, without dysplasia.…”

“…In a previous study [1], we reported on a novel tool for real-time visualization and characterization based on bioinformatically enhanced quantitative endoscopic image analysis (BEE) of high definition white-light images. In brief, a grain analysis of selected areas of the endoscopic image is accomplished by thresholding algorithms, and a non-uniformity coefficient is calculated, inspired by soil mechanics and sieve curve terminology [2].…”