Endoscopic histological assessment of colonic polyps by using elastic scattering spectroscopy

• Published in: Gastrointestinal endoscopy Vol. 81; no. 3; pp. 539 - 547
• Main Authors: Rodriguez-Diaz, Eladio, PhD, Huang, Qin, MD, Cerda, Sandra R., MD, O’Brien, Michael J., MD, Bigio, Irving J., PhD, Singh, Satish K., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2015
• Subjects: Adenocarcinoma - pathology; Adenoma - pathology; Adult; Aged; Aged, 80 and over; Algorithms; Colonic Neoplasms - pathology; Colonic Polyps - pathology; Colonoscopy - instrumentation; Colonoscopy - methods; Decision Support Techniques; Diagnosis, Differential; Female; Gastroenterology and Hepatology; Humans; Male; Middle Aged; Pilot Projects; Retrospective Studies; Sensitivity and Specificity; Spectrum Analysis - instrumentation; Spectrum Analysis - methods; SSA; colorectal cancer; ESS; Preservation and Incorporation of Valuable Endoscopic Innovations; elastic-scattering spectroscopy; HCDR; PIVI; high-confidence decision rate; VA Boston Healthcare System; probe-based confocal laser endomicroscopy; NBI; CRC; NPV; sessile serrated adenoma; narrow-band imaging; VABHS; negative predictive value; pCLE
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2014.07.012

Background Elastic-scattering spectroscopy (ESS) can assess in vivo and in real-time the scattering and absorption properties of tissue related to underlying pathologies. Objectives To evaluate the potential of ESS for differentiating neoplastic from non-neoplastic polyps during colonoscopy. Design Pilot study, retrospective data analysis. Setting Academic practice. Patients A total of 83 patients undergoing screening/surveillance colonoscopy. Interventions ESS spectra of 218 polyps (133 non-neoplastic, 85 neoplastic) were acquired during colonoscopy. Spectral data were correlated with the classification of biopsy samples by 3 GI pathologists. High-dimensional methods were used to design diagnostic algorithms. Main Outcome Measurements Diagnostic performance of ESS. Results Analysis of spectra from polyps of all sizes (N = 218) resulted in a sensitivity of 91.5%, specificity of 92.2%, and accuracy of 91.9% with a high-confidence rate of 90.4%. Restricting analysis to polyps smaller than 1 cm (n = 179) resulted in a sensitivity of 87.0%, specificity of 92.1%, and accuracy of 90.6% with a high-confidence rate of 89.3%. Analysis of polyps 5 mm or smaller (n = 157) resulted in a sensitivity of 86.8%, specificity of 91.2%, and accuracy of 90.1% with a high-confidence rate of 89.8%. Limitations Sample size, retrospective validation used to obtain performance estimates. Conclusion Results indicate that ESS permits accurate, real-time classification of polyps as neoplastic or non-neoplastic. ESS is a simple, low cost, clinically robust method with minimal impact on procedure flow, especially when integrated into standard endoscopic biopsy tools. Performance on polyps 5 mm or smaller indicates that ESS may, in theory, achieve Preservation and Incorporation of Valuable Endoscopic Innovations performance thresholds. ESS may one day prove to be a useful tool used in endoscopic screening and surveillance of colorectal cancer.