Dataset Information

In vivo classification of colorectal neoplasia using high-resolution microendoscopy: Improvement with experience.

ABSTRACT: High-resolution microendoscopy (HRME) is a novel, low-cost "optical biopsy" technology that allows for subcellular imaging. The study aim was to evaluate the learning curve of HRME for the differentiation of neoplastic from non-neoplastic colorectal polyps.In a prospective cohort fashion, a total of 162 polyps from 97 patients at a single tertiary care center were imaged by HRME and classified in real time as neoplastic (adenomatous, cancer) or non-neoplastic (normal, hyperplastic, inflammatory). Histopathology was the gold standard for comparison. Diagnostic accuracy was examined at three intervals over time throughout the study; the initial interval included the first 40 polyps, the middle interval included the next 40 polyps examined, and the final interval included the last 82 polyps examined.Sensitivity increased significantly from the initial interval (50%) to the middle interval (94%, P?=?0.02) and the last interval (97%, P?=?0.01). Similarly, specificity was 69% for the initial interval but increased to 92% (P?=?0.07) in the middle interval and 96% (P?=?0.02) in the last interval. Overall accuracy was 63% for the initial interval and then improved to 93% (P?=?0.003) in the middle interval and 96% (P?=?0.0007) in the last interval.In conclusion, this in vivo study demonstrates that an endoscopist without prior colon HRME experience can achieve greater than 90% accuracy for identifying neoplastic colorectal polyps after 40 polyps imaged. HRME is a promising modality to complement white light endoscopy in differentiating neoplastic from non-neoplastic colorectal polyps.

SUBMITTER: Parikh ND

PROVIDER: S-EPMC4504008 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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In vivo classification of colorectal neoplasia using high-resolution microendoscopy: Improvement with experience.

Parikh Neil D ND Parikh Neil D ND Perl Daniel D Lee Michelle H MH Chang Shannon S SS Polydorides Alexandros D AD Moshier Erin E Godbold James J Zhou Elinor E Mitcham Josephine J Richards-Kortum Rebecca R Anandasabapathy Sharmila S

Journal of gastroenterology and hepatology 20150701 7

<h4>Background and aims</h4>High-resolution microendoscopy (HRME) is a novel, low-cost "optical biopsy" technology that allows for subcellular imaging. The study aim was to evaluate the learning curve of HRME for the differentiation of neoplastic from non-neoplastic colorectal polyps.<h4>Methods</h4>In a prospective cohort fashion, a total of 162 polyps from 97 patients at a single tertiary care center were imaged by HRME and classified in real time as neoplastic (adenomatous, cancer) or non-neo ...[more]

PMID: 25753782

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Project description:EUS-guided FNA is one of the few techniques that can obtain cells and tissue from the liver and pancreas. However, the technique remains vulnerable to poor specimen quality and sampling error.To evaluate the ability of a high-resolution microendoscope (HRME) to visualize the cellular and architectural features of normal and malignant liver and pancreatic tissue ex vivo, to assess the ability of endosonographers to identify normal and neoplastic tissue by using HRME images, and to demonstrate preliminary technical feasibility of in vivo HRME imaging via EUS fine-needle puncture (FNP).Ex vivo pilot feasibility study in human tissue; in vivo swine model.Two academic medical centers.Co-registered HRME images and biopsies were obtained from surgically resected hepatic and pancreatic tissues from 44 patients.Images were divided into training (12 images) and test (80 images) sets containing a range of normal and pathologic conditions for each organ. After viewing the training sets, 9 endosonographers attempted to distinguish malignant tissue from normal or benign lesions in the test sets, each of which contained 40 unique images with individual diagnoses from pathology.Image acquisition feasibility, ex vivo and in vivo. Ability of endosonographers to recognize features of normal/benign or malignant tissue from the liver and pancreas.Overall, the 9 endosonographers achieved median accuracy figures of 85% in the liver and 90% in the pancreas. The endosonographers with prior experience in reading HRME images achieved accuracy rates between 90% and 95%. Technical feasibility of HRME imaging through a 19-gauge EUS-FNP needle was demonstrated in an in vivo swine model.Ex vivo study.High-resolution microendoscopy allows real-time imaging of cellular-level morphology and tissue architecture in the liver and pancreas. The technique appears to have a short learning curve, after which endosonographers achieved high accuracy rates in distinguishing malignant tissue from normal and benign pathology in both organs. Translating this imaging platform to the in vivo setting appears technically feasible.

Dataset Information

In vivo classification of colorectal neoplasia using high-resolution microendoscopy: Improvement with experience.

Publications

In vivo classification of colorectal neoplasia using high-resolution microendoscopy: Improvement with experience.

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