Diagnosis of gastric intestinal metaplasia with confocal laser endomicroscopy in vivo: a prospective study

Yt, Guo; Yq, Li; Takata, Yasuyuki; Tg, Zhang; Jn, Zhang; H, Liu; Fg, Liu; Xie, Xiao Song; Zhu, Quing; Ya, Zhao

doi:10.1055/s-2007-995633

Cited by 101 publications

(113 citation statements)

References 14 publications

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“…Gastric IM is recognized as a frequent precancerous lesion that can be very challenging to identify by using conventional white light reflectance (WLR) endoscopy with a limited diagnostic accuracy ($58.8%; ref. 4). Epidemiologic studies suggest that patients with IM have more than 10-fold increased risk of developing dysplasia into gastric cancer (5).…”

Section: Introductionmentioning

confidence: 99%

Rapid Fiber-optic Raman Spectroscopy for Real-Time In Vivo Detection of Gastric Intestinal Metaplasia during Clinical Gastroscopy

Lin

Wang

Zheng

et al. 2016

Cancer Prevention Research

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We report a unique simultaneous fingerprint (FP) and highwavenumber (HW) Raman spectroscopy technique coupled with a beveled fiber-optic Raman probe for improving in vivo detection of gastric intestinal metaplasia (IM)-precancerous lesions in realtime during clinical gastroscopy. A total of 4,520 high-quality in vivo FP/HW gastric Raman spectra (normal ¼ 4,178; IM ¼ 342) were acquired from 157 gastric patients undergoing endoscopic examination. Multivariate diagnostic algorithms based on principal components analysis and linear discriminant analysis together with the leave-one tissue site-out, cross-validation on in vivo tissue Raman spectra yield the diagnostic sensitivities of 89.3%, 89.3%, and 75.0%; specificities of 92.2%, 84.4%, and 82.0%; positive predictive values of 52.1%, 35.2%, and 28.4%; and negative predictive values of 98.9%, 98.8%, and 97.2%, respectively, by using the integrated FP/HW, FP, and HW Raman techniques for identifying IM from normal gastric tissue. Further, ROC curves generated show that the integrated FP/HW Raman technique gives the integration area under the ROC curve of 0.92 for IM classification, which is superior to either FP (0.89) or HW Raman (0.86) technique alone. This work demonstrates for the first time that the simultaneous FP/HW fiber-optic Raman spectroscopy has great potential to enhance early diagnosis of gastric precancer in vivo during routine endoscopic examination. Cancer Prev Res; 9(6); 476-83. Ó2016 AACR.

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Section: Introductionmentioning

confidence: 99%

Rapid Fiber-optic Raman Spectroscopy for Real-Time In Vivo Detection of Gastric Intestinal Metaplasia during Clinical Gastroscopy

Lin

Wang

Zheng

et al. 2016

Cancer Prevention Research

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“…7 Unfortunately, such real-time interpretation requires considerable training and is subject to intraobserver variability. [8][9][10] For broader clinical application, particularly outside a university setting, the application of image-analysis software using well-defined image classification algorithms has the potential to reduce subjectivity and improve diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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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.

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“…In 267 optical biopsies from 53 patients, intestinal metaplasia was correctly diagnosed with a specificity of 95% and a sensitivity of 98%. Interobserver agreement for diagnosis during endoscopy was 0.94 [37]. This makes CLE the only reliable endoscopic method to predict intestinal metaplasia.…”

Section: Endomicroscopy Of Gastricmentioning

confidence: 86%

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Goetz

2012

ISRN Pathology

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Confocal laser endomicroscopy (CLE) is a novel tool in the endoscopist's armamentarium. It allows on-site histological information. The ability of gastroenterologists to interpret such microscopic information has been demonstrated in multiple studies from the upper and lower gastrointestinal tract. Recently, the field of application has expanded to provide hepatobiliary and intra-abdominal CLE imaging. CLE allows "smart," targeted biopsies and is able to guide endoscopic interventions. But CLE is also translational in its approach and permits functional imaging that significantly impacts on our understanding of gastrointestinal diseases. Molecular imaging with CLE allows detection and characterization of lesions and may even be used for prediction of response to targeted therapy. This paper provides a comprehensive review over current applications of CLE in clinical applications and translational science.

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Diagnosis of gastric intestinal metaplasia with confocal laser endomicroscopy in vivo: a prospective study

Abstract: CLE is a useful and potentially important method for the diagnosis and classification of GIM in vivo.

Cited by 101 publications

References 14 publications

Rapid Fiber-optic Raman Spectroscopy for Real-Time In Vivo Detection of Gastric Intestinal Metaplasia during Clinical Gastroscopy

Rapid Fiber-optic Raman Spectroscopy for Real-Time In Vivo Detection of Gastric Intestinal Metaplasia during Clinical Gastroscopy

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

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

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