Feasibility and preliminary accuracy of high-resolution imaging of the liver and pancreas using FNA compatible microendoscopy (with video)

Regunathan, Renu; Woo, Jenny; Pierce, Mark C.; Polydorides, Alexandros; Raoufi, Mohammad; Roayaie, Sasan; Schwartz, Myron; Labow, Daniel M.; Shin, Dongsuk; Suzuki, Rei; Bhutani, Manoop S.; Coghlan, Lezlee G; Richards‐Kortum, Rebecca; Anandasabapathy, Sharmila; Kim, Michelle Kang

doi:10.1016/j.gie.2012.04.445

Cited by 22 publications

(24 citation statements)

References 24 publications

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“…High‐resolution microendoscopy (HRME) is a low‐cost “optical biopsy” technology consisting of a 1‐mm‐diameter fiber optic bundle that allows for subcellular imaging at 1000× magnification at 4‐μm resolution. HRME has already been found to be effective in gastrointestinal pathology . In order for a complementary imaging tool to enhance the ability of WLE in classifying polyps, the modality must not only be inexpensive but also one that can be learned quickly and interpreted accurately.…”

Section: Introductionmentioning

confidence: 99%

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

Parikh

Perl

Lee

et al. 2015

J of Gastro and Hepatol

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Background and Aims 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. Methods 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. Results 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. Conclusions 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.

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Section: Introductionmentioning

confidence: 99%

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

Parikh

Perl

Lee

et al. 2015

J of Gastro and Hepatol

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“…The simplicity, low cost, and real-time imaging performance of the HRME system have led to its use by several research groups in laboratory studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24] and in vivo clinical investigations [25][26][27][28]. However, the imaging properties of the HRME system have not been fully characterized; in particular, the axial imaging range and sensitivity to out-of-focus light have to the best of our knowledge, not been quantitatively studied.…”

Section: Introductionmentioning

confidence: 99%

Axial response of high-resolution microendoscopy in scattering media

Koucky

Pierce

2013

Biomed. Opt. Express

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High-resolution microendoscopy (HRME) uses epi-fluorescence imaging with a coherent fiber-optic bundle to enable in vivo examination of cellular morphology. While the HRME platform has recently gained popularity as a simple alternative to confocal endomicroscopy, the axial response of HRME in thick, scattering tissue has yet to be described quantitatively. These details are important because when analyzing images collected by HRME, out-of-focus light may affect the accuracy of quantitative parameters such as nuclear-to-cytoplasm ratio, which has been proposed as a diagnostic indicator of dysplasia or cancer. In this study we investigated the imaging properties of the HRME system by using phantoms simulating scattering tissue with fluorescently labeled nuclei. We directly compared HRME imaging with confocal endomicroscopy in phantoms and in vivo human tissue. HRME images defocused (deep) objects with apparent diameters and intensity levels that are in agreement with a simple geometric model. Out-of-focus nuclei contribute a relatively low, uniform background level to images which neither leads to the erroneous appearance of large nuclei from deep layers, nor prevents accurate imaging of superficial nuclei with high contrast. Kortum, "A pilot study of low-cost, high-resolution microendoscopy as a tool for identifying women with cervical precancer," Cancer Prev.

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“…3 In a feasibility, ex vivo (human tissue), in vivo (swine model) study of high-resolution microscopy imaging of the liver and pancreas (using topical proflavin solution and a probe through a 22-gauge needle), 9 endosonographers achieved median accuracy figures of 85% in the liver and 90% in the pancreas after a short-term training. 4 Optical coherent tomography (OCT) uses infrared light waves generating images by measuring the echo time delay and the intensity of back-scattered light. OCT technology can yield a lateral and axial spatial resolution of about 10 m. In a study involving 62 patients with superficial esophageal squamous cell carcinoma, OCT showed esophageal wall components that corresponded to the histological findings with an overall rate of 92.7% accuracy.…”

Section: Options For Management Of Anal Fissures Questionmentioning

confidence: 99%

Continuing Medical Education Exam: August 2012

Davila¹,

Lee²,

Ross³

et al. 2012

Gastrointestinal Endoscopy

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Feasibility and preliminary accuracy of high-resolution imaging of the liver and pancreas using FNA compatible microendoscopy (with video)

Abstract: Background-Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is one of the few techniques which can obtain cells and tissue from the liver and pancreas. However, the technique remains vulnerable to poor specimen quality and sampling error.

Cited by 22 publications

References 24 publications

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

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

Axial response of high-resolution microendoscopy in scattering media

Continuing Medical Education Exam: August 2012

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