Light scattering spectroscopy identifies the malignant potential of pancreatic cysts during endoscopy

Zhang, Lei; Pleskow, Douglas K.; Turzhitsky, Vladimir; Yee, Eric U.; Berzin, Tyler M.; Sawhney, Mandeep S.; Shinagare, Shweta; Vitkin, Edward; Zakharov, Yu. P.; Khan, Umar; Wang, Fen; Goldsmith, Jeffrey D.; Goldberg, Saveli; Chuttani, Ram; Itzkan, Irving; Perelman, Lev T.

doi:10.1038/s41551-017-0040

Cited by 45 publications

(47 citation statements)

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“…Thus, one can divide the light reflected from the tissue’s epithelial lining into two components: single backscattering from cell nuclei in the upper tissue structure, and a diffusely scattered background. In order to extract the single scattering component, which contains the essential information, the diffusive background can be removed using either polarization 25 , 28 , 29 , 30 or spatial 31 gating approaches. The light scattered back from the epithelial cells located at the surface retains the incoming polarization, while diffuse scattering from the deeper tissue regions layers is depolarized (see Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

Multispectral light scattering endoscopic imaging of esophageal precancer

et al. 2017

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Esophageal adenocarcinoma is the most rapidly growing cancer in America. Although the prognosis after diagnosis is unfavorable, the chance of a successful outcome increases tremendously if detected early while the lesion is still dysplastic. Unfortunately, the present standard-of-care, endoscopic surveillance, has major limitations, since dysplasia is invisible, often focal, and systematic biopsies typically sample less than one percent of the esophageal lining and therefore easily miss malignancies. To solve this problem we developed a multispectral light scattering endoscopic imaging system. It surveys the entire esophageal lining and accurately detects subcellular dysplastic changes. The system combines light scattering spectroscopy, which detects and identifies invisible dysplastic sites by analyzing light scattered from epithelial cells, with rapid scanning of the entire esophageal lining using a collimated broadband light beam delivered by an endoscopically compatible fiber optic probe. Here we report the results of the first comprehensive multispectral imaging study, conducted as part of routine endoscopic procedures performed on patients with suspected dysplasia. In a double-blind study that characterized the system’s ability to serve as a screening tool, 55 out of 57 patients were diagnosed correctly. In addition, a smaller double-blind comparison of the multispectral data in 24 patients with subsequent pathology at locations where 411 biopsies were collected yielded an accuracy of 90% in detecting individual locations of dysplasia, demonstrating the capability of this method to serve as a guide for biopsy.

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Section: Methodsmentioning

confidence: 99%

Multispectral light scattering endoscopic imaging of esophageal precancer

et al. 2017

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“…In contrast to elastic scattering properties, Raman spectroscopy measures inelastic scattering events to probe specific chemical components in biological tissue including proteins, lipids, nucleic acids, and water (Le et al, 2009). Therefore, scatteringbased techniques represent a sensitive tool to probe changes in structure compositions and have been used alone or combined with fluorescence for detection of dysplasia in oral cavity (De Veld et al, 2005;Schwarz et al, 2008;van Leeuwen-van Zaane et al, 2013;Einstein et al, 2016;Bailey et al, 2017), upper GI tract (Feng et al, 2013;Almond et al, 2014;Bergholt et al, 2014;Douplik et al, 2014;Lariviere et al, 2018), pancreas (Zhang et al, 2017), as well as in colonoscopy (Baltussen et al, 2017).…”

Section: Scattering-based Techniquesmentioning

confidence: 99%

Optical Biopsy of the Upper GI Tract Using Fluorescence Lifetime and Spectra

et al. 2020

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Screening and surveillance for gastrointestinal (GI) cancers by endoscope guided biopsy is invasive, time consuming, and has the potential for sampling error. Tissue endogenous fluorescence spectra contain biochemical and physiological information, which may enable real-time, objective diagnosis. We first briefly reviewed optical biopsy modalities for GI cancer diagnosis with a focus on fluorescence-based techniques. In an ex vivo pilot clinical study, we measured fluorescence spectra and lifetime on fresh biopsy specimens obtained during routine upper GI screening procedures. Our results demonstrated the feasibility of rapid acquisition of time-resolved fluorescence (TRF) spectra from fresh GI mucosal specimens. We also identified spectroscopic signatures that can differentiate between normal mucosal samples obtained from the esophagus, stomach, and duodenum.

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“…The system also extracts fluorescence parameters related to tissue biochemical properties that are used to augment the robot’s field of view. In addition, current approach can serve as a framework for the clinical translation of other point-scanning optical techniques, such as elastic-scattering spectroscopy, diffused reflectance spectroscopy, or Raman spectroscopy 24–26 , to name a few.…”

Section: Introductionmentioning

confidence: 99%

Autofluorescence lifetime augmented reality as a means for real-time robotic surgery guidance in human patients

Gorpas

Phipps

Bec

et al. 2019

Sci Rep

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Due to loss of tactile feedback the assessment of tumor margins during robotic surgery is based only on visual inspection, which is neither significantly sensitive nor specific. Here we demonstrate time-resolved fluorescence spectroscopy (TRFS) as a novel technique to complement the visual inspection of oral cancers during transoral robotic surgery (TORS) in real-time and without the need for exogenous contrast agents. TRFS enables identification of cancerous tissue by its distinct autofluorescence signature that is associated with the alteration of tissue structure and biochemical profile. A prototype TRFS instrument was integrated synergistically with the da Vinci Surgical robot and the combined system was validated in swine and human patients. Label-free and real-time assessment and visualization of tissue biochemical features during robotic surgery procedure, as demonstrated here, not only has the potential to improve the intraoperative decision making during TORS but also other robotic procedures without modification of conventional clinical protocols.

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Light scattering spectroscopy identifies the malignant potential of pancreatic cysts during endoscopy

Cited by 45 publications

References 50 publications

Multispectral light scattering endoscopic imaging of esophageal precancer

Multispectral light scattering endoscopic imaging of esophageal precancer

Optical Biopsy of the Upper GI Tract Using Fluorescence Lifetime and Spectra

Autofluorescence lifetime augmented reality as a means for real-time robotic surgery guidance in human patients

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