Mo1645 High-Resolution Microendoscopy (HRME) in the Detection of Anal Intraepithelial Neoplasia: Assessment of Accuracy and Interobserver Variability

Varela, Benigno R.; Perl, Daniel P.; Zhou, Elinor; Chang, Shannon; Protano, Marion-Anna; Lee, Michelle H.; Mitcham, Josephine; Gonzalez, Susana; DiMaio, Christopher J.; Amin, Sunil; Kim, Michelle K.; Eliasen, Carol a.; Richards‐Kortum, Rebecca; Gaisa, Michael; Anandasabapathy, Sharmila

doi:10.1016/j.gie.2013.03.393

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Forty one consecutive patients with abnormal anal cytology or prior HSIL underwent guided HRME imaging on Lugol's unstained areas, with subsequent biopsies. An image database was created and three expert HRME microendoscopists and 5 novice gastroenterologists and anoscopists reviewed a set of training images and then interpreted images in an independent test set.…”

Section: Resultsmentioning

confidence: 99%

Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia

Louie

Richards‐Kortum

Anandasabapathy

2014

Clinical Gastroenterology and Hepatology

Self Cite

View full text Add to dashboard Cite

The high-resolution microendoscope (HRME) is a novel imaging modality that allows real-time epithelial imaging at subcellular resolution. Used in concert with any standard endoscope, this portable, low cost, ‘optical biopsy’ technology has the ability to provide images of cellular morphology during a procedure. This technology has been the subject of a number of studies investigating its use in screening and surveillance of a range of gastrointestinal neoplasia, including esophageal adenocarcinoma(EAC), esophageal squamous cell cancer(ESCC), colorectal neoplasia(CRC) and anal neoplasia. These studies have shown that HRME is a modality that consistently provides high specificity, negative predictive value, and accuracy across different diseases. In addition, they have illustrated that HRME users can be relatively easily trained in a short period of time and that users have demonstrated solid inter-rater reliability. These features make HRME a potential complement to high definition white light imaging, narrow band imaging and other ‘red flag technologies’ in facilitating real-time clinical diagnosis, endoscopic therapy and margin determination. Further clinical validation is needed to determine whether this translates to reduced procedure times, pathology costs, and follow up procedures. Finally, the HRME has a relatively simple design compared to other similar technologies, making it portable, simple to maintain, and low cost. This may allow the HRME device to function in both advanced care settings as well as in places with less resources and specialized support systems. As a whole, the HRME device has shown good performance along with low-cost and portable construction, and its application in different conditions and settings has been promising.

show abstract

Section: Resultsmentioning

confidence: 99%

Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia

Louie

Richards‐Kortum

Anandasabapathy

2014

Clinical Gastroenterology and Hepatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Varela, et al explored the role of HRME as an adjunct to high-resolution anoscopy for detecting High-Grade Squamous Intraepithelial Lesions (HSIL) in 41 patients with prior HSIL or abnormal anal cytology [72]. All patients underwent HRME-guided imaging on Lugol's positive areas with subsequent biopsies.…”

Section: Hrme and Anal Cancermentioning

confidence: 99%

Progress and Challenges of Global High-Resolution Endoscopy

Bhushan¹,

Richards²,

Anandasabapathy³

2020

Int Arch Intern Med

View full text Add to dashboard Cite

In recent years, gastrointestinal endoscopy has seen an influx of high-resolution endoscopic technologies that are capable of providing optical biopsies of the epithelial surface in real time. Upcoming high-resolution endoscopy techniques are CLE, OCT, EC and HRME. Powered by automated diagnostic algorithms and more-cost effective alternatives, these high-resolution endoscopic technologies have the potential to not only facilitate real-time decision making, but also improve screening and surveillance of gastrointestinal cancers globally. This review discusses the most promising upcoming optical biopsy technologies and their clinical applications, along with the current trends, challenges and future directions.

show abstract

“…HRME images of precancerous anal lesions show characteristic changes in nuclear morphology including nuclear enlargement, crowding, and pleomorphism. In a pilot study of 41 patients, Varela et al ( 10 ) trained a group of 8 clinicians to visually interpret HRME images of anal epithelium and identify anal precancers. The group achieved a sensitivity of 0.93 and specificity of 0.87.…”

Section: Introductionmentioning

confidence: 99%

Automated In Vivo High-Resolution Imaging to Detect Human Papillomavirus–Associated Anal Precancer in Persons Living With HIV

Brenes

Kortum

Carns

et al. 2022

Clin Transl Gastroenterol

Self Cite

View full text Add to dashboard Cite

INTRODUCTION: In the United States, the effectiveness of anal cancer screening programs has been limited by a lack of trained professionals proficient in high-resolution anoscopy (HRA) and a high patient lost-to-follow-up rate between diagnosis and treatment. Simplifying anal intraepithelial neoplasia grade 2 or more severe (AIN 2+) detection could radically improve the access and efficiency of anal cancer prevention. Novel optical imaging providing point-of-care diagnoses could substantially improve existing HRA and histology-based diagnosis. This work aims to demonstrate the potential of high-resolution microendoscopy (HRME) coupled with a novel machine learning algorithm for the automated, in vivo diagnosis of anal precancer. METHODS: The HRME, a fiber-optic fluorescence microscope, was used to capture real-time images of anal squamous epithelial nuclei. Nuclear staining is achieved using 0.01% wt/vol proflavine, a topical contrast agent. HRME images were analyzed by a multitask deep learning network (MTN) that computed the probability of AIN 2+ for each HRME image. RESULTS: The study accrued data from 77 people living with HIV. The MTN achieved an area under the receiver operating curve of 0.84 for detection of AIN 2+. At the AIN 2+ probability cutoff of 0.212, the MTN achieved comparable performance to expert HRA impression with a sensitivity of 0.92 ( P = 0.68) and specificity of 0.60 ( P = 0.48) when using histopathology as the gold standard. DISCUSSION: When used in combination with HRA, this system could facilitate more selective biopsies and promote same-day AIN2+ treatment options by enabling real-time diagnosis.

show abstract

Mo1645 High-Resolution Microendoscopy (HRME) in the Detection of Anal Intraepithelial Neoplasia: Assessment of Accuracy and Interobserver Variability

Cited by 4 publications

References 0 publications

Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia

Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia

Progress and Challenges of Global High-Resolution Endoscopy

Automated In Vivo High-Resolution Imaging to Detect Human Papillomavirus–Associated Anal Precancer in Persons Living With HIV

Contact Info

Product

Resources

About