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Gastrointest Endosc. 2012 Jan;75(1):110-7. doi: 10.1016/j.gie.2011.08.012. Epub 2011 Oct 26.

Dual-wavelength excitation of mucosal autofluorescence for precise detection of diminutive colonic adenomas.

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1
Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.

Abstract

BACKGROUND:

The mucosal layer of the colon contains metabolism-related fluorophores, such as reduced nicotinamide adenine dinucleotide (NADH), which might have the potential to serve as biomarkers for detecting neoplasia.

OBJECTIVE:

To examine NADH fluorescence in human colonic adenoma while eliminating the effect of hemoglobin absorption and to develop a novel imaging technique for precise detection of adenomas.

DESIGN:

Cross-sectional study.

PATIENTS AND INTERVENTIONS:

A total of 66 endoscopically resected colonic polyps were investigated. After serial acquisition of autofluorescence images between 450 and 490 nm illuminated with dual-wavelength excitation at 365 nm (F(365ex)) and 405 nm (F(405ex)) on cross sections of the samples, ratio images were created by dividing F(365ex) by F(405ex). The excitation-emission wavelength combinations in F(365ex) and F(405ex) were optimized for NADH fluorescence and reference fluorescence.

MAIN OUTCOME MEASUREMENTS:

The F(365ex)/F(405ex) ratio in the tumorous (T) and normal (N) mucosa.

RESULTS:

F(365ex)/F(405ex) ratio images showed a 1.81- and 1.12-fold higher signal intensity in the adenomas and hyperplastic polyps, respectively, than in the adjacent normal mucosa. The ratio between signal intensities in tumorous mucosa and normal mucosa in F(365ex)/F(405ex) ratio images for tubular adenomas was significantly higher than that for hyperplastic polyps. The signal intensity in F(365ex)/F(405ex) ratio images was not correlated with the hemoglobin concentration index evaluated by reflection images at 550 nm and 610 nm. Diminutive adenomas (<5 mm) and large adenomas were well discriminated in F(365ex)/F(405ex) ratio images.

LIMITATIONS:

Ex vivo experiment.

CONCLUSIONS:

These results suggest that the precise measurement of NADH fluorescence intensity together with eliminating the influence of blood hemoglobin concentration serves as a method for visualizing colonic adenomas and that the dual-wavelength excitation method is a promising technique applicable to endoscopic detection of early colonic adenomas.

PMID:
22032849
DOI:
10.1016/j.gie.2011.08.012
[Indexed for MEDLINE]
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