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Clin Gastroenterol Hepatol. 2015 Feb;13(2):272-279.e2. doi: 10.1016/j.cgh.2014.07.030. Epub 2014 Jul 25.

Quantitative analysis of high-resolution microendoscopic images for diagnosis of esophageal squamous cell carcinoma.

Author information

1
Department of Bioengineering, Rice University, Houston, Texas.
2
Division of Gastroenterology, The Mount Sinai Medical Center, New York, New York.
3
Department of Pathology, The Mount Sinai Medical Center, New York, New York.
4
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
5
Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey.
6
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.
7
Department of Gastrointestinal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China.
8
Department of Endoscopy, Cancer Institute and Hospital, The Chinese Academy of Medical Sciences, Beijing, China.
9
Department of Pathology, Cancer Institute and Hospital, The Chinese Academy of Medical Sciences, Beijing, China.
10
Department of Bioengineering, Rice University, Houston, Texas. Electronic address: rkortum@rice.edu.

Abstract

BACKGROUND & AIMS:

High-resolution microendoscopy is an optical imaging technique with the potential to improve the accuracy of endoscopic screening for esophageal squamous neoplasia. Although these microscopic images can be interpreted readily by trained personnel, quantitative image analysis software could facilitate the use of this technology in low-resource settings. In this study, we developed and evaluated quantitative image analysis criteria for the evaluation of neoplastic and non-neoplastic squamous esophageal mucosa.

METHODS:

We performed an image analysis of 177 patients undergoing standard upper endoscopy for screening or surveillance of esophageal squamous neoplasia, using high-resolution microendoscopy, at 2 hospitals in China and at 1 hospital in the United States from May 2010 to October 2012. Biopsy specimens were collected from imaged sites (n = 375), and a consensus diagnosis was provided by 2 expert gastrointestinal pathologists and used as the standard.

RESULTS:

Quantitative information from the high-resolution images was used to develop an algorithm to identify high-grade squamous dysplasia or invasive squamous cell cancer, based on histopathology findings. Optimal performance was obtained using the mean nuclear area as the basis for classification, resulting in sensitivities and specificities of 93% and 92% in the training set, 87% and 97% in the test set, and 84% and 95% in an independent validation set, respectively.

CONCLUSIONS:

High-resolution microendoscopy with quantitative image analysis can aid in the identification of esophageal squamous neoplasia. Use of software-based image guides may overcome issues of training and expertise in low-resource settings, allowing for widespread use of these optical biopsy technologies.

KEYWORDS:

Diagnostic; Esophageal Cancer; HRME; Quantitative Diagnosis

PMID:
25066838
PMCID:
PMC4305504
DOI:
10.1016/j.cgh.2014.07.030
[Indexed for MEDLINE]
Free PMC Article

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