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Design and validation of a near-infrared fluorescence endoscope for detection of early esophageal malignancy.

Published version
Peer-reviewed

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Type

Article

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Authors

Waterhouse, Dale J 
Neves, André A 
di Pietro, Massimiliano 
Brindle, Kevin M 

Abstract

Barrett’s esophagus is a known precursor lesion to esophageal adenocarcinoma. In these patients, early detection of premalignant disease, known as dysplasia, allows curative minimally invasive endoscopic therapy, but is confounded by a lack of contrast in white light endoscopy. Imaging fluorescently labeled lectins applied topically to the tissue has the potential to more accurately delineate dysplasia, but tissue autofluorescence limits both sensitivity and contrast when operating in the visible region. To overcome this challenge, we synthesized near-infrared (NIR) fluorescent wheat germ agglutinin (WGA-IR800CW) and constructed a clinically translatable bimodal NIR and white light endoscope. Images of NIR and white light with a field of view of 63 deg and an image resolution of 182  μm are coregistered and the honeycomb artifact arising from the fiber bundle is removed. A minimum detectable concentration of 110 nM was determined using a dilution series of WGA-IR800CW. We demonstrated ex vivo that this system can distinguish between gastric and squamous tissue types in mouse stomachs (p=0.0005) and accurately detect WGA-IR800CW fluorescence in human esophageal resections (compared with a gold standard imaging system, rs>0.90). Based on these findings, future work will optimize the bimodal endoscopic system for clinical trials in Barrett’s surveillance.

Description

Keywords

Adenocarcinoma, Animals, Barrett Esophagus, Endoscopes, Esophageal Neoplasms, Esophagoscopy, Fluorescence, Humans, Precancerous Conditions, Reproducibility of Results, Spectroscopy, Near-Infrared

Journal Title

J Biomed Opt

Conference Name

Journal ISSN

1083-3668
1560-2281

Volume Title

21

Publisher

SPIE-Intl Soc Optical Eng
Sponsorship
Cancer Research Uk (None)
Cancer Research UK (CB4100)
Cancer Research UK (C14303/A17197)
Medical Research Council (MC_PC_13059)
European Commission (630729)
TCC (None)
This work was funded by the EPSRC-CRUK Cancer Imaging Centre in Cambridge and Manchester (Grant no. C197/ A16465), CRUK (C14303/A17197) and the EU FP7 agreement FP7-PEOPLE-2013-CIG-630729. Additional funds were provided by the University of Cambridge MRC Confidence in Concept Award. SEB is supported by a CRUK Career Establishment Award (Grant no. C47594/A16267).