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First-in-human pilot study of snapshot multispectral endoscopy for early detection of Barrett's-related neoplasia.

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Waterhouse, Dale J 
Bano, Sophia 
Januszewicz, Wladyslaw 
Stoyanov, Dan 
Fitzgerald, Rebecca C 


SIGNIFICANCE: The early detection of dysplasia in patients with Barrett's esophagus could improve outcomes by enabling curative intervention; however, dysplasia is often inconspicuous using conventional white-light endoscopy. AIM: We sought to determine whether multispectral imaging (MSI) could be applied in endoscopy to improve detection of dysplasia in the upper gastrointestinal (GI) tract. APPROACH: We used a commercial fiberscope to relay imaging data from within the upper GI tract to a snapshot MSI camera capable of collecting data from nine spectral bands. The system was deployed in a pilot clinical study of 20 patients ( NCT03388047) to capture 727 in vivo image cubes matched with gold-standard diagnosis from histopathology. We compared the performance of seven learning-based methods for data classification, including linear discriminant analysis, k-nearest neighbor classification, and a neural network. RESULTS: Validation of our approach using a Macbeth color chart achieved an image-based classification accuracy of 96.5%. Although our patient cohort showed significant intra- and interpatient variance, we were able to resolve disease-specific contributions to the recorded MSI data. In classification, a combined principal component analysis and k-nearest-neighbor approach performed best, achieving accuracies of 95.8%, 90.7%, and 76.1%, respectively, for squamous, non-dysplastic Barrett's esophagus and neoplasia based on majority decisions per-image. CONCLUSIONS: MSI shows promise for disease classification in Barrett's esophagus and merits further investigation as a tool in high-definition "chip-on-tip" endoscopes.



computer assisted diagnosis, dysplasia, endoscopy, esophagus, multispectral, Barrett Esophagus, Cohort Studies, Esophageal Neoplasms, Esophagoscopy, Humans, Pilot Projects

Journal Title

J Biomed Opt

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SPIE-Intl Soc Optical Eng


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Cancer Research Uk (None)
Engineering and Physical Sciences Research Council (EP/N014588/1)
Cancer Research UK (C14303/A17197)
Engineering and Physical Sciences Research Council (EP/R003599/1)
Cancer Research UK (21102)
Cancer Research UK (24669)
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