Abstract
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), affects over 1 million Americans and 2 million Europeans, and the incidence is increasing worldwide. While these diseases require unique medical care, the differentiation between UC and CD lacks a gold standard, and therefore relies on long term follow up, success or failure of existing treatment, and recurrence of the disease. Here, we present colonoscopy-coupled fiber optic probe-based Raman spectroscopy as a minimally-invasive diagnostic tool for IBD of the colon (UC and Crohn's colitis). This pilot in vivo study of subjects with existing IBD diagnoses of UC (n = 8), CD (n = 15), and normal control (n = 8) aimed to characterize spectral signatures of UC and CD. Samples were correlated with tissue pathology markers and endoscopic evaluation. The collected spectra were processed and analyzed using multivariate statistical techniques to identify spectral markers and discriminate IBD and disease classes. Confounding factors including the presence of active inflammation and the particular colon segment measured were investigated and integrated into the devised prediction algorithm, reaching 90% sensitivity and 75% specificity to CD from this in vivo data set. These results represent significant progress towards improved real-time classification for accurate and automated in vivo detection and discrimination of IBD during colonoscopy procedures.
Highlights
Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), affects nearly one million Americans and two million Europeans, and the incidence is increasing worldwide [1]
The goal of this study is to demonstrate the potential for Raman spectroscopy to detect tissue changes consistent with inflammatory bowel disease in the colon as a potential diagnostic adjunct
Prior work has demonstrated that Raman spectroscopy is sensitive to IBD subtype specific signatures in ex vivo tissue sample evaluations
Summary
Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), affects nearly one million Americans and two million Europeans, and the incidence is increasing worldwide [1]. This complex illness is characterized by both chronic and acute disease states, with periods of inflammatory flare, quiescence, and relapse. With the high drug costs and rates of surgery (up to 75% of CD and 25-33% of UC patients), IBD is one of the costliest conditions on a per year basis in the US, with expenses for CD surpassing diabetes, coronary artery disease, and chronic obstructive pulmonary disease [4, 5]
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