Endoscopic histological assessment of colonic polyps by using elastic scattering spectroscopy

Abstract

Elastic-scattering spectroscopy (ESS) can assess invivo and in real-time the scattering and absorption properties of tissue related to underlying pathologies. To evaluate the potential of ESS for differentiating neoplastic from non-neoplastic polyps during colonoscopy. Pilot study, retrospective data analysis. Academic practice. A total of 83 patients undergoing screening/surveillance colonoscopy. ESS spectra of 218 polyps (133 non-neoplastic, 85 neoplastic) were acquired during colonoscopy. Spectral data were correlated with the classification of biopsy samples by 3 GI pathologists. High-dimensional methods were used to design diagnostic algorithms. Diagnostic performance of ESS. Analysis of spectra from polyps of all sizes (N= 218) resulted in a sensitivity of 91.5%, specificity of 92.2%, and accuracy of 91.9% with a high-confidence rate of 90.4%. Restricting analysis to polyps smaller than 1 cm (n= 179) resulted in a sensitivity of 87.0%, specificity of 92.1%, and accuracy of 90.6% with a high-confidence rate of 89.3%. Analysis of polyps 5mm or smaller (n= 157) resulted in a sensitivity of 86.8%, specificity of 91.2%, and accuracy of 90.1% with a high-confidence rate of 89.8%. Sample size, retrospective validation used to obtain performance estimates. Results indicate that ESS permits accurate, real-time classification of polyps as neoplastic or non-neoplastic. ESS is a simple, low cost, clinically robust method with minimal impact on procedure flow, especially when integrated into standard endoscopic biopsy tools. Performance on polyps 5mm or smaller indicates that ESS may, in theory, achieve Preservation and Incorporation of Valuable Endoscopic Innovations performance thresholds. ESS may one day prove to be a useful tool used in endoscopic screening and surveillance of colorectal cancer.