Abstract
We propose a multimodal endoscopic system based on white light (WL), multispectral (MS), and photometric stereo (PS) imaging for the examination of colorectal cancer (CRC). Recently, the enhancement of the diagnostic accuracy of CRC colonoscopy has been reported; however, tumor diagnosis for a variety of lesion types remains challenging using current endoscopy. In this study, we demonstrate that our developed system can simultaneously discriminate tumor distributions and provide three-dimensional (3D) morphological information about the colon surface using the WL, MS, and PS imaging modalities. The results demonstrate that the proposed system has considerable potential for CRC diagnosis.
Highlights
The progress of colorectal cancer (CRC) follows the multistep chronological model, wherein the growth of genetic mutations and epigenetic alterations form cancer precursors over time, such as polyps, metastasizing to lymph nodes and distant organs [1]
The results demonstrate that the proposed multimodal endoscopic system can detect the tumor distribution and provide 3D morphological information of the colon, suggesting that it has the potential to be an advanced tool for enhancing the CRC diagnosis accuracy
The three imaging techniques, in particular, are synergetic and complementary with respect to surface tumor characterization for the following reasons: (1) real-time white light (WL) imaging enables the determination of the region of interest (ROI) using the color and contrast changes in the ROI, which appears cancerous; (2) MS imaging precisely provides the tumor distributions through the comparison of the emission spectra of tumors and normal tissues at different/consecutive wavelengths, which may not be achievable with WL and photometric stereo (PS) imaging; and (3) PS imaging qualitatively provides 3D morphological images, increasing the detectability and classification accuracy of tumors
Summary
The progress of colorectal cancer (CRC) follows the multistep chronological model, wherein the growth of genetic mutations and epigenetic alterations form cancer precursors over time, such as polyps, metastasizing to lymph nodes and distant organs [1]. The progression to high-grade intraepithelial neoplasia or invasive carcinoma is correlated with the tumor distribution, morphology, and histological findings [3]. The documentation and description of the tumor distribution and morphology using the Paris classification system are recommended. On the basis of the shape, the lesions on the colon are differentiated as pedunculated (Ip), sessile (Is), and nonpolypoid (slightly elevated (IIa), flat (IIb), or depressed (IIc)) or as excavated/ulcerated lesions in the Paris classification system. Sessile and flat polyps are described as granular or nongranular laterally spreading tumors [4]. Colonoscopy screening is a critical procedure for preventing the worsening of the situation by determining a suitable treatment plan for CRC, according to the distribution and morphology of the tumors on colon-tissue surfaces. Smaller and variously shaped tumors reduce the WL endoscopy discrimination rate [5]
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