Abstract
Qualitative screening for colorectal polyps via fiber bundle microendoscopy imaging has shown promising results, with studies reporting high rates of sensitivity and specificity, as well as low interobserver variability with trained clinicians. A quantitative image quality control and image feature extraction algorithm (QFEA) was designed to lessen the burden of training and provide objective data for improved clinical efficacy of this method. After a quantitative image quality control step, QFEA extracts field-of-view area, crypt area, crypt circularity, and crypt number per image. To develop and validate this QFEA, a training set of microendoscopy images was collected from freshly resected porcine colon epithelium. The algorithm was then further validated on ex vivo image data collected from eight human subjects, selected from clinically normal appearing regions distant from grossly visible tumor in surgically resected colorectal tissue. QFEA has proven flexible in application to both mosaics and individual images, and its automated crypt detection sensitivity ranges from 71 to 94% despite intensity and contrast variation within the field of view. It also demonstrates the ability to detect and quantify differences in grossly normal regions among different subjects, suggesting the potential efficacy of this approach in detecting occult regions of dysplasia.
Highlights
Colorectal cancer (CRC) commonly arises from adenomatous polyps, some of which may progress into invasive adenocarcinomas over time.[3]
Screening for colorectal polyps via conventional white light colonoscopy has had a dramatic effect on reducing the overall morbidity and mortality due to CRC, as visible polyps can be safely removed during this procedure.[5]
We present both a quantitative image quality control algorithm to exclude low-quality images, as well as an intensity-adaptive quantitative image feature extraction algorithm (QFEA) to segment and quantify crypt morphology in images of superficial colorectal epithelium acquired via fiber bundle microendoscopy
Summary
Colorectal cancer (CRC) is currently the third leading cause of cancer death in the United States, despite increased screening rates and a concomitant decline in incidence and mortality.[1,2] CRC commonly arises from adenomatous polyps, some of which may progress into invasive adenocarcinomas over time.[3]. A broad range of alternative strategies have been recently employed to improve endoscopic screening methods, including autofluorescence endoscopy with real-time image processing, narrow band reflectance imaging, and combined multimodal methods.[6,7,8] While these approaches have demonstrated improved sensitivity for early detection of neoplasia, false positive rates remain elevated, limiting widespread adoption of these methods for screening purposes.[9]
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