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Proceedings Paper

Real-time in-vivo endoscopic imaging of fluorescence from human colonic adenomas
Author(s): Thomas D. Wang; Jacques Van Dam; James M. Crawford; Yang Wang; Irving Itzkan; Michael S. Feld
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Paper Abstract

Previous in vitro studies showed that autofluorescence images of colonic mucosa collected endoscopically can be used to detect dysplasia with high sensitivity. This method is extended to collection of fluorescence images of adenomatous polyps in vivo. Fluorescence images were collected during colonoscopy in 30 patients. A total of 12 adenomatous and 6 hyperplastic polyps were identified. An optical fiber excitation probe, located in the instrument channel of the colonoscope, delivered 300 mW of near- ultraviolet light at (lambda) ex equals 351 and 364 nm. Mucosal fluorescence in the spectral bandwidth between 400 and 700 nm was imaged, processed, and displayed with various likelihoods of associated dysplasia. Adenomatous polyps exhibited decreased fluorescence intensity compared to adjacent mucosa with normal appearance. With the fluorescence threshold set to 80% of the average intensity of normal mucosa, a sensitivity of 83% for dysplasia detection was achieved. All hyperplastic polyps were correctly identified as being non-dysplastic. Optimal identification of dysplastic regions was obtained with the colonoscope oriented at near-normal incidence to the polyps. At higher angles of incidence, artifacts due to illumination shadows were introduced. The dysplasia associated with adenomatous polyps can be detected in vivo on fluorescence imaging with high sensitivity, thus demonstrating the potential to guide endoscopic biopsy.

Paper Details

Date Published: 10 April 1998
PDF: 9 pages
Proc. SPIE 3259, Systems and Technologies for Clinical Diagnostics and Drug Discovery, (10 April 1998); doi: 10.1117/12.307335
Show Author Affiliations
Thomas D. Wang, Harvard Medical School and Massachusetts Institute of Technology (United States)
Jacques Van Dam, Harvard Medical School and Brigham and Women's Hospital (United States)
James M. Crawford, Yale Univ. School of Medicine (United States)
Yang Wang, Merck & Co., Inc. (United States)
Irving Itzkan, Massachusetts Institute of Technology (United States)
Michael S. Feld, Massachusetts Institute of Technology (United States)

Published in SPIE Proceedings Vol. 3259:
Systems and Technologies for Clinical Diagnostics and Drug Discovery
Gerald E. Cohn; John C. Owicki, Editor(s)

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