New method for real-time visualization and quantitative characterization of early colorectal cancer in endoscopy: a pilot study

Andrej Wagner; Stephan Zandanell; Alexander Ziachehabi; Alexander Mitrakov; Eckhard Klieser; Daniel Neureiter; Tobias Kiesslich; Christian Mayr; Frieder Berr; Michael Fedoruk; Franz Singhartinger; Josef Holzinger

doi:10.1055/a-1847-2820

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(08): E1147-E1154
DOI: 10.1055/a-1847-2820

Innovation forum

New method for real-time visualization and quantitative characterization of early colorectal cancer in endoscopy: a pilot study

Authors

Andrej Wagner

¹Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
Stephan Zandanell

¹Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
Alexander Ziachehabi

²Department of Medicine II, Kepler Medical University, Linz, Austria
Alexander Mitrakov

³Endoscopy Division, Nizhniy Novgorod Cancer Hospital, Nizhniy Novgorod, Russian Federation
Eckhard Klieser

⁴Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
Daniel Neureiter

⁴Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
Tobias Kiesslich

¹Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria

⁵Laboratory for Tumour Biology and Experimental Therapies (TREAT), Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
Christian Mayr

⁵Laboratory for Tumour Biology and Experimental Therapies (TREAT), Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
Frieder Berr

¹Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
Michael Fedoruk

⁶Vortex Photonics, Planegg, Germany
Franz Singhartinger

⁷Department of Surgery, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
Josef Holzinger

⁷Department of Surgery, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria

Abstract

Background and study aims Endoscopic optical diagnosis is crucial to the therapeutic strategy for early gastrointestinal cancer. It accurately (> 85 %) predicts pT category based on microsurface (SP) and vascular patterns (VP). However, interobserver variability is a major problem. We have visualized and digitalized the graded irregularities based on bioinformatically enhanced quantitative endoscopic image analysis (BEE) of high-definition white-light images.

Methods In a pilot study of 26 large colorectal lesions (LCLs, mean diameter 39 mm), we retrospectively compared BEE variables with corresponding histopathology of the resected LCLs.

Results We included 10 adenomas with low-grade intraepithelial neoplasia (LGIN), nine with high-grade intraepithelial neoplasia (HGIN) and early adenocarcinoma (EAC), and seven deeply submucosal invasive carcinomas. Quantified density (d) and nonuniformity (C_U) of vascular and surface structures correlated with histology (r_s d VP: –0.77, r_s C_U VP: 0.13, r_s d SP: –0.76, and r_s C_U SP: 0.45, respectively). A computed BEE score showed a sensitivity and specificity of 90 % and 100 % in the group with LGINs, 89 % and 41 % in the group with HGINs and EACs, and 100 % and 95 % in the group with deeply invasive carcinoma, respectively.

Conclusions In this pilot study, BEE showed promise as a tool for endoscopic characterization of LCLs during routine endoscopy. Prospective clinical studies are needed.

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References

References
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