CC BY 4.0 · Endoscopy 2018; 50(06): 618-625
DOI: 10.1055/s-0043-124080
Innovations and brief communications
Owner and Copyright © Georg Thieme Verlag KG 2018

Detection of early neoplasia in Barrett’s esophagus using lectin-based near-infrared imaging: an ex vivo study on human tissue

André A. Neves*
Cancer Research UK Cambridge Institute, Li Ka-Shing Centre, Cambridge, UK
,
Massimiliano Di Pietro*
Cancer Research UK Cambridge Institute, Li Ka-Shing Centre, Cambridge, UK
,
Maria O’Donovan
Department of Histopathology, Cambridge University Hospitals, Cambridge, UK
,
Dale J. Waterhouse
Cancer Research UK Cambridge Institute, Li Ka-Shing Centre, Cambridge, UK
Department of Physics, University of Cambridge, Cambridge, UK
,
Sarah E. Bohndiek
Cancer Research UK Cambridge Institute, Li Ka-Shing Centre, Cambridge, UK
Department of Physics, University of Cambridge, Cambridge, UK
,
Kevin M. Brindle
Cancer Research UK Cambridge Institute, Li Ka-Shing Centre, Cambridge, UK
,
Rebecca C. Fitzgerald
Medical Research Council, Cancer Unit, University of Cambridge, Cambridge, UK
› Author Affiliations
Further Information

Publication History

submitted 03 July 2017

accepted after revision 10 October 2017

Publication Date:
17 January 2018 (eFirst)

Abstract

Background and study aims Endoscopic surveillance for Barrett’s esophagus (BE) is limited by long procedure times and sampling error. Near-infrared (NIR) fluorescence imaging minimizes tissue autofluorescence and optical scattering. We assessed the feasibility of a topically applied NIR dye-labeled lectin for the detection of early neoplasia in BE in an ex vivo setting.

Methods Consecutive patients undergoing endoscopic mucosal resection (EMR) for BE-related early neoplasia were recruited. Freshly collected EMR specimens were sprayed at the bedside with fluorescent lectin and then imaged. Punch biopsies were collected from each EMR under NIR light guidance. We compared the fluorescence intensity from dysplastic and nondysplastic areas within EMRs and from punch biopsies with different histological grades.

Results 29 EMR specimens were included from 17 patients. A significantly lower fluorescence was found for dysplastic regions across whole EMR specimens (P < 0.001). We found a 41 % reduction in the fluorescence of dysplastic compared to nondysplastic punch biopsies (P < 0.001), with a sensitivity and specificity for dysplasia detection of 80 % and 82.9 %, respectively.

Conclusion Lectin-based NIR imaging can differentiate dysplastic from nondysplastic Barrett’s mucosa ex vivo.

* These authors contributed equally to the study.