Design and validation of a near-infrared fluorescence endoscope for detection of early esophageal malignancy

Dale J. Waterhouse, James Joseph, André A. Neves, Massimiliano di Pietro, Kevin M. Brindle, Rebecca C. Fitzgerald, Sarah E. Bohndiek

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Barrett's esophagus is a known precursor lesion to esophageal adenocarcinoma. In these patients, early detection of premalignant disease, known as dysplasia, allows curative minimally invasive endoscopic therapy, but is confounded by a lack of contrast in white light endoscopy. Imaging fluorescently labeled lectins applied topically to the tissue has the potential to more accurately delineate dysplasia, but tissue autofluorescence limits both sensitivity and contrast when operating in the visible region. To overcome this challenge, we synthesized near-infrared (NIR) fluorescent wheat germ agglutinin (WGA-IR800CW) and constructed a clinically translatable bimodal NIR and white light endoscope. Images of NIR and white light with a field of view of 63 deg and an image resolution of 182μm are coregistered and the honeycomb artifact arising from the fiber bundle is removed. A minimum detectable concentration of 110 nM was determined using a dilution series of WGA-IR800CW. We demonstrated ex vivo that this system can distinguish between gastric and squamous tissue types in mouse stomachs (p=0.0005) and accurately detect WGA-IR800CW fluorescence in human esophageal resections (compared with a gold standard imaging system, rs>0.90). Based on these findings, future work will optimize the bimodal endoscopic system for clinical trials in Barrett's surveillance.

Original languageEnglish
Article number084001
Number of pages12
JournalJournal of Biomedical Optics
Volume21
Issue number8
DOIs
Publication statusPublished - 4 Aug 2016

Keywords

  • Barrett's esophagus
  • clinical translation
  • dysplasia
  • Flexible endoscope
  • fluorescence
  • near-infrared

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    Waterhouse, D. J., Joseph, J., Neves, A. A., di Pietro, M., Brindle, K. M., Fitzgerald, R. C., & Bohndiek, S. E. (2016). Design and validation of a near-infrared fluorescence endoscope for detection of early esophageal malignancy. Journal of Biomedical Optics, 21(8), [084001]. https://doi.org/10.1117/1.JBO.21.8.084001