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First-in-human pilot study of snapshot multispectral endoscopy for early detection of Barrett’s-related neoplasia
Journal of Biomedical Optics  (IF3.17),  Pub Date : 2021-10-01, DOI: 10.1117/1.jbo.26.10.106002
Dale J. Waterhouse, Sophia Bano, Wladyslaw Januszewicz, Dan Stoyanov, Rebecca C. Fitzgerald, Massimiliano di Pietro, Sarah E. Bohndiek

Significance: The early detection of dysplasia in patients with Barrett’s esophagus could improve outcomes by enabling curative intervention; however, dysplasia is often inconspicuous using conventional white-light endoscopy. Aim: We sought to determine whether multispectral imaging (MSI) could be applied in endoscopy to improve detection of dysplasia in the upper gastrointestinal (GI) tract. Approach: We used a commercial fiberscope to relay imaging data from within the upper GI tract to a snapshot MSI camera capable of collecting data from nine spectral bands. The system was deployed in a pilot clinical study of 20 patients (ClinicalTrials.gov NCT03388047) to capture 727 in vivo image cubes matched with gold-standard diagnosis from histopathology. We compared the performance of seven learning-based methods for data classification, including linear discriminant analysis, k-nearest neighbor classification, and a neural network. Results: Validation of our approach using a Macbeth color chart achieved an image-based classification accuracy of 96.5%. Although our patient cohort showed significant intra- and interpatient variance, we were able to resolve disease-specific contributions to the recorded MSI data. In classification, a combined principal component analysis and k-nearest-neighbor approach performed best, achieving accuracies of 95.8%, 90.7%, and 76.1%, respectively, for squamous, non-dysplastic Barrett’s esophagus and neoplasia based on majority decisions per-image. Conclusions: MSI shows promise for disease classification in Barrett’s esophagus and merits further investigation as a tool in high-definition “chip-on-tip” endoscopes.