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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

Andrej Wagner
1   Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
,
Stephan Zandanell
1   Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
,
Alexander Ziachehabi
2   Department of Medicine II, Kepler Medical University, Linz, Austria
,
Alexander Mitrakov
3   Endoscopy Division, Nizhniy Novgorod Cancer Hospital, Nizhniy Novgorod, Russian Federation
,
Eckhard Klieser
4   Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
,
Daniel Neureiter
4   Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
,
Tobias Kiesslich
1   Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
5   Laboratory for Tumour Biology and Experimental Therapies (TREAT), Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
,
Christian Mayr
5   Laboratory for Tumour Biology and Experimental Therapies (TREAT), Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
,
Frieder Berr
1   Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
,
Michael Fedoruk
6   Vortex Photonics, Planegg, Germany
,
Franz Singhartinger
7   Department of Surgery, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
,
Josef Holzinger
7   Department of Surgery, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria
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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 (CU) of vascular and surface structures correlated with histology (rs d VP: –0.77, rs CU VP: 0.13, rs d SP: –0.76, and rs CU 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.

Supplementary material



Publication History

Received: 31 August 2021

Accepted after revision: 09 May 2022

Accepted Manuscript online:
09 May 2022

Article published online:
15 August 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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