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Title: Rapid, high-resolution, label-free, and 3-dimensional imaging to differentiate colorectal adenomas and non-neoplastic polyps with micro-optical coherence tomography
Authors: Ding, Qianshan
Deng, Yunchao
Yu, Xiaojun
Yuan, Jingping
Zeng, Zhi
Mu, Ganggang
Wan, Xinyue
Zhang, Jun
Zhou, Wei
Huang, Li
Yao, Liwen
Gong, Dexin
Chen, Mingkai
Zhu, Xu
Liu, Linbo
Yu, Honggang
Keywords: Coherence Tomography
Engineering::Electrical and electronic engineering
Colorectal Adenomas
Issue Date: 2019
Source: Ding, Q., Deng, Y., Yu, X., Yuan, J., Zeng, Z., Mu, G., . . . Yu, H. (2019). Rapid, high-resolution, label-free, and 3-dimensional imaging to differentiate colorectal adenomas and non-neoplastic polyps with micro-optical coherence tomography. Clinical and Translational Gastroenterology, 10(6), e00049-. doi:10.14309/ctg.0000000000000049
Series/Report no.: Clinical and Translational Gastroenterology
Abstract: INTRODUCTION: “Resect and discard” paradigm is one of the main strategies to deal with colorectal diminutive polyps after optical diagnosis. However, there are risks that unrecognized potentially malignant lesions are discarded without accurate diagnosis. The purpose of this study is to validate the potential of microoptical coherence tomography (mOCT) to improve the diagnostic accuracy of colorectal lesions and help endoscopists make better clinical decision without additional pathology costs. METHODS: Fresh tissue samples were obtained from patients with colorectal polyps or colorectal cancer who received endoscopic therapy or laparoscopic surgery. These samples were instantly imaged by mOCT and then sent to pathological evaluation. Then, mOCT images were compared with corresponding HE sections. We created consensus mOCT image criteria and then tested to determine sensitivity, specificity, and accuracy of our system to discriminate neoplastic polyps from non-neoplastic polyps. RESULTS: Our mOCT system achieved a resolution of 2.0 mm in both axial and lateral directions, clearly illustrated both cross-sectional and en face subcellular-level microstructures of colorectal lesions ex vivo, demonstrating distinctive patterns for inflammatory granulation tissue, hyperplastic polyp, adenoma, and cancerous tissue. For the 58 cases of polyps, the accuracy of the model was 94.83% (95% confidence interval [CI], 85.30%–98.79%), the sensitivity for identification of adenomas was 96.88% (95% CI, 82.89%–99.99%), and the specificity was 92.31% (95% CI, 74.74%–98.98%). Our diagnostic criteria could help both expert endoscopists and nonexpert endoscopists to identify neoplastic from non-neoplastic polyps with satisfactory accuracy and good interobserver agreement. DISCUSSION: We propose a new strategy usingmOCT to differentiate benign polyps and adenomas after the lesions are resected. The application of mOCT can potentially reduce the cost of pathological examination and minimize the risk of discarding malignant lesions during colonosocpy examination.
DOI: 10.14309/ctg.0000000000000049
Schools: School of Electrical and Electronic Engineering 
Rights: © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journa
Fulltext Permission: open
Fulltext Availability: With Fulltext
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