Endoscopic histological assessment of colonic polyps by using elastic scattering spectroscopy

Gastrointest Endosc. 2015 Mar;81(3):539-47. doi: 10.1016/j.gie.2014.07.012. Epub 2014 Sep 23.


Background: Elastic-scattering spectroscopy (ESS) can assess in vivo and in real-time the scattering and absorption properties of tissue related to underlying pathologies.

Objectives: To evaluate the potential of ESS for differentiating neoplastic from non-neoplastic polyps during colonoscopy.

Design: Pilot study, retrospective data analysis.

Setting: Academic practice.

Patients: A total of 83 patients undergoing screening/surveillance colonoscopy.

Interventions: ESS spectra of 218 polyps (133 non-neoplastic, 85 neoplastic) were acquired during colonoscopy. Spectral data were correlated with the classification of biopsy samples by 3 GI pathologists. High-dimensional methods were used to design diagnostic algorithms.

Main outcome measurements: Diagnostic performance of ESS.

Results: Analysis of spectra from polyps of all sizes (N = 218) resulted in a sensitivity of 91.5%, specificity of 92.2%, and accuracy of 91.9% with a high-confidence rate of 90.4%. Restricting analysis to polyps smaller than 1 cm (n = 179) resulted in a sensitivity of 87.0%, specificity of 92.1%, and accuracy of 90.6% with a high-confidence rate of 89.3%. Analysis of polyps 5 mm or smaller (n = 157) resulted in a sensitivity of 86.8%, specificity of 91.2%, and accuracy of 90.1% with a high-confidence rate of 89.8%.

Limitations: Sample size, retrospective validation used to obtain performance estimates.

Conclusion: Results indicate that ESS permits accurate, real-time classification of polyps as neoplastic or non-neoplastic. ESS is a simple, low cost, clinically robust method with minimal impact on procedure flow, especially when integrated into standard endoscopic biopsy tools. Performance on polyps 5 mm or smaller indicates that ESS may, in theory, achieve Preservation and Incorporation of Valuable Endoscopic Innovations performance thresholds. ESS may one day prove to be a useful tool used in endoscopic screening and surveillance of colorectal cancer.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenoma / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Colonic Neoplasms / pathology*
  • Colonic Polyps / pathology*
  • Colonoscopy / instrumentation
  • Colonoscopy / methods*
  • Decision Support Techniques
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spectrum Analysis / instrumentation
  • Spectrum Analysis / methods*