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Endoscopic Fluorescence Imaging Spectroscopy for Highly-Sensitive and High-Fidelity Diagnosis of Gastrointestinal Cancer in Vivo
14 Pages Posted: 22 Apr 2024
More...Abstract
Background: White-light endoscopy lacks molecular specificity and detects morphological changes of lesions. Fluorescence endoscopy commonly provides intensity distribution, which is highly sensitive to the distribution of probes. The aggregation of probe is limited by its complex metabolism in vivo and changes over time, leading to false positive and missed detection in clinical diagnosis.
Methods: Fluorescence spectrum contains more complete molecular-specific information that corrects mischaracterization of lesions by fluorescence intensity due to fluorophore concentration and detection errors, enabling accurate tissue typing. Here, we developed an endoscopic fluorescence imaging spectroscopy. In the scheme, fluorescent signals from the targeted probe can deliver to the camera and spectrometer, enabling fluorescence imaging and spectroscopy on a single device.
Findings: We explored the potential of our method by identifying esophageal squamous cell carcinoma in vivo. After using the self-synthesized activatable fluorescent probe, the mouse subcutaneous tumor-bearing model can be used for such potential validation. By imaging fluorescence emission and detecting spectral peak redshift before and after probe activation, our endoscopic scheme technology identified and corrected most of the false positive/false negative representations, achieving 92.3% sensitivity and 100% specificity,
Interpretation: we developed an endoscopic fluorescence imaging spectroscopy and improved the sensitivity of endoscopic examination of gastrointestinal cancers and reduces the rate of false positives and missed detections.
Funding: This work was supported in part by the National Key Research and Development Program of China (2022YFB3203800), the National Natural Science Foundation of China (62275210, 32101115, 62105255), the National Young Talent Program (None), the Shaanxi Young Top-notch Talent Program (None), the Fok Ying-Tung Education Foundation of China (161104), Key Research and Development Projects of Shaanxi Province (2022SF-214, 2023-YBSF-293), Fundamental Research Funds for the Central Universities (ZYTS23187).
Declaration of Interest: All authors declare no conflicts of interest.
Ethical Approval: Animal experiments were approved by the First Affiliated Hospital of Fourth Military Medical University in accordance with the Ethical Guidelines for Animal Care (KY20163349-1).
Keywords: Fluorescence imaging spectroscopy, endoscopy, gastrointestinal cancer, fluorescence imaging, spectrum shift, esophageal squamous cell carcinoma
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