Multispectral endoscopy for early detection of dysplasia in Barrett’s oesophagus (MuSE): a pilot study (Conference Presentation)

Barrett’s oesophagus is an acquired condition that predisposes patients to the development of oesophageal adenocarcinoma through intermediate stages of dysplasia. Early detection of dysplasia allows curative endoscopic therapy, but current standard of care surveillance achieves only around 40% sensitivity for dysplasia. Multispectral imaging (MSI) allows simultaneous collection of morphological (spatial) and biochemical (spectral) information from tissue, which can help to more effectively delineate disease. This motivated the design and construction of a compact, clinically translatable multispectral endoscope (MuSE) that can be introduced through the accessory channel of a standard gastroscope to collect multispectral images in vivo. MuSE is based around a spectrally resolved detector array (SRDA) with 9 spectral filters (8 narrow bands; average FWHM 30nm, center wavelengths 553, 587, 629, 665, 714, 749, 791, 829nm; 1 broadband; 500–850nm). The SRDA was coupled to a clinically approved 10,000-fibre endoscope (PolyScope) for imaging. Illumination was provided by sequentially by a broadband (400–750nm) and narrowband (400–480nm) source for reflectance and autofluorescence imaging respectively. Subjects due to undergo clinically indicated endoscopy with a previous diagnosis of dysplasia or early adenocarcinoma were enrolled for experimental imaging using MuSE in a pilot clinical study. Patients with clearly visible lesions were selected to allow co-registration of the image cubes with pathology of biopsies. Here, we present the results from these first-in-human tests of MuSE, including evaluation of the image quality and classification potential of the multispectral image cubes.