Original Contribution

Diseases of the Colon & Rectum

, Volume 51, Issue 9, pp 1381-1386

Spectral Slope from the Endoscopically-Normal Mucosa Predicts Concurrent Colonic Neoplasia: A Pilot Ex-Vivo Clinical Study

  • Hemant K. RoyAffiliated withDepartment of Internal Medicine, Evanston Northwestern Healthcare Research Institute Email author 
  • , Vladimir TurzhitskyAffiliated withBiomedical Engineering Department, Northwestern University
  • , Young L. KimAffiliated withBiomedical Engineering Department, Northwestern University
  • , Michael J. GoldbergAffiliated withDepartment of Internal Medicine, Evanston Northwestern Healthcare Research Institute
  • , Joseph P. MuldoonAffiliated withDepartment of Surgery, Evanston-Northwestern Healthcare
  • , Yang LiuAffiliated withBiomedical Engineering Department, Northwestern University
  • , Randall E. BrandAffiliated withDepartment of Internal Medicine, Evanston Northwestern Healthcare Research Institute
  • , Curtis HallAffiliated withDepartment of Pathology, Evanston-Northwestern Healthcare
  • , Nahla HasabouAffiliated withDepartment of Internal Medicine, Evanston Northwestern Healthcare Research Institute
    • , Mohammed JameelAffiliated withDepartment of Internal Medicine, Evanston Northwestern Healthcare Research Institute
    • , Vadim BackmanAffiliated withBiomedical Engineering Department, Northwestern University

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Abstract

Purpose

We previously reported that analysis of histologically normal intestinal epithelium for spectral slope, a marker for aberrations in nanoscale tissue architecture, had outstanding accuracy in identifying field carcinogenesis in preclinical colorectal cancer models. In this study, we assessed the translatability of spectral slope analysis to human colorectal cancer screening.

Methods

Subjects (n = 127) undergoing colonoscopy had spectral slope determined from two endoscopically normal midtransverse colonic biopsies using four-dimensional elastic light-scattering fingerprinting and correlated with clinical findings.

Results

Four-dimensional elastic light-scattering fingerprinting analysis showed the submicron particles size progressively shifted toward larger sizes in subjects harboring neoplasia. There was a corresponding decrease in spectral slope values from the endoscopically normal mucosa in subjects harboring adenomas (n = 41) and advanced adenomas (n = 10), compared to neoplasia-free subjects (P ≤ 0.00001). These factors did not appear to be confounded by either age or adenoma location. For detecting advanced adenomas, spectral slope had a negative and positive predictive value of 95 percent and 50 percent respectively.

Conclusions

We demonstrate, for the first time, that spectral slope in “normal” mucosa can accurately risk-stratify patients for colonic neoplasia. This proof of concept study serves to underscore the promise of four-dimensional elastic light-scattering fingerprinting analysis for colorectal cancer screening.

Key words

Colon cancer Colon cancer screening Spectroscopy