European Radiology

, Volume 25, Issue 6, pp 1814–1822 | Cite as

Feasibility study of novel endoscopic Cerenkov luminescence imaging system in detecting and quantifying gastrointestinal disease: first human results

  • Hao Hu
  • Xin Cao
  • Fei Kang
  • Min Wang
  • Yenan Lin
  • Muhan Liu
  • Shujun Li
  • Liping Yao
  • Jie Liang
  • Jimin Liang
  • Yongzhan Nie
  • Xueli Chen
  • Jing Wang
  • Kaichun Wu
Molecular Imaging



Cerenkov luminescence imaging (CLI) provides potential to use clinical radiotracers for optical imaging. The goal of this study was to present a newly developed endoscopic CLI (ECLI) system and illustrate its feasibility and potential in distinguishing and quantifying cancerous lesions of the GI tract.


The ECLI system was established by integrating an electron-multiplying charge-coupled device camera with a flexible fibre endoscope. Phantom experiments and animal studies were conducted to test and illustrate the system in detecting and quantifying the presence of radionuclide in vitro and in vivo. A pilot clinical study was performed to evaluate our system in clinical settings.


Phantom and mice experiments demonstrated its ability to acquire both the luminescent and photographic images with high accuracy. Linear quantitative relationships were also obtained when comparing the ECLI radiance with the radiotracer activity (r 2 = 0.9779) and traditional CLI values (r 2 = 0.9025). Imaging of patients revealed the potential of ECLI in the identification and quantification of cancerous tissue from normal, which showed good consistence with the clinical PET examination.


The new ECLI system shows good consistence with the clinical PET examination and has great potential for clinical translation and in aiding detection of the GI tract disease.

Key Points

CLI preserves the characteristics of both optical and radionuclide imaging.

CLI provides great potential for clinical translation of optical imaging.

The newly developed endoscopic CLI (ECLI) has quantification and imaging capacities.

GI tract has accessible open surfaces, making ECLI a potentially suitable technique.

Cerenkov endoscopy has great clinical potential in detecting GI disease.


Molecular imaging Radionuclide imaging Optical imaging Endoscopy Gastrointestinal disease 



Cerenkov luminescence imaging


Cerenkov luminescence tomography


Endoscopic Cerenkov luminescence imaging


Electron-multiplying charge-coupled device





The scientific guarantor of this publication is Xueli Chen at Xidian University. The authors would like to thank Dr. Xiaowei Ma from Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University for the technical assistance. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This work was supported in part by the National Natural Science Foundation of China under Grant Nos. 81090270, 81090272, 81090273, 81101083, 81230033, 81371615 and 81370585; Program of the National Basic Research and Development Program of China (973) under Grant Nos. 2011CB707702, 2010CB529302, the National Municipal Science and Technology Project under Grant Nos. 2009ZX09103-667, 2009ZX09301-009-RC06, and the Open Research Project under Grant 20120101 from SKLMCCS. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Approval from the institutional animal care committee was obtained. Methodology: experimental, performed at one institution.

Supplementary material

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Supplementary Figure S1

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High resolution image (TIFF 1329 kb)
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Supplementary Figure S2

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High resolution image (TIFF 132 kb)
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Supplementary Figure S3

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High resolution image (TIFF 404 kb)
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Supplementary Table S1 (DOCX 16 kb)
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ESM 1 (DOCX 18 kb)


  1. 1.
    Ruggiero A, Holland JP, Lewis JS, Grimm J (2010) Cerenkov luminescence imaging of medical isotopes. J Nucl Med 51:1123–1130CrossRefPubMedCentralPubMedGoogle Scholar
  2. 2.
    Spinelli AE, D’Ambrosio D, Calderan L, Marengo M, Sbarbati A, Boschi F (2010) Cerenkov radiation allows in vivo optical imaging of positron emitting radiotracers. Phys Med Biol 55:483CrossRefPubMedGoogle Scholar
  3. 3.
    Xu Y, Liu H, Cheng Z (2011) Harnessing the power of radionuclides for optical imaging: Cerenkov luminescence imaging. J Nucl Med 52:2009–2018CrossRefPubMedGoogle Scholar
  4. 4.
    Jelley J (1955) Cerenkov radiation and its applications. Br J Appl Phys 6:227CrossRefGoogle Scholar
  5. 5.
    Robertson R, Germanos MS, Li C, Mitchell GS, Cherry SR, Silva MD (2009) Optical imaging of Cerenkov light generation from positron-emitting radiotracers. Phys Med Biol 54:N355–N365CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Spinelli AE, Ferdeghini M, Cavedon C et al (2013) First human Cerenkography. J Biomed Opt 18:020502CrossRefGoogle Scholar
  7. 7.
    Boschi F, Calderan L, D’Ambrosio D et al (2011) In vivo 18F-FDG tumour uptake measurements in small animals using Cerenkov radiation. Eur J Nucl Med Mol Imaging 38:120–127CrossRefPubMedGoogle Scholar
  8. 8.
    Hu Z, Ma X, Qu X et al (2012) Three-dimensional noninvasive monitoring iodine-131 uptake in the thyroid using a modified Cerenkov luminescence tomography approach. PLoS ONE 7:e37623CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Jeong SY, Hwang M-H, Kim JE et al (2011) Combined Cerenkov luminescence and nuclear imaging of radioiodine in the thyroid gland and thyroid cancer cells expressing sodium iodide symporter: initial feasibility study. Endocr J 58:575CrossRefPubMedGoogle Scholar
  10. 10.
    Robertson R, Germanos MS, Manfredi MG, Smith PG, Silva MD (2011) Multimodal imaging with 18F-FDG PET and Cerenkov luminescence imaging after MLN4924 treatment in a human lymphoma xenograft model. J Nucl Med 52:1764–1769CrossRefPubMedGoogle Scholar
  11. 11.
    Li C, Mitchell GS, Cherry SR (2010) Cerenkov luminescence tomography for small animal imaging. Opt Lett 35:1109–1111CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Hu Z, Liang J, Yang W et al (2010) Experimental Cerenkov luminescence tomography of the mouse model with SPECT imaging validation. Opt Express 18:24441–24450CrossRefPubMedGoogle Scholar
  13. 13.
    Liu H, Carpenter CM, Jiang H et al (2012) Intraoperative imaging of tumors using Cerenkov luminescence endoscopy: a feasibility experimental study. J Nucl Med 53:1579–1584CrossRefPubMedGoogle Scholar
  14. 14.
    Kothapalli S-R, Liu H, Liao JC, Cheng Z, Gambhir SS (2012) Endoscopic imaging of Cerenkov luminescence. Biomed Opt Express 3:1215CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Ma X, Yang W, Zhou S et al (2012) Study of penetration depth and resolution of Cerenkov luminescence emitted from (18)F-FDG and (131)I. J Nucl Med 53:55CrossRefGoogle Scholar
  16. 16.
    China Food and Drug Administration, imported instrument database history (2006) Accessed 5 Apr 2014
  17. 17.
    Thorek DL, Ogirala A, Beattie BJ, Grimm J (2013) Quantitative imaging of disease signatures through radioactive decay signal conversion. Nat Med 19:1345–1350CrossRefPubMedCentralPubMedGoogle Scholar
  18. 18.
    Chen X, Gao X, Chen D et al (2010) 3D reconstruction of light flux distribution on arbitrary surfaces from 2D multi-photographic images. Opt Express 18:19876–19893CrossRefPubMedGoogle Scholar
  19. 19.
    Dothager RS, Goiffon RJ, Jackson E, Harpstrite S, Piwnica-Worms D (2010) Cerenkov radiation energy transfer (CRET) imaging: a novel method for optical imaging of PET isotopes in biological systems. PLoS ONE 5:e13300CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Liu H, Zhang X, Xing B, Han P, Gambhir SS, Cheng Z (2010) Radiation‐luminescence‐excited quantum dots for in vivo multiplexed optical imaging. Small 6:1087–1091CrossRefPubMedGoogle Scholar
  21. 21.
    Carpenter CM, Sun C, Pratx G, Liu H, Cheng Z, Xing L (2012) Radioluminescent nanophosphors enable multiplexed small-animal imaging. Opt Express 20:11598CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Luo H, Zhang L, Liu X et al (2013) Water exchange enhanced cecal intubation in potentially difficult colonoscopy. Unsedated patients with prior abdominal or pelvic surgery: a prospective, randomized, controlled trial. Gastrointest Endosc 77:767–773CrossRefPubMedGoogle Scholar
  23. 23.
    Xu Y, Chang E, Liu H, Jiang H, Gambhir SS, Cheng Z (2012) Proof-of-concept study of monitoring cancer drug therapy with cerenkov luminescence imaging. J Nucl Med 53:312–317CrossRefPubMedCentralPubMedGoogle Scholar
  24. 24.
    Thorek DL, Riedl C, Grimm J (2014) Clinical Cerenkov luminescence imaging of 18F-FDG. J Nucl Med 55:95–98CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Hao Hu
    • 1
  • Xin Cao
    • 2
  • Fei Kang
    • 3
  • Min Wang
    • 4
  • Yenan Lin
    • 2
  • Muhan Liu
    • 2
  • Shujun Li
    • 1
  • Liping Yao
    • 1
  • Jie Liang
    • 1
  • Jimin Liang
    • 2
  • Yongzhan Nie
    • 1
  • Xueli Chen
    • 2
  • Jing Wang
    • 3
  • Kaichun Wu
    • 1
  1. 1.State Key Laboratory of Cancer Biology, Department of Digestive Diseases, Xijing HospitalFourth Military Medical UniversityXi’anChina
  2. 2.School of Life Science and TechnologyXidian UniversityXi’anChina
  3. 3.Department of Nuclear Medicine, Xijing HospitalFourth Military Medical UniversityXi’anChina
  4. 4.Department of GastroenterologyXi’an Children’s HospitalXi’anChina

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