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Second Harmonic Generation Imaging Distinguishes Both High-Grade Dysplasia and Cancer from Normal Colonic Mucosa

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Abstract

Background and Aim

Second harmonic generation (SHG) is a novel imaging technology that could provide optical biopsy during endoscopy with advantages over current technology. SHG has the unique ability to evaluate the amount of extracellular matrix collagen protein and its alignment.

Methods

Hematoxylin- and eosin-stained slides from colon biopsies (normal, low-grade dysplasia (LGD), high-grade dysplasia (HGD), and cancer) were examined with SHG imaging. Both signal intensity and collagen fiber alignment were measured. Average intensity per pixel (AIPP) was obtained, and an analyzing polarizer was used to calculate β, an alignment parameter.

Results

The mean AIPP for normal mucosa was 48, LGD was 38, HGD was 42, and malignancy was 123 (p < 0.01). The AIPP ROC curve between malignant versus non-malignant tissue was 0.96 (0.93–0.99). An AIPP value of 60 can differentiate malignancy with 87 % sensitivity and 90 % specificity. The mean β for normal tissue was 0.490, LGD was 0.379, HGD was 0.345, and cancer was 0.453 (p = 0.013), with a normal tissue mean rank of 6.5 compared to 2.5 for HGD (p = 0.029).

Conclusions

SHG signal intensity can differentiate malignant from non-malignant colonic polyp tissue with high sensitivity and specificity. Anisotropic polarization can discern HGD from normal colonic polyp tissue. SHG can thus distinguish both HGD and malignant lesions in an objective numeric fashion, without contrast agents or interpretation skills. SHG could be incorporated into endoscopy equipment to enhance white light endoscopy.

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Acknowledgments

The authors thank Ms. Amy Pallotti (UConn Health Center) for her assistance with formatting and submitting the article.

Conflict of interest

None.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-1845, USA

    John W. Birk & Micheal Tadros

  2. Department of Gastroenterology, Sacramento Medical Center, 2025 Morse Avenue, Sacramento, CA, 95825, USA

    Koorosh Moezardalan

  3. Faculty of Science, Utrecht University, Postbus 80.010, 3508 TA, Utrecht, The Netherlands

    Oleg Nadyarnykh

  4. Department of Pathology and Laboratory Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-3985, USA

    Faripour Forouhar

  5. Section of Gastroenterology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA

    Joseph Anderson

  6. Department of Biomedical Engineering, College of Engineering, University of Wisconsin-Madison, 1415 Engineering Drive, Madison, WI, 53706, USA

    Paul Campagnola

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  1. John W. Birk
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  2. Micheal Tadros
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Correspondence to John W. Birk.

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Birk, J.W., Tadros, M., Moezardalan, K. et al. Second Harmonic Generation Imaging Distinguishes Both High-Grade Dysplasia and Cancer from Normal Colonic Mucosa. Dig Dis Sci 59, 1529–1534 (2014). https://doi.org/10.1007/s10620-014-3121-7

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  • DOI: https://doi.org/10.1007/s10620-014-3121-7

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