Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Metho...Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.展开更多
Artificial intelligence(AI)is making significant strides in revolutionizing the detection of Barrett's esophagus(BE),a precursor to esophageal adenocarcinoma.In the research article by Tsai et al,researchers utili...Artificial intelligence(AI)is making significant strides in revolutionizing the detection of Barrett's esophagus(BE),a precursor to esophageal adenocarcinoma.In the research article by Tsai et al,researchers utilized endoscopic images to train an AI model,challenging the traditional distinction between endoscopic and histological BE.This approach yielded remarkable results,with the AI system achieving an accuracy of 94.37%,sensitivity of 94.29%,and specificity of 94.44%.The study's extensive dataset enhances the AI model's practicality,offering valuable support to endoscopists by minimizing unnecessary biopsies.However,questions about the applicability to different endoscopic systems remain.The study underscores the potential of AI in BE detection while highlighting the need for further research to assess its adaptability to diverse clinical settings.展开更多
Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality.The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric canc...Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality.The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage.In high prevalence regions such as Japan and Korea,this has led to the implementation of population screening programs.However,guidelines remain ambiguous in lower prevalence regions.In recent years,there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions.More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection.In addition,promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging.Data on endoscopic resection(ER)are particularly robust in Japan and Korea,with high rates of curative ER and markedly reduced procedural morbidity.However,there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries.Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER,as both technology and proceduralist expertise continue to grow.展开更多
BACKGROUND In recent years,two new narrow-band imaging(NBI)classifications have been proposed:The NBI international colorectal endoscopic(NICE)classification and Japanese NBI expert team(JNET)classification.Most valid...BACKGROUND In recent years,two new narrow-band imaging(NBI)classifications have been proposed:The NBI international colorectal endoscopic(NICE)classification and Japanese NBI expert team(JNET)classification.Most validation studies of the two new NBI classifications were conducted in classification setting units by experienced endoscopists,and the application of use in different centers among endoscopists with different endoscopy skills remains unknown.AIM To evaluate clinical application and possible problems of NICE and JNET classification for the differential diagnosis of colorectal cancer and precancerous lesions.METHODS Six endoscopists with varying levels of experience participated in this study.Eighty-seven consecutive patients with a total of 125 lesions were photographed during non-magnifying conventional white-light colonoscopy,non-magnifying NBI,and magnifying NBI.The three groups of endoscopic pictures of each lesion were evaluated by the six endoscopists in randomized order using the NICE and JENT classifications separately.Then we calculated the six endoscopists’sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for each category of the two classifications.RESULTS The sensitivity,specificity,and accuracy of JNET classification type 1 and 3 were similar to NICE classification type 1 and 3 in both the highly experienced endoscopist(HEE)and less-experienced endoscopist(LEE)groups.The specificity of JNET classification type 1 and 3 and NICE classification type 3 in both the HEE and LEE groups was>95%,and the overall interobserver agreement was good in both groups.The sensitivity of NICE classification type 3 lesions for diagnosis of SM-d carcinoma in the HEE group was significantly superior to that in the LEE group(91.7%vs 83.3%;P=0.042).The sensitivity of JNET classification type 2B lesions for the diagnosis of high-grade dysplasia or superficial submucosal invasive carcinoma in the HEE and LEE groups was 53.8%and 51.3%,respectively.Compared with other types of JNET classification,the diagnostic ability of type 2B was the weakest.CONCLUSION The treatment strategy of the two classification type 1 and 3 lesions can be based on the results of endoscopic examination.JNET type 2B lesions need further examination.展开更多
A method of fabricating multi-core polymer image fiber is proposed.Image fiber preform is fabricated by stacking thousands of polymer fibers each with a 0.25-mm diameter orderly in a die by only one step.The preform i...A method of fabricating multi-core polymer image fiber is proposed.Image fiber preform is fabricated by stacking thousands of polymer fibers each with a 0.25-mm diameter orderly in a die by only one step.The preform is heated and stretched into image fiber with an outer diameter of 2mm.Then a portable eyewear-style three-dimensional(3D) endoscope system is designed,fabricated,and characterized.This endoscopic system is composed of two graded index lenses,two pieces of 0.35-m length image guide fibers,and a pair of oculars.It shows good ?exibility and portability,and can provide the depth information accordingly.展开更多
Oral endoscope image stitching algorithm is studied to obtain wide-field oral images through regis-tration and stitching,which is of great significance for auxiliary diagnosis.Compared with natural images,oral images ...Oral endoscope image stitching algorithm is studied to obtain wide-field oral images through regis-tration and stitching,which is of great significance for auxiliary diagnosis.Compared with natural images,oral images have lower textures and fewer features.However,traditional feature-based image stitching methods rely heavily on feature extraction quality,often showing an unsatisfactory performance when stitching images with few features.Moreover,due to the hand-held shooting,there are large depth and perspective disparities between the captured images,which also pose a challenge to image stitching.To overcome the above problems,we propose an unsupervised oral endoscope image stitching algorithm based on the extraction of overlapping regions and the loss of deep features.In the registration stage,we extract the overlapping region of the input images by sketching polygon intersection for feature points screening and estimate homography from coarse to fine on a three-layer feature pyramid structure.Moreover,we calculate loss using deep features instead of pixel values to emphasize the importance of depth disparities in homography estimation.Finally,we reconstruct the stitched images from feature to pixel,which can eliminate artifacts caused by large parallax.Our method is compared with both feature-based and previous deep-based methods on the UDIS-D dataset and our oral endoscopy image dataset.The experimental results show that our algorithm can achieve higher homography estimation accuracy,and better visual quality,and can be effectively applied to oral endoscope image stitching.展开更多
Current gradient-index(GRIN)lens based proximal-driven intracoronary optical coherence tomography(ICOCT)probes consist of a spacer and a GRIN lens with large gradient constant.This design provides great flexibility to...Current gradient-index(GRIN)lens based proximal-driven intracoronary optical coherence tomography(ICOCT)probes consist of a spacer and a GRIN lens with large gradient constant.This design provides great flexibility to control beam profiles,but the spacer length should be well controlled to obtain desired beam profiles and thus it sets an obstacle in mass catheter fabrication.Besides,although GRIN lens with large gradient constant can provide tight focus spot,it has short depth of focus and fast-expanded beam which leads to poor lateral resolution for deep tissue.In this paper,a type of spacer-removed probe is demonstrated with a small gradient constant GRIN lens.This design simplifies the fabrica-tion process and is suitable for mass production.The output beam of the catheter is a narrow nearly collimated light beam,referred to as pencil beam here.The full width at half maximum beam size varies from 35.1μm to 75.3μm in air over 3-mm range.Probe design principles are elaborated with probe/catheter fabrication and performance test.The in vivo imaging of the catheter was verified by a clinical ICOCT system.Those results prove that this novel pencil-beam scanning catheter is potentially a good choice for ICOCT systems.展开更多
Acoustic/ultrasonic sensors are devices that can convert mechanical energy into electrical signals.The Fabry–Perot cavity is processed on the end face of the double-clad fiber by a two-photon three-dimensional lithog...Acoustic/ultrasonic sensors are devices that can convert mechanical energy into electrical signals.The Fabry–Perot cavity is processed on the end face of the double-clad fiber by a two-photon three-dimensional lithography machine.In this study,the outer diameter of the core cladding was 250μm,the diameter of the core was 9μm,and the microcavity sensing unit was only 30μm.It could measure ultrasonic signals with high precision.The characteristics of the proposed ultrasonic sensor were investigated,and its feasibility was proven through experiments.Its design has a small size and can replace a larger ultrasonic detector device for photoacoustic signal detection.The sensor is applicable to the field of biomedical information technology,including medical diagnosis,photoacoustic endoscopy,and photoacoustic imaging.展开更多
Over the past few years,emerging new approaches in endoscopic imaging technologies facilitate a high-quality assessment of lesions found in the gastrointestinal(GI)tract.Endocytoscopy(EC),as a novel tool in endoscopy,...Over the past few years,emerging new approaches in endoscopic imaging technologies facilitate a high-quality assessment of lesions found in the gastrointestinal(GI)tract.Endocytoscopy(EC),as a novel tool in endoscopy,aids the more accurate evaluation of superficial mucosal surface.This review article aims to represent the most relevant information related to the latest EC technology and its clinical application in the lower GI tract diagnostic.We discuss EC-computer-aided diagnosis capability to differentiate between non-neoplastic and neoplastic lesion that offers a closer look to in-vivo assessment and diagnosis of cancerous tissue.Nevertheless,artificial-assisted EC diagnostics could also be employed with benefits in patients with inflammatory bowel disease(IBD)by accurately highlighting the presence of mucosal injury.In our review we included those studies comprising data about colonoscopy with narrow banding imaging and computer-aided diagnosis,as well as EC.Last but not least,artificial-assisted EC facilitates in-vivo diagnosis of the lower GI tract and may,in the future,remodel the field of in-vivo endoscopic diagnosis of colorectal lesions,representing another step towards the so-called optical biopsy.展开更多
All endoscopic imaging system using a plenoptic technique to reconstruct 3-D information is demonstrated and analyzed in this Letter. The proposed setup integrates a clinical surgical endoscope with a plenoptic camera...All endoscopic imaging system using a plenoptic technique to reconstruct 3-D information is demonstrated and analyzed in this Letter. The proposed setup integrates a clinical surgical endoscope with a plenoptic camera to achieve a depth accuracy error of about 1 mm and a precision error of about 2 mm, within a 25 mm×25 mm field of view, operating at 11 frames per second.展开更多
Esophageal adenocarcinoma is the most rapidly growing cancer in America.Although the prognosis after diagnosis is unfavorable,the chance of a successful outcome increases tremendously if detected early while the lesio...Esophageal adenocarcinoma is the most rapidly growing cancer in America.Although the prognosis after diagnosis is unfavorable,the chance of a successful outcome increases tremendously if detected early while the lesion is still dysplastic.Unfortunately,the present standard-of-care,endoscopic surveillance,has major limitations,since dysplasia is invisible,often focal,and systematic biopsies typically sample less than one percent of the esophageal lining and therefore easily miss malignancies.To solve this problem we developed a multispectral light scattering endoscopic imaging system.It surveys the entire esophageal lining and accurately detects subcellular dysplastic changes.The system combines light scattering spectroscopy,which detects and identifies invisible dysplastic sites by analyzing light scattered from epithelial cells,with rapid scanning of the entire esophageal lining using a collimated broadband light beam delivered by an endoscopically compatible fiber optic probe.Here we report the results of the first comprehensive multispectral imaging study,conducted as part of routine endoscopic procedures performed on patients with suspected dysplasia.In a double-blind study that characterized the system’s ability to serve as a screening tool,55 out of 57 patients were diagnosed correctly.In addition,a smaller double-blind comparison of the multispectral data in 24 patients with subsequent pathology at locations where 411 biopsies were collected yielded an accuracy of 90%in detecting individual locations of dysplasia,demonstrating the capability of this method to serve as a guide for biopsy.展开更多
文摘Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.
文摘Artificial intelligence(AI)is making significant strides in revolutionizing the detection of Barrett's esophagus(BE),a precursor to esophageal adenocarcinoma.In the research article by Tsai et al,researchers utilized endoscopic images to train an AI model,challenging the traditional distinction between endoscopic and histological BE.This approach yielded remarkable results,with the AI system achieving an accuracy of 94.37%,sensitivity of 94.29%,and specificity of 94.44%.The study's extensive dataset enhances the AI model's practicality,offering valuable support to endoscopists by minimizing unnecessary biopsies.However,questions about the applicability to different endoscopic systems remain.The study underscores the potential of AI in BE detection while highlighting the need for further research to assess its adaptability to diverse clinical settings.
文摘Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality.The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage.In high prevalence regions such as Japan and Korea,this has led to the implementation of population screening programs.However,guidelines remain ambiguous in lower prevalence regions.In recent years,there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions.More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection.In addition,promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging.Data on endoscopic resection(ER)are particularly robust in Japan and Korea,with high rates of curative ER and markedly reduced procedural morbidity.However,there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries.Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER,as both technology and proceduralist expertise continue to grow.
基金Supported by Digestive Medical Coordinated Development Center of Beijing Hospitals Authority,No.XXZ015Capital Citizens Health Cultivation Project of Beijing Municipal Science&Technology Commission,No.Z161100000116084+1 种基金Medical and Health Public Foundation of Beijing,No.YWJKJJHKYJJ-B17262-067Science and Technology Development Project of China State Railway Group,No.N2019Z004.
文摘BACKGROUND In recent years,two new narrow-band imaging(NBI)classifications have been proposed:The NBI international colorectal endoscopic(NICE)classification and Japanese NBI expert team(JNET)classification.Most validation studies of the two new NBI classifications were conducted in classification setting units by experienced endoscopists,and the application of use in different centers among endoscopists with different endoscopy skills remains unknown.AIM To evaluate clinical application and possible problems of NICE and JNET classification for the differential diagnosis of colorectal cancer and precancerous lesions.METHODS Six endoscopists with varying levels of experience participated in this study.Eighty-seven consecutive patients with a total of 125 lesions were photographed during non-magnifying conventional white-light colonoscopy,non-magnifying NBI,and magnifying NBI.The three groups of endoscopic pictures of each lesion were evaluated by the six endoscopists in randomized order using the NICE and JENT classifications separately.Then we calculated the six endoscopists’sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for each category of the two classifications.RESULTS The sensitivity,specificity,and accuracy of JNET classification type 1 and 3 were similar to NICE classification type 1 and 3 in both the highly experienced endoscopist(HEE)and less-experienced endoscopist(LEE)groups.The specificity of JNET classification type 1 and 3 and NICE classification type 3 in both the HEE and LEE groups was>95%,and the overall interobserver agreement was good in both groups.The sensitivity of NICE classification type 3 lesions for diagnosis of SM-d carcinoma in the HEE group was significantly superior to that in the LEE group(91.7%vs 83.3%;P=0.042).The sensitivity of JNET classification type 2B lesions for the diagnosis of high-grade dysplasia or superficial submucosal invasive carcinoma in the HEE and LEE groups was 53.8%and 51.3%,respectively.Compared with other types of JNET classification,the diagnostic ability of type 2B was the weakest.CONCLUSION The treatment strategy of the two classification type 1 and 3 lesions can be based on the results of endoscopic examination.JNET type 2B lesions need further examination.
基金Project supported by the National Natural Science Foundation of China (Grant No. 61275106 and 61275086)
文摘A method of fabricating multi-core polymer image fiber is proposed.Image fiber preform is fabricated by stacking thousands of polymer fibers each with a 0.25-mm diameter orderly in a die by only one step.The preform is heated and stretched into image fiber with an outer diameter of 2mm.Then a portable eyewear-style three-dimensional(3D) endoscope system is designed,fabricated,and characterized.This endoscopic system is composed of two graded index lenses,two pieces of 0.35-m length image guide fibers,and a pair of oculars.It shows good ?exibility and portability,and can provide the depth information accordingly.
基金the National Natural Science Foundation of China(No.61976091)。
文摘Oral endoscope image stitching algorithm is studied to obtain wide-field oral images through regis-tration and stitching,which is of great significance for auxiliary diagnosis.Compared with natural images,oral images have lower textures and fewer features.However,traditional feature-based image stitching methods rely heavily on feature extraction quality,often showing an unsatisfactory performance when stitching images with few features.Moreover,due to the hand-held shooting,there are large depth and perspective disparities between the captured images,which also pose a challenge to image stitching.To overcome the above problems,we propose an unsupervised oral endoscope image stitching algorithm based on the extraction of overlapping regions and the loss of deep features.In the registration stage,we extract the overlapping region of the input images by sketching polygon intersection for feature points screening and estimate homography from coarse to fine on a three-layer feature pyramid structure.Moreover,we calculate loss using deep features instead of pixel values to emphasize the importance of depth disparities in homography estimation.Finally,we reconstruct the stitched images from feature to pixel,which can eliminate artifacts caused by large parallax.Our method is compared with both feature-based and previous deep-based methods on the UDIS-D dataset and our oral endoscopy image dataset.The experimental results show that our algorithm can achieve higher homography estimation accuracy,and better visual quality,and can be effectively applied to oral endoscope image stitching.
基金financial supports from the National Natural Science Foundation of China(Grant No.81927805)Shenzhen Municipal Science and Technology Plan Project,China(Grant No.JCYJ20160427183803458)。
文摘Current gradient-index(GRIN)lens based proximal-driven intracoronary optical coherence tomography(ICOCT)probes consist of a spacer and a GRIN lens with large gradient constant.This design provides great flexibility to control beam profiles,but the spacer length should be well controlled to obtain desired beam profiles and thus it sets an obstacle in mass catheter fabrication.Besides,although GRIN lens with large gradient constant can provide tight focus spot,it has short depth of focus and fast-expanded beam which leads to poor lateral resolution for deep tissue.In this paper,a type of spacer-removed probe is demonstrated with a small gradient constant GRIN lens.This design simplifies the fabrica-tion process and is suitable for mass production.The output beam of the catheter is a narrow nearly collimated light beam,referred to as pencil beam here.The full width at half maximum beam size varies from 35.1μm to 75.3μm in air over 3-mm range.Probe design principles are elaborated with probe/catheter fabrication and performance test.The in vivo imaging of the catheter was verified by a clinical ICOCT system.Those results prove that this novel pencil-beam scanning catheter is potentially a good choice for ICOCT systems.
基金This work was supported in part by the Natural Science Foundation of Guangdong Province,No.2020A1515010958Key Project of Shenzhen Science and Technology Plan,No.JCYJ20200109113808048.
文摘Acoustic/ultrasonic sensors are devices that can convert mechanical energy into electrical signals.The Fabry–Perot cavity is processed on the end face of the double-clad fiber by a two-photon three-dimensional lithography machine.In this study,the outer diameter of the core cladding was 250μm,the diameter of the core was 9μm,and the microcavity sensing unit was only 30μm.It could measure ultrasonic signals with high precision.The characteristics of the proposed ultrasonic sensor were investigated,and its feasibility was proven through experiments.Its design has a small size and can replace a larger ultrasonic detector device for photoacoustic signal detection.The sensor is applicable to the field of biomedical information technology,including medical diagnosis,photoacoustic endoscopy,and photoacoustic imaging.
文摘Over the past few years,emerging new approaches in endoscopic imaging technologies facilitate a high-quality assessment of lesions found in the gastrointestinal(GI)tract.Endocytoscopy(EC),as a novel tool in endoscopy,aids the more accurate evaluation of superficial mucosal surface.This review article aims to represent the most relevant information related to the latest EC technology and its clinical application in the lower GI tract diagnostic.We discuss EC-computer-aided diagnosis capability to differentiate between non-neoplastic and neoplastic lesion that offers a closer look to in-vivo assessment and diagnosis of cancerous tissue.Nevertheless,artificial-assisted EC diagnostics could also be employed with benefits in patients with inflammatory bowel disease(IBD)by accurately highlighting the presence of mucosal injury.In our review we included those studies comprising data about colonoscopy with narrow banding imaging and computer-aided diagnosis,as well as EC.Last but not least,artificial-assisted EC facilitates in-vivo diagnosis of the lower GI tract and may,in the future,remodel the field of in-vivo endoscopic diagnosis of colorectal lesions,representing another step towards the so-called optical biopsy.
基金supported by the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health under Grant no.1R01EB020610
文摘All endoscopic imaging system using a plenoptic technique to reconstruct 3-D information is demonstrated and analyzed in this Letter. The proposed setup integrates a clinical surgical endoscope with a plenoptic camera to achieve a depth accuracy error of about 1 mm and a precision error of about 2 mm, within a 25 mm×25 mm field of view, operating at 11 frames per second.
基金supported by the US National Institutes of Health grants R01 EB003472,R01 EB025173 and R01 CA205431the US National Science Foundation grants EFRI-1240410,CBET-1402926 and CBET-1605116.
文摘Esophageal adenocarcinoma is the most rapidly growing cancer in America.Although the prognosis after diagnosis is unfavorable,the chance of a successful outcome increases tremendously if detected early while the lesion is still dysplastic.Unfortunately,the present standard-of-care,endoscopic surveillance,has major limitations,since dysplasia is invisible,often focal,and systematic biopsies typically sample less than one percent of the esophageal lining and therefore easily miss malignancies.To solve this problem we developed a multispectral light scattering endoscopic imaging system.It surveys the entire esophageal lining and accurately detects subcellular dysplastic changes.The system combines light scattering spectroscopy,which detects and identifies invisible dysplastic sites by analyzing light scattered from epithelial cells,with rapid scanning of the entire esophageal lining using a collimated broadband light beam delivered by an endoscopically compatible fiber optic probe.Here we report the results of the first comprehensive multispectral imaging study,conducted as part of routine endoscopic procedures performed on patients with suspected dysplasia.In a double-blind study that characterized the system’s ability to serve as a screening tool,55 out of 57 patients were diagnosed correctly.In addition,a smaller double-blind comparison of the multispectral data in 24 patients with subsequent pathology at locations where 411 biopsies were collected yielded an accuracy of 90%in detecting individual locations of dysplasia,demonstrating the capability of this method to serve as a guide for biopsy.