Rectal Optical Markers for in Vivo Risk Stratification of Premalignant Colorectal Lesions

Andrew J. Radosevic, Nikhil N. Mutyal, Adam Eshein, The Quyen Nguyen, Bradley Gould, Jeremy D. Rogers, Michael J. Goldberg, Laura K. Bianchi, Eugene F. Yen, Vani Konda, Douglas K. Rex, Jacques Van Dam, Vadim Backman, Hemant K. Roy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Purpose: Colorectal cancer remains the second leading cause of cancer deaths in the United States despite being eminently preventable by colonoscopy via removal of premalignant adenomas. In order to more effectively reduce colorectal cancer mortality, improved screening paradigms are needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to detect the presence of adenomas throughout the colon via optical interrogation of the rectal mucosa. In a previous ex vivo biopsy study of 219 patients, LEBS demonstrated excellent diagnostic potential with 89.5% accuracy for advanced adenomas. The objective of the current cross-sectional study is to assess the viability of rectal LEBS in vivo. Experimental Design: Measurements from 619 patients were taken using a minimally invasive 3.4-mm diameter LEBS probe introduced into the rectum via anoscope or direct insertion, requiring approximately 1 minute from probe insertion to withdrawal. The diagnostic LEBS marker was formed as a logistic regression of the optical reduced scattering coefficient μs and mass density distribution factor D. Results: The rectal LEBS marker was significantly altered in patients harboring advanced adenomas and multiple nonadvanced adenomas throughout the colon. Blinded and cross-validated test performance characteristics showed 88% sensitivity to advanced adenomas, 71% sensitivity to multiple non-advanced adenomas, and 72% specificity in the validation set. Conclusions: We demonstrate the viability of in vivo LEBS measurement of histologically normal rectal mucosa to predict the presence of clinically relevant adenomas throughout the colon. The current work represents the next step in the development of rectal LEBS as a tool for colorectal cancer risk stratification.

Original languageEnglish (US)
Pages (from-to)4347-4355
Number of pages9
JournalClinical Cancer Research
Issue number19
StatePublished - Oct 1 2015

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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