Hyperspectral and auto-fluorescence imaging show promise for detection of esophageal cancer

Esophageal cancer's increasing prevalence coupled with a 5-year average survival rate below 20% due largely to late detection indicates a significant need for improved imaging tools that can detect and localize early, unseen lesions and be incorporated into endoscopy for screening and evaluation of early symptoms. While white light imaging or virtual chromoendoscopy contrast-enhancement techniques like narrow-band imaging have largely seen commercialization, there remain emerging label-free imaging-based techniques that show promise for improving diagnosis and biopsy guidance. Among them we investigate the clinical potential of hyperspectral (HSI) and autofluorescence imaging (AFI) which lend themselves well to implementation in an endoscopic system. We performed ex-vivo imaging on esophageal biopsies suspicious for carcinoma (N=11) and/or Barrett's esophagus (N=6) and adjacent normal appearing squamous mucosa in the same patient as controls. Our results indicate AFI and HSI are both promising imaging modalities for detecting and localizing morphological and metabolic changes associated with esophageal cancer.