Detection of Sessile Serrated Adenomas in the Proximal Colon Using Wide-Field Fluorescence Endoscopy

Area of Science:

• Gastroenterology
• Oncology
• Medical Imaging

Background:

• Sessile serrated adenomas (SSAs) are difficult to detect via conventional colonoscopy.
• Many SSAs harbor the BRAF V600E mutation, a potential diagnostic target.
• Early detection of SSAs is crucial for preventing proximal colon cancers.

Purpose of the Study:

• To identify a peptide that specifically binds to SSAs.
• To evaluate the safety and efficacy of a fluorescently labeled peptide for SSA detection.
• To assess the utility of targeted imaging for improving SSA detection during colonoscopy.

Main Methods:

• Phage display was used to isolate a peptide targeting SSAs.
• In vitro and in vivo studies assessed peptide binding and toxicity.
• Clinical trials evaluated the peptide's sensitivity and specificity in identifying SSAs during colonoscopy.

Main Results:

• A peptide (KCCFPAQ) was identified with high affinity for SSAs.
• Fluorescence imaging revealed a 2.43-fold increase in SSA fluorescence intensity.
• The peptide achieved 89% sensitivity and 92% specificity in distinguishing SSAs from normal mucosa.

Conclusions:

• A safe, fluorescently labeled peptide enables wide-field imaging of proximal colon lesions.
• This targeted imaging method shows promise for early detection of premalignant serrated lesions.
• The peptide accurately differentiates SSAs from normal colonic mucosa and hyperplastic polyps.