Endoscopy-coupled Raman spectroscopy for in vivo discrimination of inflammatory bowel disease

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's colitis (CC), affects nearly 2 million Americans, and the incidence is increasing worldwide. It has been established that UC and CC are distinct forms of IBD and require different medical care, however the distinction made between UC and CC is based upon inexact clinical, radiological, endoscopic, and pathologic features. A diagnosis of indeterminate colitis occurs in up to 15% of patients when UC and CC features overlap and cannot be differentiated; in these patients, diagnosis relies on long term followup, success or failure of existing treatment, and recurrence of the disease. Thus, there is need for a tool that can improve the sensitivity and specificity for fast, accurate and automated diagnosis of IBD. Here we present colonoscopy-coupled fiber probe-based Raman spectroscopy as a novel in vivo diagnostic tool for IBD. This in vivo study of both healthy control (NC, N=10) and diagnosed IBD patients with UC (N=15) and CC (N=26) aims to characterize spectral signatures of NC, UC, and CC. Samples are correlated with tissue pathology markers and endoscopic evaluation. Optimal collection parameters for detection have been identified based upon the new, application specific instrument design. The collected spectra are processed and analyzed using multivariate statistical techniques to identify spectral markers and discriminate NC, UC, and CC. Development of spectral markers to discriminate disease type is a necessary first step in the development of real-time, accurate and automated in vivo detection of IBD during colonoscopy procedures.