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Quantitative spectroscopic imaging for non-invasive early cancer detection
Chung-Chieh Yu, Condon Lau, Geoffrey O'Donoghue, Jelena Mirkovic, Sasha McGee, Luis Galindo, Alphi Elackattu, Elizabeth Stier, Gregory Grillone, Kamran Badizadegan, Ramachandra R. Dasari, and Michael S. Feld »View Author Affiliations
1George R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
2Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA
3Department of Obstetrics and Gynecology, Boston University Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA
4Department of Pathology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, WRN219, Boston, MA 02114, USA
*Corresponding author: chungyu@mit.edu
Optics Express, Vol. 16, Issue 20, pp. 16227-16239 (2008)
http://dx.doi.org/10.1364/OE.16.016227
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Abstract
We report a fully quantitative spectroscopy imaging instrument for wide area detection of early cancer (dysplasia). This instrument provides quantitative maps of tissue biochemistry and morphology, making it a potentially powerful surveillance tool for objective early cancer detection. We describe the design, construction, calibration, and first clinical application of this new system. We demonstrate its accuracy using physical tissue models. We validate its diagnostic ability on a resected colon adenoma, and demonstrate feasibility of in vivo imaging in the oral cavity.
© 2008 Optical Society of America
OCIS Codes
(170.0110) Medical optics and biotechnology : Imaging systems
(170.1610) Medical optics and biotechnology : Clinical applications
(170.3890) Medical optics and biotechnology : Medical optics instrumentation
(170.4580) Medical optics and biotechnology : Optical diagnostics for medicine
(300.0300) Spectroscopy : Spectroscopy
ToC Category:
Medical Optics and Biotechnology
History
Original Manuscript: July 25, 2008
Revised Manuscript: September 18, 2008
Manuscript Accepted: September 22, 2008
Published: September 26, 2008
Virtual Issues
Vol. 3, Iss. 11 Virtual Journal for Biomedical Optics
Citation
Chung-Chieh Yu, Condon Lau, Geoffrey O'Donoghue, Jelena Mirkovic, Sasha McGee, Luis Galindo, Alphi Elackattu, Elizabeth Stier, Gregory Grillone, Kamran Badizadegan, Ramachandra R. Dasari, and Michael S. Feld, "Quantitative spectroscopic imaging for non-invasive early cancer detection," Opt. Express 16, 16227-16239 (2008)
http://www.opticsinfobase.org/oe/abstract.cfm?URI=oe-16-20-16227
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References
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- I. Georgakoudi, E. E. Sheets, M. G. Muller, V. Backman, C. P. Crum, K. Badizadegan, R. R. Dasari, and M. S. Feld, "Trimodal spectroscopy for the detection and characterization of cervical precancers in vivo," Am. J. Obstet. Gynecol. 186, 374-382 (2002). [CrossRef] [PubMed]
- M. G. Muller, T. A. Valdez, I. Georgakoudi, V. Backman, C. Fuentes, S. Kabani, N. Laver, Z. M. Wang, C. W. Boone, R. R. Dasari, S. M. Shapshay, and M. S. Feld, "Spectroscopic detection and evaluation of morphologic and biochemical changes in early human oral carcinoma," Cancer 97, 1681-1692 (2003). [CrossRef] [PubMed]
- J. W. Tunnell, A. E. Desjardins, L. Galindo, I. Georgakoudi, S. A. McGee, J. Mirkovic, M. G. Mueller, J. Nazemi, F. T. Nguyen, A. Wax, Q. G. Zhang, R. R. Dasari, and M. S. Feld, "Instrumentation for multi-modal spectroscopic diagnosis of epithelial dysplasia," Technol. Cancer Res. Treat. 2, 505-514 (2003). [PubMed]
- I. Georgakoudi, E. E. Sheets, M. G. Muller, V. Backman, C. P. Crum, K. Badizadegan, R. R. Dasari, and M. S. Feld, "Trimodal spectroscopy for the detection and characterization of cervical precancers in vivo," Am. J. Obstet. Gynecol. 186, 374-382 (2002). [CrossRef] [PubMed]
- W. G. McCluggage, M. Y. Walsh, C. M. Thornton, P. W. Hamilton, A. Date, L. M. Caughley, and H. Bharucha, "Inter- and intra-observer variation in the histopathological reporting of cervical squamous intraepithelial lesions using a modified Bethesda grading system," Br. J. Obstet. Gynaecol. 105, 206-210 (1998). [CrossRef] [PubMed]
- D. C. G. de Veld, M. Skurichina, M. J. H. Wities, R. P. W. Duin, H. J. C. M. Sterenborg, and J. L. N. Roodenburg, "Autofluorescence and diffuse reflectance spectroscopy for oral oncology," Lasers Surg. Med. 36, 356-364 (2005). [CrossRef] [PubMed]
- G. S. Fiarman, M. H. Nathanson, A. B. West, L. I. Deckelbaum, L. Kelly, and C. R. Kapadia, "Differences in Laser-Induced Autofluorescence between Adenomatous and Hyperplastic Polyps and Normal Colonic Mucosa by Confocal Microscopy," Dig. Dis. Sci. 40, 1261-1268 (1995). [CrossRef] [PubMed]
- J. W. Tunnell, A. E. Desjardins, L. Galindo, I. Georgakoudi, S. A. McGee, J. Mirkovic, M. G. Mueller, J. Nazemi, F. T. Nguyen, A. Wax, Q. G. Zhang, R. R. Dasari, and M. S. Feld, "Instrumentation for multi-modal spectroscopic diagnosis of epithelial dysplasia," Technol. Cancer Res. Treat. 2, 505-514 (2003). [PubMed]
- H. Yoon, A. Martin, R. Benamouzig, E. Longchampt, J. Deyra, S. Chaussade, and A. Grp, "Inter-observer agreement on histological diagnosis of colorectal polyps: the APACC study," Gastroenterol. Clin. Et Biol. 26, 220-224 (2002).
- K. T. Schomacker, T. M. Meese, C. S. Jiang, C. C. Abele, K. Dickson, S. T. Sum, and R. F. Flewelling, "Novel optical detection system for in vivo identification and localization of cervical intraepithelial neoplasia," J. Biomed. Opt. 11, 034009 (2006). [CrossRef]
- S. M. Ismail, A. B. Colclough, J. S. Dinnen, D. Eakins, D. M. D. Evans, E. Gradwell, J. P. Osullivan, J. M. Summerell, and R. Newcombe, "Intrapathologist and Interpathologist Variation in Reporting Cervical Intra-Epithelial Neoplasia and Factors Associated with Disagreement," J. Pathol. 160, A176-A176 (1990).
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Adv. Opt. Biopsy Opt. Mammography
- T. Vo-Dinh, M. Panjehpour, and B. F. Overholt, "Laser-induced fluorescence for esophageal cancer and dysplasia diagnosis," Adv. Opt. Biopsy Opt. Mammography 838, 116-122 (1998).
Am. J. Obstet. Gynecol.
- I. Georgakoudi, E. E. Sheets, M. G. Muller, V. Backman, C. P. Crum, K. Badizadegan, R. R. Dasari, and M. S. Feld, "Trimodal spectroscopy for the detection and characterization of cervical precancers in vivo," Am. J. Obstet. Gynecol. 186, 374-382 (2002). [CrossRef] [PubMed]
Appl. Opt.
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Arch. Otolaryngol. Head Neck Surg.
- A. Gillenwater, R. Jacob, R. Ganeshappa, B. Kemp, A. K. El-Naggar, J. L. Palmer, G. Clayman, M. F. Mitchell, and R. Richards-Kortum, "Noninvasive diagnosis of oral neoplasia based on fluorescence spectroscopy and native tissue autofluorescence," Arch. Otolaryngol. Head Neck Surg. 124, 1251-1258 (1998). [PubMed]
Br. J. Obstet. Gynaecol.
- W. G. McCluggage, M. Y. Walsh, C. M. Thornton, P. W. Hamilton, A. Date, L. M. Caughley, and H. Bharucha, "Inter- and intra-observer variation in the histopathological reporting of cervical squamous intraepithelial lesions using a modified Bethesda grading system," Br. J. Obstet. Gynaecol. 105, 206-210 (1998). [CrossRef] [PubMed]
Cancer
- M. G. Muller, T. A. Valdez, I. Georgakoudi, V. Backman, C. Fuentes, S. Kabani, N. Laver, Z. M. Wang, C. W. Boone, R. R. Dasari, S. M. Shapshay, and M. S. Feld, "Spectroscopic detection and evaluation of morphologic and biochemical changes in early human oral carcinoma," Cancer 97, 1681-1692 (2003). [CrossRef] [PubMed]
Chest
- M. P. L. Bard, A. Amelink, M. Skurichina, V. N. Hegt, R. P. W. Duin, H. J. C. M. Sterenborg, H. C. Hoogsteden, and J. G. J. V. Aerts, "Optical spectroscopy for the classification of malignant lesions of the bronchial tree," Chest 129, 995-1001 (2006). [CrossRef] [PubMed]
Curr. Sci.
- S. K. Majumder, S. K. Mohanty, N. Ghosh, P. K. Gupta, D. K. Jain, and F. Khan, "A pilot study on the use of autofluorescence spectroscopy for diagnosis of the cancer of human oral cavity," Curr. Sci. 79, 1089-1094 (2000).
Dig. Dis. Sci.
- G. S. Fiarman, M. H. Nathanson, A. B. West, L. I. Deckelbaum, L. Kelly, and C. R. Kapadia, "Differences in Laser-Induced Autofluorescence between Adenomatous and Hyperplastic Polyps and Normal Colonic Mucosa by Confocal Microscopy," Dig. Dis. Sci. 40, 1261-1268 (1995). [CrossRef] [PubMed]
Gastroenterol. Clin. Et Biol.
- H. Yoon, A. Martin, R. Benamouzig, E. Longchampt, J. Deyra, S. Chaussade, and A. Grp, "Inter-observer agreement on histological diagnosis of colorectal polyps: the APACC study," Gastroenterol. Clin. Et Biol. 26, 220-224 (2002).
Gastroenterology
- I. Georgakoudi, B. C. Jacobson, J. Van Dam, V. Backman, M. B. Wallace, M. G. Muller, Q. Zhang, K. Badizadegan, D. Sun, G. A. Thomas, L. T. Perelman, and M. S. Feld, "Fluorescence, reflectance, and light-scattering spectroscopy for evaluating dysplasia in patients with Barrett's esophagus," Gastroenterology 120, 1620-1629 (2001). [CrossRef] [PubMed]
Hum. Pathol.
- B. J. Reid, R. C. Haggitt, C. E. Rubin, G. Roth, C. M. Surawicz, G. Vanbelle, K. Lewin, W. M. Weinstein, D. A. Antonioli, H. Goldman, W. Macdonald, and D. Owen, "Observer Variation in the Diagnosis of Dysplasia in Barretts Esophagus," Hum. Pathol. 19, 166-178 (1988). [CrossRef] [PubMed]
IEEE Eng. Med. Biol. Mag.
- T. Vo-Dinh, D. L. Stokes, M. B. Wabuyele, M. E. Martin, J. M. Song, R. Jagannathan, E. Michaud, R. J. Lee, and X. G. Pan, "A hyperspectral imaging system for in vivo optical diagnosis," IEEE Eng. Med. Biol. Mag. 23, 40-49 (2004). [CrossRef] [PubMed]
J. Biol. Chem.
- H. Nagase, and J. F. Woessner, "Matrix metalloproteinases," J. Biol. Chem. 274, 21491-21494 (1999). [CrossRef] [PubMed]
J. Biomed. Opt.
- K. T. Schomacker, T. M. Meese, C. S. Jiang, C. C. Abele, K. Dickson, S. T. Sum, and R. F. Flewelling, "Novel optical detection system for in vivo identification and localization of cervical intraepithelial neoplasia," J. Biomed. Opt. 11, 034009 (2006). [CrossRef]
- J. A. Freeberg, D. M. Serachitopol, N. McKinnon, R. Price, E. N. Atkinson, D. D. Cox, C. MacAulay, R. Richards-Kortum, M. Follen, and B. Pikkula, "Fluorescence and reflectance device variability throughout the progression of a phase II clinical trial to detect and screen for cervical neoplasia using a fiber optic probe," J. Biomed. Opt. 12, 034015 (2007). [CrossRef] [PubMed]
- S. K. Chang, Y. N. Mirabal, E. N. Atkinson, D. Cox, A. Malpica, M. Follen, and R. Richards-Kortum, "Combined reflectance and fluorescence spectroscopy for in vivo detection of cervical pre-cancer," J. Biomed. Opt. 10, 024031 (2005). [CrossRef] [PubMed]
J. Pathol.
- S. M. Ismail, A. B. Colclough, J. S. Dinnen, D. Eakins, D. M. D. Evans, E. Gradwell, J. P. Osullivan, J. M. Summerell, and R. Newcombe, "Intrapathologist and Interpathologist Variation in Reporting Cervical Intra-Epithelial Neoplasia and Factors Associated with Disagreement," J. Pathol. 160, A176-A176 (1990).
Lasers Surg. Med.
- D. C. G. de Veld, M. Skurichina, M. J. H. Wities, R. P. W. Duin, H. J. C. M. Sterenborg, and J. L. N. Roodenburg, "Autofluorescence and diffuse reflectance spectroscopy for oral oncology," Lasers Surg. Med. 36, 356-364 (2005). [CrossRef] [PubMed]
- J. R. Mourant, I. J. Bigio, J. Boyer, R. L. Conn, T. Johnson, and T. Shimada, "Spectroscopic diagnosis of bladder cancer with elastic light scattering," Lasers Surg. Med. 17, 350-357 (1995). [CrossRef] [PubMed]
Nat. Rev. Cancer
- R. Kalluri, and M. Zeisberg, "Fibroblasts in cancer," Nat. Rev. Cancer 6, 392-401 (2006). [CrossRef] [PubMed]
Obstet. Gynecol.
- M. F. Mitchell, S. B. Cantor, N. Ramanujam, G. Tortolero-Luna, and R. Richards-Kortum, "Fluorescence spectroscopy for diagnosis of squamous intraepithelial lesions of the cervix," Obstet. Gynecol. 93, 462-470 (1999). [CrossRef] [PubMed]
Opt. Express.
- J. M. Benavides, S. Chang, S. Y. Park, R. Richards-Kortum, N. Mackinnon, C. MacAulay, A. Milbourne, A. Malpica, and M. Follen, "Multispectral digital colposcopy for in vivo detection of cervical cancer," Opt. Express. 11, 1223-1236 (2003). [CrossRef] [PubMed]
Oral Oncol.
- A. Amelink, O. P. Kaspers, H. J. C. M. Sterenborg, J. E. van der Wal, J. L. N. Roodenburg, and M. J. H. Witjes, "Non-invasive measurement of the morphology and physiology of oral mucosa by use of optical spectroscopy," Oral Oncol. 44, 65-71 (2008). [CrossRef]
Photochem. Photobiol.
- D. L. Heintzelman, U. Utzinger, H. Fuchs, A. Zuluaga, K. Gossage, A. M. Gillenwater, R. Jacob, B. Kemp, and R. R. Richards-Kortum, "Optimal excitation wavelengths for in vivo detection of oral neoplasia using fluorescence spectroscopy," Photochem. Photobiol. 72, 103-113 (2000). [CrossRef] [PubMed]
Science
- B. Chance, P. Cohen, F. Jobsis, and B. Schoener, "Intracellular oxidation-reduction states in vivo," Science 137, 499-508 (1962). [CrossRef] [PubMed]
Technol. Cancer Res. Treat.
- J. W. Tunnell, A. E. Desjardins, L. Galindo, I. Georgakoudi, S. A. McGee, J. Mirkovic, M. G. Mueller, J. Nazemi, F. T. Nguyen, A. Wax, Q. G. Zhang, R. R. Dasari, and M. S. Feld, "Instrumentation for multi-modal spectroscopic diagnosis of epithelial dysplasia," Technol. Cancer Res. Treat. 2, 505-514 (2003). [PubMed]
Other
- C. D. Kuglin, and D. C. Hines, "The phase correlation image alignment method," in IEEE Int. Conf. on Cybernetics and Society (1975).
- L. V. Wang, and H.-i. Wu, Biomedical Optics: Principles and Imaging (Wiley, 2007).
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- B. Rosner, Fundamentals of biostatistics, 6th ed. (Thomson-Brooks/Cole, Belmont, CA, 2006), p. 868.
2008, Amelink, Oral Oncol.
- A. Amelink, O. P. Kaspers, H. J. C. M. Sterenborg, J. E. van der Wal, J. L. N. Roodenburg, and M. J. H. Witjes, "Non-invasive measurement of the morphology and physiology of oral mucosa by use of optical spectroscopy," Oral Oncol. 44, 65-71 (2008). [CrossRef]
- J. A. Freeberg, D. M. Serachitopol, N. McKinnon, R. Price, E. N. Atkinson, D. D. Cox, C. MacAulay, R. Richards-Kortum, M. Follen, and B. Pikkula, "Fluorescence and reflectance device variability throughout the progression of a phase II clinical trial to detect and screen for cervical neoplasia using a fiber optic probe," J. Biomed. Opt. 12, 034015 (2007). [CrossRef] [PubMed]
- M. P. L. Bard, A. Amelink, M. Skurichina, V. N. Hegt, R. P. W. Duin, H. J. C. M. Sterenborg, H. C. Hoogsteden, and J. G. J. V. Aerts, "Optical spectroscopy for the classification of malignant lesions of the bronchial tree," Chest 129, 995-1001 (2006). [CrossRef] [PubMed]
- K. T. Schomacker, T. M. Meese, C. S. Jiang, C. C. Abele, K. Dickson, S. T. Sum, and R. F. Flewelling, "Novel optical detection system for in vivo identification and localization of cervical intraepithelial neoplasia," J. Biomed. Opt. 11, 034009 (2006). [CrossRef]
- R. Kalluri, and M. Zeisberg, "Fibroblasts in cancer," Nat. Rev. Cancer 6, 392-401 (2006). [CrossRef] [PubMed]
- S. K. Chang, Y. N. Mirabal, E. N. Atkinson, D. Cox, A. Malpica, M. Follen, and R. Richards-Kortum, "Combined reflectance and fluorescence spectroscopy for in vivo detection of cervical pre-cancer," J. Biomed. Opt. 10, 024031 (2005). [CrossRef] [PubMed]
- D. C. G. de Veld, M. Skurichina, M. J. H. Wities, R. P. W. Duin, H. J. C. M. Sterenborg, and J. L. N. Roodenburg, "Autofluorescence and diffuse reflectance spectroscopy for oral oncology," Lasers Surg. Med. 36, 356-364 (2005). [CrossRef] [PubMed]
- T. Vo-Dinh, D. L. Stokes, M. B. Wabuyele, M. E. Martin, J. M. Song, R. Jagannathan, E. Michaud, R. J. Lee, and X. G. Pan, "A hyperspectral imaging system for in vivo optical diagnosis," IEEE Eng. Med. Biol. Mag. 23, 40-49 (2004). [CrossRef] [PubMed]
- J. M. Benavides, S. Chang, S. Y. Park, R. Richards-Kortum, N. Mackinnon, C. MacAulay, A. Milbourne, A. Malpica, and M. Follen, "Multispectral digital colposcopy for in vivo detection of cervical cancer," Opt. Express. 11, 1223-1236 (2003). [CrossRef] [PubMed]
- J. W. Tunnell, A. E. Desjardins, L. Galindo, I. Georgakoudi, S. A. McGee, J. Mirkovic, M. G. Mueller, J. Nazemi, F. T. Nguyen, A. Wax, Q. G. Zhang, R. R. Dasari, and M. S. Feld, "Instrumentation for multi-modal spectroscopic diagnosis of epithelial dysplasia," Technol. Cancer Res. Treat. 2, 505-514 (2003). [PubMed]
- M. G. Muller, T. A. Valdez, I. Georgakoudi, V. Backman, C. Fuentes, S. Kabani, N. Laver, Z. M. Wang, C. W. Boone, R. R. Dasari, S. M. Shapshay, and M. S. Feld, "Spectroscopic detection and evaluation of morphologic and biochemical changes in early human oral carcinoma," Cancer 97, 1681-1692 (2003). [CrossRef] [PubMed]
- I. Georgakoudi, E. E. Sheets, M. G. Muller, V. Backman, C. P. Crum, K. Badizadegan, R. R. Dasari, and M. S. Feld, "Trimodal spectroscopy for the detection and characterization of cervical precancers in vivo," Am. J. Obstet. Gynecol. 186, 374-382 (2002). [CrossRef] [PubMed]
- H. Yoon, A. Martin, R. Benamouzig, E. Longchampt, J. Deyra, S. Chaussade, and A. Grp, "Inter-observer agreement on histological diagnosis of colorectal polyps: the APACC study," Gastroenterol. Clin. Et Biol. 26, 220-224 (2002).
- I. Georgakoudi, B. C. Jacobson, J. Van Dam, V. Backman, M. B. Wallace, M. G. Muller, Q. Zhang, K. Badizadegan, D. Sun, G. A. Thomas, L. T. Perelman, and M. S. Feld, "Fluorescence, reflectance, and light-scattering spectroscopy for evaluating dysplasia in patients with Barrett's esophagus," Gastroenterology 120, 1620-1629 (2001). [CrossRef] [PubMed]
- D. L. Heintzelman, U. Utzinger, H. Fuchs, A. Zuluaga, K. Gossage, A. M. Gillenwater, R. Jacob, B. Kemp, and R. R. Richards-Kortum, "Optimal excitation wavelengths for in vivo detection of oral neoplasia using fluorescence spectroscopy," Photochem. Photobiol. 72, 103-113 (2000). [CrossRef] [PubMed]
- S. K. Majumder, S. K. Mohanty, N. Ghosh, P. K. Gupta, D. K. Jain, and F. Khan, "A pilot study on the use of autofluorescence spectroscopy for diagnosis of the cancer of human oral cavity," Curr. Sci. 79, 1089-1094 (2000).
- M. F. Mitchell, S. B. Cantor, N. Ramanujam, G. Tortolero-Luna, and R. Richards-Kortum, "Fluorescence spectroscopy for diagnosis of squamous intraepithelial lesions of the cervix," Obstet. Gynecol. 93, 462-470 (1999). [CrossRef] [PubMed]
- H. Nagase, and J. F. Woessner, "Matrix metalloproteinases," J. Biol. Chem. 274, 21491-21494 (1999). [CrossRef] [PubMed]
- W. G. McCluggage, M. Y. Walsh, C. M. Thornton, P. W. Hamilton, A. Date, L. M. Caughley, and H. Bharucha, "Inter- and intra-observer variation in the histopathological reporting of cervical squamous intraepithelial lesions using a modified Bethesda grading system," Br. J. Obstet. Gynaecol. 105, 206-210 (1998). [CrossRef] [PubMed]
- A. Gillenwater, R. Jacob, R. Ganeshappa, B. Kemp, A. K. El-Naggar, J. L. Palmer, G. Clayman, M. F. Mitchell, and R. Richards-Kortum, "Noninvasive diagnosis of oral neoplasia based on fluorescence spectroscopy and native tissue autofluorescence," Arch. Otolaryngol. Head Neck Surg. 124, 1251-1258 (1998). [PubMed]
- T. Vo-Dinh, M. Panjehpour, and B. F. Overholt, "Laser-induced fluorescence for esophageal cancer and dysplasia diagnosis," Adv. Opt. Biopsy Opt. Mammography 838, 116-122 (1998).
- J. R. Mourant, I. J. Bigio, J. Boyer, R. L. Conn, T. Johnson, and T. Shimada, "Spectroscopic diagnosis of bladder cancer with elastic light scattering," Lasers Surg. Med. 17, 350-357 (1995). [CrossRef] [PubMed]
- G. S. Fiarman, M. H. Nathanson, A. B. West, L. I. Deckelbaum, L. Kelly, and C. R. Kapadia, "Differences in Laser-Induced Autofluorescence between Adenomatous and Hyperplastic Polyps and Normal Colonic Mucosa by Confocal Microscopy," Dig. Dis. Sci. 40, 1261-1268 (1995). [CrossRef] [PubMed]
- S. M. Ismail, A. B. Colclough, J. S. Dinnen, D. Eakins, D. M. D. Evans, E. Gradwell, J. P. Osullivan, J. M. Summerell, and R. Newcombe, "Intrapathologist and Interpathologist Variation in Reporting Cervical Intra-Epithelial Neoplasia and Factors Associated with Disagreement," J. Pathol. 160, A176-A176 (1990).
- B. J. Reid, R. C. Haggitt, C. E. Rubin, G. Roth, C. M. Surawicz, G. Vanbelle, K. Lewin, W. M. Weinstein, D. A. Antonioli, H. Goldman, W. Macdonald, and D. Owen, "Observer Variation in the Diagnosis of Dysplasia in Barretts Esophagus," Hum. Pathol. 19, 166-178 (1988). [CrossRef] [PubMed]
- B. Chance, P. Cohen, F. Jobsis, and B. Schoener, "Intracellular oxidation-reduction states in vivo," Science 137, 499-508 (1962). [CrossRef] [PubMed]
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