Detecting colorectal cancer by 1H magnetic resonance spectroscopy of fecal extracts

Colorectal cancer is one of the most common cancers in the western world. Its early detection has been found to improve the prognosis of the patient, providing a wide window of opportunity for successful therapeutic interventions. However, current diagnostic techniques all have some limitations; there is a need to develop a better technique for routine screening purposes. We present a new methodology based on magnetic resonance spectroscopy of fecal extracts for the non‐invasive detection of colorectal cancer. Five hundred twenty‐three human subjects (412 with no colonic neoplasia and 111 with colorectal cancer, who were scheduled for colonoscopy or surgery) were recruited to donate a single sample of stool. One‐dimensional 1H magnetic resonance spectroscopy (MRS) experiments were performed on the supernatant of aqueous dispersions of the stool samples. Using a statistical classification strategy, several multivariate classifiers were developed. Applying the preprocessing, feature selection and classifier development stages of the Statistical Classification Strategy led to ∼87% average balanced sensitivity and specificity for both training and monitoring sets, improving to ∼92% when only crisp results, i.e. class assignment probabilities ≥75%, are considered. These results indicate that 1H magnetic resonance spectroscopy of human fecal extracts, combined with appropriate data analysis methodology, has the potential to detect colorectal neoplasia accurately and reliably, and could be a useful addition to the current screening tools. Copyright © 2009 John Wiley & Sons, Ltd.