Light-based scan shows promise for early detection of deadly bowel disease in preterm infants

Necrotizing enterocolitis (NEC) is a life-threatening intestinal inflammation that primarily affects premature infants, with a mortality rate exceeding 20 percent and an estimated incidence of up to 5 percent among all preterm babies and 10 percent among those weighing less than 1,500 grams. The disease can progress from mild symptoms such as abdominal distension to severe tissue death requiring surgical removal of intestine segments, and no drugs exist to halt its worsening once established.

Pediatric surgeon Seth Goldstein of Lurie Children's Hospital of Chicago and colleagues at Northwestern University exploited the near-translucent skin of preterm infants to develop a noninvasive scanning technique. NEC darkens intestinal tissue as blood supply diminishes, and the researchers hypothesized that visible and infrared light could detect this color change through the abdominal wall.

In a pilot study published in February in the Journal of Pediatric Surgery, the team used a probe to illuminate the abdomens of 96 premature infants with broadband visible and infrared light, then measured reflected wavelengths with a spectrometer. A machine learning model analyzed the spectral data. The scans correctly identified all 10 infants who developed NEC, though the method also produced a significant number of false positives.

Goldstein said the goal is to make the technology routine in every neonatal intensive care unit bassinet. The team plans a larger study within the next year to test whether regular scanning can detect NEC before clinical symptoms appear, building on earlier mouse studies where daily scans achieved early detection. They are also developing a low-cost handheld device for broader accessibility.

Ravi Patel, director of neonatal clinical research at Emory University, who was not involved in the study, called the pilot a proof-of-concept but cautioned that the small case count limits knowledge of real-world performance. He noted that false positives raise concerns about overtreatment, but said the technology is "worth looking into more."

Other research avenues for NEC include developing new probiotics and identifying blood-based biomarkers. Early detection and prevention remain critical because treatment options are extremely limited once the disease develops.

The study was published as A.C. Dodd et al., "First-in-human pilot study of broadband optical spectroscopy (BOS) as noninvasive surveillance for necrotizing enterocolitis (NEC)," Journal of Pediatric Surgery, 2026.