Endoscopic imaging: emerging optical techniques for the detection of colorectal neoplasia.
OBJECTIVE
Advances in bioengineering have spawned various imaging modalities which have revolutionized endoscopy. Some of these technologies provide real-time, high-resolution, subcellular imaging. This review provides an update on these technologies and their role in the evaluation of colorectal neoplasia.


RESULTS
Narrow band imaging has been shown to visualize capillary patterns in early cancer and is complementary to magnification endoscopy. Optical coherence tomography has been used to evaluate neoplastic progression and distinguish Crohn's from ulcerative colitis. Confocal endomicroscopy has been shown to accurately predict neoplastic changes in polyps and identify areas of neoplasia in patients with colitis. Among the spectroscopic techniques, autofluorescence is best studied in the colon and has been used to identify adenomas and dysplasia in inflammatory bowel disease. Endocytoscopy is a relatively new technology but shows promise in distinguishing neoplastic lesions.


CONCLUSIONS
Recently a number of imaging technologies have arisen that have the potential to enhance our detection of colorectal neoplasia. Several of these, such as autofluorescent imaging and narrow band imaging, are 'red flag' techniques which enhance our visualization of mucosal change(s). Complementary technologies, such as confocal endomicroscopy and endocytoscopy, provide subcellular imaging. Combined with a 'red flag' technique, these may transform our approach to colonoscopy, allowing the real-time detection and diagnosis of neoplasia.
Department of Gastroenterology, Hepatology and Nutrition, University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77030, USA. sananda@mdanderson.org
Sharmila
S
Anandasabapathy
D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004396:Coloring Agents; D006801:Humans; D018613:Microscopy, Confocal; D008856:Microscopy, Fluorescence / Q000379:methods; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis / Q000379:methods; D041623:Tomography, Optical Coherence / Q000379:methods
D004396:Coloring Agents