Advances in Endoscopic Imaging of Colorectal Neoplasia
Section snippets
Technologies for Imaging
In the past 40 years, we have seen remarkable advancements in optical and mechanical technologies for imaging the gastrointestinal tract. Since the first creation of flexible fiber optics and flexible endoscopy,6 the field has advanced to include video imaging via electronic charge-coupled devices capable of translating light energy into electronic video signals. As electronics improved and charge-coupled device chips became more densely packaged with pixels, high-definition colonoscopy became
Standard Video Imaging
Of all the methods currently available for colonoscopy, attention to standard, high-quality technique has the greatest potential for improvement in the effectiveness of colonoscopy. Although not definitively proven, the major reason colonoscopy fails to prevent all colon cancers is likely missed precancerous polyps, including flat, sessile, and pedunculated. Studies of missed polyps, using either back to back colonoscopy, or even surgical resection specimens, suggest that up to 26% of all
Chromoendoscopy
In chromoendoscopy, intravital dyes like indigo carmine or methylene blue are topically applied onto the mucosal surface to enhance superficial patterns and contrast of pathologic versus normal mucosa (Figure 1 and Supplementary Video 1, which can be found at www.gastrojournal.org). This relatively old technique can be used in an untargeted fashion (“panchromoendoscopy”) to detect lesions or in a targeted mode to define the borders of a lesion and its pit pattern.20 In the landmark study by
Whole-Body Molecular Imaging
As novel oncological treatments increasingly strive to target molecular pathways within the cancer cell, so the need for noninvasive molecular imaging also increases. Positron emission technology has considerable promise in this regard, as positron emission technology radiotracers allow the imaging of intracellular molecular processes known to be present in malignancy. Development of therapeutics, such as antiangiogenics, which target tumor blood flow, should be closely followed with
Endoscopic Ultrasound
The role of endoscopic ultrasound (EUS) in colorectal neoplasia is limited to rectal cancer staging and restaging. Colon cancer is virtually always treated surgically, independent of local stage, due to local complications of bleeding and obstruction, thus local staging with EUS does not affect clinical management. The primary role of EUS in this setting is detection of locally advanced rectal cancers that may benefit from neoadjuvant therapy followed by surgery. Harewood et al demonstrated
Summary and Future Directions
The ability to accurate detect, classify, and stage colorectal neoplasia with advanced imaging methods has allowed substantial improvements in the care and outcomes of these patients. Prior to these advances, the majority of colorectal neoplasia requires surgical resection. With the advent of colonoscopy, most polypoid precancerous lesions could be treated endoscopically. Now with advanced methods to classify and stage neoplasia, most flat neoplasia and even early cancers can be treated with
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Cited by (96)
Quantitative characterization of the colorectal cancer in a rabbit model using high-frequency endoscopic ultrasound
2021, UltrasonicsCitation Excerpt :However, it is limited to evaluate the penetration of lesion invasion into the colorectal wall, which is a crucial factor for the CRC diagnosis [2]. During the last decades, technologies are emerging to complement with the conventional endoscopy to further improve the outcome of the clinical intervention, such as chromoendoscopy [3], autofluorescence endoscopy [4], confocal endoscopy [5], OCT endoscopy [6], two-photon endoscopy [7], photoacoustic endoscopy [8] and wireless capsule endoscope [9]. Enabling imaging strategies are still demanding for better administration of the complications of colorectal cancer in the clinical or pre-clinical studies.
Color-based template selection for detection of gastric abnormalities in video endoscopy
2020, Biomedical Signal Processing and ControlCitation Excerpt :It is an image-enhanced endoscopy method, in which dyes (methylene blue) is used to stain the mucosal surface and it highlights the mucosal patterns [5]. On the other hand, digital filters and image enhancement techniques are used to manifest the effect of traditional colorant-based chromoendoscopy in the digital (virtual) chromoendoscopy [6]. The extraction of important characteristics from medical images is an important step for detection of abnormalities in a computer-aided diagnosis system.
8 years observational study on colorectal cancer in UAE
2019, Journal of ColoproctologyComputer-based classification of chromoendoscopy images using homogeneous texture descriptors
2017, Computers in Biology and MedicineCitation Excerpt :An endoscope is composed of a flexible tube with a mounted camera, light source, and surgical apparatus [6]. Therefore, an endoscope is also sometimes used for performing GI biopsies [7]. Inspection of the GI tract via an endoscope is an indispensable task for the timely identification of irregularities (e.g., cancer, ulcer, and polyps) in gastric patients.
Raman fiber-optical method for colon cancer detection: Cross-validation and outlier identification approach
2017, Spectrochimica Acta - Part A: Molecular and Biomolecular Spectroscopy
Conflicts of interest Dr Wallace has received research and educational funding from Mauna Kea below the federal threshold considered for conflict of interest. He also receives research from Olympus Co and Fujinon Co. Dr Kiesslich discloses no conflicts.