Advanced endoscopic methods in gastrointestinal diseases: a systematic review

Area of Science:

• Gastroenterology
• Medical Imaging
• Endoscopic Technologies

Background:

• Gastrointestinal diseases pose significant health risks.
• White light endoscopy (WLE) is a primary diagnostic tool but lacks diagnostic accuracy.
• Advanced endoscopic imaging aims to improve detection and diagnosis.

Purpose of the Study:

• To review emerging endoscopic imaging technologies for gastrointestinal disease detection.
• To discuss the clinical applicability of these advanced methods.
• To highlight improvements in diagnostic accuracy and early cancer detection.

Main Methods:

• Review of advanced endoscopic imaging techniques: Chromoendoscopy (CE), Narrow band imaging (NBI), Flexible spectral imaging color enhancement (FICE), i-Scan, probe-based confocal laser endomicroscopy (pCLE), endoscopic optical coherence tomography (EOCT), and photoacoustic endoscopy (PAE).
• Focus on visualization of mucosal and cellular structures.
• Assessment of diagnostic capabilities for gastrointestinal diseases and early cancer detection.

Main Results:

• CE, NBI, FICE, and i-Scan enhance mucosal visualization but have limited early cancer detection capabilities.
• pCLE provides cellular-level visualization, consistent with biopsy, enabling early cancer detection.
• EOCT and PAE show promise for gastrointestinal disease diagnosis.

Conclusions:

• Advanced endoscopic imaging significantly improves upon WLE for gastrointestinal disease detection.
• pCLE offers a breakthrough for in vivo cellular assessment and early cancer diagnosis.
• Further research and clinical application of these technologies are warranted.