The status of advanced imaging techniques for ‘optical biopsy’ of colonic polyps
File(s)
Published version
Author(s)
Glover, Benjamin
Teare, Julian
Patel, Nisha
Type
Journal Article
Abstract
Introduction:
The progressive miniaturisation of photonics components presents the opportunity to obtain unprecedented microscopic images of colonic polyps in real-time, during endoscopy. This information has the potential to act as an ‘optical biopsy’ to aid clinical decision making, including the possibility of adopting new paradigms such as a ‘resect and discard’ approach for low-risk lesions. The technologies discussed in this review include Confocal Laser Endomicroscopy, Optical Coherence Tomography, Multiphoton Microscopy, Raman Spectroscopy and Hyperspectral Imaging. These are in different stages of development and clinical readiness, but all show the potential to produce reliable in-vivo discrimination of different tissue types.
Methods:
A structured literature search of the imaging techniques for colorectal polyps has been conducted. The significant developments in endoscopic imaging was identified for each modality, and the status of current development was discussed.
Conclusions:
Of the advanced imaging techniques discussed, Confocal Laser Endomicroscopy is in clinical use, and under optimal conditions with an experienced operator, can provide accurate histological assessment of tissue. The remaining techniques show potential for incorporation into endoscopic equipment and practice, although further component development is needed, followed by robust prospective validation of accuracy. Optical Coherence Tomography illustrates tissue ‘texture’ well and gives good assessment of mucosal thickness and layers. Multiphoton Microscopy produces high resolution images at a subcellular resolution. Raman Spectroscopy and Hyperspectral Imaging are less developed endoscopically but provide a tissue ‘fingerprint’ which can distinguish between tissue types. Molecular Imaging may become a powerful adjunct to other techniques, with its ability to precisely label specific molecules within tissue and thereby enhance imaging.
The progressive miniaturisation of photonics components presents the opportunity to obtain unprecedented microscopic images of colonic polyps in real-time, during endoscopy. This information has the potential to act as an ‘optical biopsy’ to aid clinical decision making, including the possibility of adopting new paradigms such as a ‘resect and discard’ approach for low-risk lesions. The technologies discussed in this review include Confocal Laser Endomicroscopy, Optical Coherence Tomography, Multiphoton Microscopy, Raman Spectroscopy and Hyperspectral Imaging. These are in different stages of development and clinical readiness, but all show the potential to produce reliable in-vivo discrimination of different tissue types.
Methods:
A structured literature search of the imaging techniques for colorectal polyps has been conducted. The significant developments in endoscopic imaging was identified for each modality, and the status of current development was discussed.
Conclusions:
Of the advanced imaging techniques discussed, Confocal Laser Endomicroscopy is in clinical use, and under optimal conditions with an experienced operator, can provide accurate histological assessment of tissue. The remaining techniques show potential for incorporation into endoscopic equipment and practice, although further component development is needed, followed by robust prospective validation of accuracy. Optical Coherence Tomography illustrates tissue ‘texture’ well and gives good assessment of mucosal thickness and layers. Multiphoton Microscopy produces high resolution images at a subcellular resolution. Raman Spectroscopy and Hyperspectral Imaging are less developed endoscopically but provide a tissue ‘fingerprint’ which can distinguish between tissue types. Molecular Imaging may become a powerful adjunct to other techniques, with its ability to precisely label specific molecules within tissue and thereby enhance imaging.
Date Issued
2020-03
Date Acceptance
2020-01-03
Citation
Clinical and Translational Gastroenterology, 2020, 11 (3), pp.1-11
ISSN
2155-384X
Publisher
Nature Publishing Group
Start Page
1
End Page
11
Journal / Book Title
Clinical and Translational Gastroenterology
Volume
11
Issue
3
Copyright Statement
© 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. This is an open-access article distributed under the terms of the
Creative Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used
commercially without permission from the journal.
Creative Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used
commercially without permission from the journal.
Sponsor
European Commission
Identifier
https://journals.lww.com/ctg/FullText/2020/03000/The_Status_of_Advanced_Imaging_Techniques_for.4.aspx
Subjects
1103 Clinical Sciences
Publication Status
Published
Date Publish Online
2020-03-04