Advanced mucosal imaging in colonoscopy: technical details and clinical applications

Abstract

Over the past decades, the significant development in endoscopic imaging has revolutionized digestive endoscopy. Real-time optical diagnosis has become possible using different tools and techniques (dye-based and virtual chromoendoscopy) such as narrow band imaging, flexible spectral imaging color enhancement, i-Scan, blue-laser imaging and linked-color imaging. Polyp detection and characterization, and prediction of depth of invasion of colorectal cancers have improved remarkably. Confocal laser endomicroscopy and endocytoscopy have allowed the evaluation of lesions on a cellular level. Not far from the horizon are newer technological innovations such as artificial intelligence and texture and color enhancement imaging that are now being studied for their potential to further improve mucosal visualization, optical diagnosis and virtual histology. This review gives an overview of image-enhanced endoscopy (IEE) and discusses its clinical applications and future directions in the lower gastrointestinal (GI) tract.

Keywords

Image-enhanced endoscopy (IEE) / high-definition (HD) / white light endoscopy (WLE) / narrow-band imaging (NBI) / FICE / i-Scan / blue-laser imaging (BLI) / linked-color imaging (LCI) / confocal laser endomicroscopy / endocytoscopy

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