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Biophotonic endoscopy: a review of clinical research techniques for optical imaging and sensing of early gastrointestinal cancer.

Coda S, Siersema PD, Stamp GW, Thillainayagam AV - Endosc Int Open (2015)

Bottom Line: In theory, biophotonic advances have the potential to unite these elements to allow in vivo "optical biopsy." These techniques may ultimately offer the potential to increase the rates of detection of high risk lesions and the ability to target biopsies and resections, and so reduce the need for biopsy, costs, and uncertainty for patients.However, their utility and sensitivity in clinical practice must be evaluated against those of conventional histopathology.Particular emphasis has been placed on translational label-free optical techniques, such as fluorescence spectroscopy, fluorescence lifetime imaging microscopy (FLIM), two-photon and multi-photon microscopy, second harmonic generation (SHG) and third harmonic generation (THG) imaging, optical coherence tomography (OCT), diffuse reflectance, Raman spectroscopy, and molecular imaging.

View Article: PubMed Central - PubMed

Affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Imperial College London, London, United Kingdom ; Photonics Group, Department of Physics, Imperial College London, London, United Kingdom ; Endoscopy Unit, Department of Gastroenterology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom ; Department of Endoscopy, North East London NHS Treatment Centre, Care UK, London, United Kingdom.

ABSTRACT
Detection, characterization, and staging constitute the fundamental elements in the endoscopic diagnosis of gastrointestinal diseases, but histology still remains the diagnostic gold standard. New developments in endoscopic techniques may challenge histopathology in the near future. An ideal endoscopic technique should combine a wide-field, "red flag" screening technique with an optical contrast or microscopy method for characterization and staging, all simultaneously available during the procedure. In theory, biophotonic advances have the potential to unite these elements to allow in vivo "optical biopsy." These techniques may ultimately offer the potential to increase the rates of detection of high risk lesions and the ability to target biopsies and resections, and so reduce the need for biopsy, costs, and uncertainty for patients. However, their utility and sensitivity in clinical practice must be evaluated against those of conventional histopathology. This review describes some of the most recent applications of biophotonics in endoscopic optical imaging and metrology, along with their fundamental principles and the clinical experience that has been acquired in their deployment as tools for the endoscopist. Particular emphasis has been placed on translational label-free optical techniques, such as fluorescence spectroscopy, fluorescence lifetime imaging microscopy (FLIM), two-photon and multi-photon microscopy, second harmonic generation (SHG) and third harmonic generation (THG) imaging, optical coherence tomography (OCT), diffuse reflectance, Raman spectroscopy, and molecular imaging.

No MeSH data available.


Related in: MedlinePlus

 Stylized Venn diagram showing predominant targets and potential relationships/overlaps between different biophotonic techniques in detecting, characterizing, and staging diseases at endoscopy. DRS, diffuse reflectance spectroscopy; fa/LCI, frequency-domain angle-resolved low coherence interferometry; FLIM, fluorescence lifetime imaging microscopy; FLS, fluorescence lifetime spectroscopy; SHG, second harmonic generation; MPM, multiphoton microscopy; OCT, optical coherence tomography; CARS, coherent anti-Stokes Raman scattering.
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FI158-1:  Stylized Venn diagram showing predominant targets and potential relationships/overlaps between different biophotonic techniques in detecting, characterizing, and staging diseases at endoscopy. DRS, diffuse reflectance spectroscopy; fa/LCI, frequency-domain angle-resolved low coherence interferometry; FLIM, fluorescence lifetime imaging microscopy; FLS, fluorescence lifetime spectroscopy; SHG, second harmonic generation; MPM, multiphoton microscopy; OCT, optical coherence tomography; CARS, coherent anti-Stokes Raman scattering.

Mentions: It is difficult at present to classify each method according to its potential clinical use and according to what diseases it is best applied because different modalities might be used for one or all elements of diagnosis and be applied to a variety of different conditions. Although individual techniques aim to prove useful for a specific aspect of the diagnostic process, there is some cluster overlap between the elements, as shown in the stylized Venn diagram in Fig. 1.


Biophotonic endoscopy: a review of clinical research techniques for optical imaging and sensing of early gastrointestinal cancer.

Coda S, Siersema PD, Stamp GW, Thillainayagam AV - Endosc Int Open (2015)

 Stylized Venn diagram showing predominant targets and potential relationships/overlaps between different biophotonic techniques in detecting, characterizing, and staging diseases at endoscopy. DRS, diffuse reflectance spectroscopy; fa/LCI, frequency-domain angle-resolved low coherence interferometry; FLIM, fluorescence lifetime imaging microscopy; FLS, fluorescence lifetime spectroscopy; SHG, second harmonic generation; MPM, multiphoton microscopy; OCT, optical coherence tomography; CARS, coherent anti-Stokes Raman scattering.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4612244&req=5

FI158-1:  Stylized Venn diagram showing predominant targets and potential relationships/overlaps between different biophotonic techniques in detecting, characterizing, and staging diseases at endoscopy. DRS, diffuse reflectance spectroscopy; fa/LCI, frequency-domain angle-resolved low coherence interferometry; FLIM, fluorescence lifetime imaging microscopy; FLS, fluorescence lifetime spectroscopy; SHG, second harmonic generation; MPM, multiphoton microscopy; OCT, optical coherence tomography; CARS, coherent anti-Stokes Raman scattering.
Mentions: It is difficult at present to classify each method according to its potential clinical use and according to what diseases it is best applied because different modalities might be used for one or all elements of diagnosis and be applied to a variety of different conditions. Although individual techniques aim to prove useful for a specific aspect of the diagnostic process, there is some cluster overlap between the elements, as shown in the stylized Venn diagram in Fig. 1.

Bottom Line: In theory, biophotonic advances have the potential to unite these elements to allow in vivo "optical biopsy." These techniques may ultimately offer the potential to increase the rates of detection of high risk lesions and the ability to target biopsies and resections, and so reduce the need for biopsy, costs, and uncertainty for patients.However, their utility and sensitivity in clinical practice must be evaluated against those of conventional histopathology.Particular emphasis has been placed on translational label-free optical techniques, such as fluorescence spectroscopy, fluorescence lifetime imaging microscopy (FLIM), two-photon and multi-photon microscopy, second harmonic generation (SHG) and third harmonic generation (THG) imaging, optical coherence tomography (OCT), diffuse reflectance, Raman spectroscopy, and molecular imaging.

View Article: PubMed Central - PubMed

Affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Imperial College London, London, United Kingdom ; Photonics Group, Department of Physics, Imperial College London, London, United Kingdom ; Endoscopy Unit, Department of Gastroenterology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom ; Department of Endoscopy, North East London NHS Treatment Centre, Care UK, London, United Kingdom.

ABSTRACT
Detection, characterization, and staging constitute the fundamental elements in the endoscopic diagnosis of gastrointestinal diseases, but histology still remains the diagnostic gold standard. New developments in endoscopic techniques may challenge histopathology in the near future. An ideal endoscopic technique should combine a wide-field, "red flag" screening technique with an optical contrast or microscopy method for characterization and staging, all simultaneously available during the procedure. In theory, biophotonic advances have the potential to unite these elements to allow in vivo "optical biopsy." These techniques may ultimately offer the potential to increase the rates of detection of high risk lesions and the ability to target biopsies and resections, and so reduce the need for biopsy, costs, and uncertainty for patients. However, their utility and sensitivity in clinical practice must be evaluated against those of conventional histopathology. This review describes some of the most recent applications of biophotonics in endoscopic optical imaging and metrology, along with their fundamental principles and the clinical experience that has been acquired in their deployment as tools for the endoscopist. Particular emphasis has been placed on translational label-free optical techniques, such as fluorescence spectroscopy, fluorescence lifetime imaging microscopy (FLIM), two-photon and multi-photon microscopy, second harmonic generation (SHG) and third harmonic generation (THG) imaging, optical coherence tomography (OCT), diffuse reflectance, Raman spectroscopy, and molecular imaging.

No MeSH data available.


Related in: MedlinePlus