Masterclass: Advanced GI Endoscopic Imaging (Live/Virtual) | December 2025-Wang

Wang - Real Time Molecular Imaging

Pdf Summary

This presentation by Dr. Kenneth K. Wang provides an overview of real-time molecular imaging in the gastrointestinal (GI) tract, highlighting its definition, rationale, methods, and current technologies. Molecular imaging is described as a rapidly emerging discipline in GI endoscopy that leverages the molecular signatures of cells for minimally invasive, targeted visualization of GI diseases. The rationale centers on detecting molecular changes not visible through standard endoscopy, which is crucial for early diagnosis and tailored therapies.<br /><br />The presentation reviews traditional imaging innovations (e.g., Narrow Band Imaging) and notes their limitations, emphasizing the need for molecular-level detection to identify heterogeneous tumor markers such as CLDN18.2 in gastric cancers. Real-time molecular imaging can reveal genomic abnormalities in non-dysplastic Barrett’s esophagus mucosa, enabling targeted detection of potentially pre-cancerous lesions.<br /><br />Key applications include enhancing diagnostics for dysplasia, pancreatic cysts, submucosal tumors, biliary neoplasia, and mucosal inflammation. Molecular imaging also supports targeted therapies by identifying specific markers for emerging oncologic treatments like immune checkpoint inhibitors and CAR T-cell therapies.<br /><br />Technologically, molecular imaging involves fluorescence-tagged peptide probes developed via phage display to bind molecular targets quickly and specifically. Various advanced endoscopes capable of multi-spectral or two-photon fluorescence imaging are detailed, offering improved visualization of molecular abnormalities and tissue microstructure in vivo.<br /><br />The talk concludes that aptamers and peptides are among the best labeling strategies for GI molecular targeting, with topical application requiring rapid, specific binding to minimize nonspecific signal. Existing fluorescent endoscopes demonstrate the potential for label-free imaging methods. Overall, real-time molecular imaging represents a significant advance towards personalized medicine by enabling precise detection and treatment of GI diseases at the molecular level.

Keywords

real-time molecular imaging

gastrointestinal tract

GI endoscopy

molecular signatures

early diagnosis

Narrow Band Imaging

CLDN18.2

Barrett’s esophagus

fluorescence-tagged peptide probes

personalized medicine