Masterclass: Advanced GI Endoscopic Imaging (On-Demand) | December 2025-Wang

Wang - Endomicroscopy and Advanced Imaging

Pdf Summary

This presentation by Dr. Kenneth K. Wang covers the evolving field of endoscopic advanced imaging, focusing on the shift from traditional histology-level visualization to detailed subcellular imaging for better cancer risk assessment and molecular diagnostics.

Key technologies reviewed include:

1. <strong>Endocytoscopy</strong>: Developed initially by Haruhiro Inoue, this catheter-based method offers up to 500-520X magnification, allowing cellular-level visualization of the esophagus, stomach, and colon. Recent devices like Olympus's GIF-H290EC provide up to 600X magnification. Studies show high diagnostic accuracy (over 90%) for identifying neoplastic changes and eosinophilic esophagitis. However, image stability, cost-effectiveness, and standardization remain challenges.

2. <strong>Confocal Laser Endomicroscopy (CLE)</strong>: Two main systems—optical CLE (eCLE) and probe-based CLE (pCLE)—offer in vivo microscopic imaging with near-histological resolution. CLE has demonstrated high sensitivity and specificity in detecting dysplasia in Barrett’s esophagus, gastric, and colorectal lesions, improving real-time diagnosis and potentially reducing biopsies. Large multicenter trials confirm its clinical utility, especially when combined with high-definition white-light endoscopy.

3. <strong>Volume Laser Endomicroscopy (VLE)</strong>: Provides wide-field, histology-level imaging over larger tissue areas, enabling quantification of abnormal regions like buried high-grade dysplasia not easily detected by conventional methods.

4. <strong>Emerging Technologies</strong>:
   - <strong>Angle-Resolved Low-Coherence Interferometry (a/LCI)</strong> uses light scattering to detect submicron cellular and nuclear structures for dysplasia detection with high sensitivity and specificity.
   - <strong>Spectroscopic OCT</strong> combined with a/LCI enhances targeted imaging, facilitating better detection and classification.
   - <strong>Low-Coherence Enhanced Backscattering (LEBS)</strong> spectroscopy detects nanoscale alterations in tissues, aiding in early cancer detection in colon and pancreatic diseases.
   - <strong>Partial Wave Spectroscopy Microscopy</strong> explores nanostructural chromatin changes related to chemotherapy resistance.

The presentation emphasizes that next-generation advanced imaging integrates wide-field and spectrographic techniques, providing subcellular and nanoscale resolution with potential applications in cancer invasion assessment, metastasis risk, and molecular abnormality visualization. Overall, these innovations promise improved diagnosis, targeted surveillance, and personalized therapy in gastroenterology.

Keywords

Endoscopic advanced imaging

Endocytoscopy

Confocal Laser Endomicroscopy

Volume Laser Endomicroscopy

Angle-Resolved Low-Coherence Interferometry

Spectroscopic OCT

Low-Coherence Enhanced Backscattering

Partial Wave Spectroscopy Microscopy

Cancer risk assessment

Molecular diagnostics