Shahsavari Dariush, Waqar Muhammad, Thoguluva Chandrasekar Viveksandeep
Augusta University Medical Center, Augusta, GA, USA.
Transl Gastroenterol Hepatol. 2023 Jul 25;8:26. doi: 10.21037/tgh-23-17. eCollection 2023.
Colonoscopy has been proven to be a successful approach in both identifying and preventing colorectal cancer. The incorporation of advanced imaging technologies, such as image-enhanced endoscopy (IEE), plays a vital role in real-time diagnosis. The advancements in endoscopic imaging technology have been continuous, from replacing fiber optics with charge-coupled devices to the introduction of chromoendoscopy in the 1970s. Recent technological advancements include "push-button" technologies like autofluorescence imaging (AFI), narrowed-spectrum endoscopy, and confocal laser endomicroscopy (CLE). Dye-based chromoendoscopy (DCE) is falling out of favor due to the longer time required for application and removal of the dye and the difficulty of identifying lesions in certain situations. Narrow band imaging (NBI) is a technology that filters the light used for illumination leading to improved contrast and better visibility of structures on the mucosal surface and has shown a consistently higher adenoma detection rate (ADR) compared to white light endoscopy. CLE has high sensitivity and specificity for polyp detection and characterization, and several classifications have been developed for accurate identification of normal, regenerative, and dysplastic epithelium. Other IEE technologies, such as blue laser imaging (BLI), linked-color imaging (LCI), i-SCAN, and AFI, have also shown promise in improving ADR and characterizing polyps. New technologies, such as Optivista, red dichromatic imaging (RDI), texture and color enhancement imaging (TXI), and computer-aided detection (CAD) using artificial intelligence (AI), are being developed to improve polyp detection and pathology prediction prior to widespread use in clinical practice.
结肠镜检查已被证明是识别和预防结直肠癌的一种成功方法。先进成像技术的融入，如图像增强内镜检查（IEE），在实时诊断中起着至关重要的作用。内镜成像技术一直在不断进步，从用电荷耦合器件取代光纤到20世纪70年代引入色素内镜检查。最近的技术进步包括“一键式”技术，如自体荧光成像（AFI）、窄谱内镜检查和共聚焦激光显微内镜检查（CLE）。基于染料的色素内镜检查（DCE）因应用和去除染料所需时间较长以及在某些情况下难以识别病变而逐渐失宠。窄带成像（NBI）是一种过滤用于照明的光线的技术，可提高对比度，使黏膜表面结构的可视性更好，与白光内镜检查相比，其腺瘤检出率（ADR）一直较高。CLE对息肉的检测和特征描述具有高灵敏度和特异性，并且已经开发了几种分类方法来准确识别正常、再生和发育异常的上皮。其他IEE技术，如蓝光激光成像（BLI）、联动成像（LCI）、i-SCAN和AFI，在提高ADR和描述息肉特征方面也显示出前景。诸如Optivista、红色双色成像（RDI）、纹理和颜色增强成像（TXI）以及使用人工智能（AI）的计算机辅助检测（CAD）等新技术正在研发中，以便在临床实践广泛应用之前改善息肉检测和病理预测。
