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Cancer risk in IBD: How to diagnose and how to manage DALM and ALM

World Journal of Gastroenterology 2011年第27期17卷 3184-3191页

作者： Helmut Neumann Michael Vieth Cord Langner Markus F Neurath Jonas Mudter Department of Medicine 1 Department of SurgeryUniversity of Erlangen-Nuremberg Ulmenweg 1891054 ErlangenGermany Institute of Pathology Klinikum Bayreuth GmbHPreuschwitzer Str. 10195445 BayreuthGermany Institute of Pathology Medical University of GrazAuenbruggerplatz 25A-8036 Graz Austria

The risk of developing neoplasia leading to colorectal cancer is significantly increased in ulcerative colitis (UC) and most likely in Crohn's disease. Several endoscopic surveillance strategies have been implemented to identify these lesions. The main issue is that colitisassociated neoplasms often occurs in flat mucosa, often being detected on taking random biopsies rather than by identification of these lesions via endoscopic imaging. The standard diagnostic procedure in long lasting UC is to take four biopsies every 10 cm. Image enhancement methods, such as chromoendoscopy and virtual histology using endomicroscopy, have greatly im- proved neoplasia detection rates and may contribute toreduced random biopsies by taking targeted "smart" biopsies. Chromoendoscopy may effectively be performed by experienced endoscopists for routine screening of UC patients. By contrast, endomicroscopy is often only available in selected specialized endoscopic centers. Importantly, advanced endoscopic imaging has the poten- tial to increase the detection rate of neoplasia whereas the interplay between endoscopic experience and interpretation of histological biopsy evaluation allows the physician to make a proper diagnosis and to find the appropriate therapeutic approach. Colitis-associated intraepithelial neoplasms may occur in flat mucosa of endoscopically normal appearance or may arise as dysplasia-associated lesion or mass (DALM), which may be indistinguishable from sporadic adenomas in healthy or non-colitis mucosa [adenoma-like mass (ALM)]. The aim of this review was to summarize endoscopic and histological characteristics of DALM and ALM in the context of therapeutic procedures.

关键词： Inflammatory bowel disease Crohn’s dis- ease Endoscopy Colitis Dysplasia-associated lesion or mass Adenoma-like mass endomicroscopy Ulcerative colitis endomicroscopy Confocal laser endomicroscopy Probe-based confocal laser endomicroscopy Integrated confocal laser endomicroscopy Endoscope-based confocal laser endomicroscopy Narrow band imaging Chromoendoscopy Cancer Dysplasia

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New endoscopic approaches in IBD

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World Journal of Gastroenterology 2011年第1期17卷 63-68页

作者： Helmut Neumann Markus F Neurath Jonas Mudter Department of Medicine I University of Erlangen-Nuremberg91054 ErlangenGermany

Recent advances in endoscopic imaging techniques have revolutionized the diagnostic approach of patients with inflammatory bowel disease(IBD).New,emerging endoscopic imaging techniques visualized a plethora of new mucosal details even at the cellular and subcellular *** review offers an overview about new endoscopic techniques,including chromoendoscopy,magnification endoscopy,spectroscopy,confocal laser endomicroscopy and endocytoscopy in the face of IBD.

关键词： Endoscopy Inflammatory bowel disease endomicroscopy Endocytoscopy Narrow band imaging Fujinon intelligent color enhancement i-Scan Spectroscopy Chromoendoscopy Ulcerative colitis Crohn's disease Fluorescence endoscopy

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Advanced imaging in surveillance of Barrett’s esophagus: Is the juice worth the squeeze?

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World Journal of Gastroenterology 2019年第25期25卷 3108-3115页

作者： Sara A Cerrone Arvind J Trindade Division of Gastroenterology Long Island Jewish Medical CenterZucker School of Medicine at Hofstra/NorthwellNorthwell Health System

Esophageal cancer is on the *** known precursor lesion is Barrett’s esophagus(BE).Patients with dysplasia are at higher risk of developing esophageal *** the gold standard for surveillance endoscopy involves taking targeted biopsies of abnormal areas as well as random biopsies every 1-2 cm of the length of the Barrett’*** studies have shown that this surveillance can miss dysplasia and *** imaging technologies have been developed that may help detect dysplasia in *** opinion review discusses advanced imaging in BE surveillance endoscopy and its utility in clinical practice.

关键词： Barrett’s esophagus Advanced imaging Chromoendoscopy endomicroscopy

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Diagnostic imaging advances in murine models of colitis

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World Journal of Gastroenterology 2016年第3期22卷 996-1007页

作者： Markus Brückner Philipp Lenz Marcus M Mücke Faekah Gohar Peter Willeke Dirk Domagk Dominik Bettenworth Department of Medicine B University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Paediatric Rheumatology and Immunology University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Medicine D University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Medicine I Josephs-Hospital WarendorfAcademic Teaching HospitalUniversity of MünsterAm Krankenhaus 2D-48231 WarendorfGermany

Inflammatory bowel diseases(IBD) such as Crohn's disease and ulcerative colitis are chronic-remittent inflammatory disorders of the gastrointestinal tract still evoking challenging clinical diagnostic and therapeutic situations. Murine models of experimental colitis are a vital component of research into human IBD concerning questions of its complex pathogenesis or the evaluation of potential new drugs. To monitor the course of colitis, to the present day, classical parameters like histological tissue alterations or analysis of mucosal cytokine/chemokine expression often require euthanasia of animals. Recent advances mean revolutionary noninvasive imaging techniques for in vivo murine colitis diagnostics are increasingly available. These novel and emerging imaging techniques not only allow direct visualization of intestinal inflammation, but also enable molecular imaging and targeting of specific alterations of the inflamed murine mucosa. For the first time, in vivo imaging techniques allow for longitudinal examinations and evaluation of intra-individual therapeutic response. This review discusses the latest developments in the different fields of ultrasound, molecularly targeted contrast agent ultrasound, fluorescence endoscopy, confocal laser endomicroscopy as well as tomographic imaging with magnetic resonance imaging, computed tomography and fluorescence-mediated tomography,discussing their individual limitations and potential future diagnostic applications in the management of human patients with IBD.

关键词： confocal laser endomicroscopy contrastenhanced ultrasound Dextran Sodium Sulphate colitis experimental colitis fluorescence imaging endoscopy Imaging Inflammatory bowel disease Tomography

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New horizons in the endoscopic ultrasonography-based diagnosis of pancreatic cystic lesions

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World Journal of Gastroenterology 2018年第26期24卷 2853-2866页

作者： María-Victoria Alvarez-Sánchez Bertrand Napoléon Instituto de Investigación Sanitaria Galicia Sur Complejo Hospitalario Universitario de Pontevedra Department of Gastroenterology Ramsay Générale de Santé Private Hospital Jean Mermoz

Pancreatic cystic lesions(PCLs) are increasingly being identified because of the widespread use of highresolution abdominal imaging. These cysts encompass a spectrum from malignant disease to benign lesions, and therefore, accurate diagnosis is crucial to determine the best management strategy, either surgical resection or surveillance. However, the current standard of diagnosis is not accurate enough due to limitations of imaging and tissue sampling techniques, which entail the risk of unnecessary burdensome surgery for benign lesions or missed opportunities of prophylactic surgery for potentially malignant PCLs. In the last decade, endoscopic innovations based on endoscopic ultrasonography(EUS) imaging have emerged, aiming to overcome the present limitations. These new EUS-based technologies are contrast harmonic EUS, needle-based confocal endomicroscopy, through-the-needle cystoscopy and through-the needle intracystic biopsy. Here, we present a comprehensive and critical review of these emerging endoscopic tools for the diagnosis of PCLs, with a special emphasis on feasibility, safety and diagnostic performance.

关键词： Intraductal papillary mucinous neoplasm Pancreatic cystic lesions Endoscopic ultrasonography Confocal endomicroscopy Mucinous cystadenoma Through-the-needle cystoscopy Serous cystadenoma Through-the-needle forceps biopsy Contrast harmonic endoscopic ultrasonography

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Colonic lesion characterization in inflammatory bowel disease:A systematic review and meta-analysis

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World Journal of Gastroenterology 2018年第10期24卷 1167-1180页

作者： Richard Lord Nicholas E Burr Noor Mohammed Venkataraman Subramanian Department of Gastroenterology Leeds Teaching Hospitals NHS TrustLeeds LS97TFUnited Kingdom University of Leeds Leeds Institute of Biomedical and Clinical SciencesLeeds LS97TFUnited Kingdom

AIM To perform a systematic review and meta-analysis for the diagnostic accuracy of in vivo lesion characterization in colonic inflammatory bowel disease(IBD), using optical imaging techniques, including virtual chromoendoscopy(VCE), dye-based chromoendoscopy(DBC), magnification endoscopy and confocal laser endomicroscopy(CLE). METHODS We searched Medline, Embase and the Cochrane library. We performed a bivariate meta-analysis to calculate the pooled estimate sensitivities, specificities, positive and negative likelihood ratios(+LHR,-LHR), diagnostic odds ratios(DOR), and area under the SROC curve(AUSROC) for each technology group. A subgroup analysis was performed to investigate differences in real-time nonmagnified Kudo pit patterns(with VCE and DBC) and real-time *** We included 22 studies [1491 patients; 4674 polyps, of which 539(11.5%) were neoplastic]. Real-time CLE had a pooled sensitivity of 91%(95%CI: 66%-98%), specificity of 97%(95%CI: 94%-98%), and an AUSROC of 0.98(95%CI: 0.97-0.99). Magnification endoscopy had a pooled sensitivity of 90%(95%CI: 77%-96%)and specificity of 87%(95%CI: 81%-91%). VCE had a pooled sensitivity of 86%(95%CI: 62%-95%) and specificity of 87%(95%CI: 72%-95%). DBC had a pooled sensitivity of 67%(95%CI: 44%-84%) and specificity of 86%(95%CI: 72%-94%). CONCLUSION Real-time CLE is a highly accurate technology for differentiating neoplastic from non-neoplastic lesions in patients with colonic IBD. However, most CLE studies were performed by single expert users within tertiary centres, potentially confounding these results.

关键词： Inflammatory bowel disease dysplasia Lesion characterization Confocal laser endomicroscopy Narrow band imaging I-scan Fujinon intelligence chromoendoscopy

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Hybrid multimode - multicore fibre based holographic endoscope for deep-tissue neurophotonics

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Light(Advanced Manufacturing) 2022年第3期3卷 84-92页

作者： Yang Du Sergey Turtaev Ivo T Leite Adrian Lorenz Jens Kobelke Katrin Wondraczek Tomas Cizmar Leibniz Institute of Photonic Technology Albert-Einstein-Straβe 9Jena07745Germany Institute of Scientific Instruments of CAS Kralovopolska 147Brno61264Czechia Institute of Applied Optics Friedrich Schiller University JenaFrobelstieg 107743 JenaGermany

In-vivo microendoscopy in animal models became a groundbreaking technique in neuroscience that rapidly expands our understanding of the *** hair-thin endoscopes based on multimode fibres are now opening up the prospect of ultra-minimally invasive neuroimaging of deeply located brain *** these advancements with methods of functional imaging and optogenetics,as well as extending its applicability to awake and motile animals constitute the most pressing challenges for this *** we demonstrate a novel fibre design capable of both,high-resolution imaging in immobilised animals and bending-resilient optical addressing of neurons in motile *** optimised refractive index profile and the probe structure allowed reaching a spatial resolution of 2μm across a 230μm field of view for the initial layout of the ***,the fibre exhibits negligible cross-talk between individual inner-cores during fibre *** work provides a technological solution for imaging-assisted spatially selective photo-activation and activity monitoring in awake and freely moving animal models.

关键词： Multimode fibre Multicore fibre Fibre-based imaging Microendoscopy endomicroscopy Holographic endoscopy

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Recent advances in targeted endoscopic imaging:Early detection of gastrointestinal neoplasms

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World Journal of Gastrointestinal Endoscopy 2012年第3期4卷 57-64页

作者： Yong-Soo Kwon Young-Seok Cho Tae-Jong Yoon Ho-Shik Kim Myung-Gyu Choi Department of Applied Bioscience CHA University Department of Gastroenterology Uijeongbu St.Mary's HospitalCollege of MedicineThe Catholic University of Korea Department of Biochemistry College of MedicineThe Catholic University of Korea Department of Gastroenterology Seoul St.Mary's HospitalCollege of MedicineThe Catholic University of Korea

Molecular imaging has emerged as a new discipline in gastrointestinal *** technology encompasses modalities that can visualize disease-specific morphological or functional tissue changes based on the molecular signature of individual *** imaging has several advantages including minimal damage to tissues,repetitive visualization,and utility for conducting quantitative *** in basic science coupled with endoscopy have made early detection of gastrointestinal cancer *** imaging during gastrointestinal endoscopy requires thedevelopment of safe biomarkers and exogenous probes to detect molecular changes in cells with high specificity anda high signal-to-background ***,a high-resolution endoscope with an accurate wide-field viewing capability must be *** endoscopic imaging is expected to improve early diagnosis and individual therapy of gastrointestinal cancer.

关键词： Autofluorescence endoscopy Confocal endomicroscopy Endoscopy Molecular imaging Molecular probes,Near-infrared fluorescence imaging Targeted endoscopic imaging

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What's new about inflammatory bowel diseases in 2011

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World Journal of Gastroenterology 2011年第27期17卷 3177-3177页

作者： Jonas Mudter Department of Internal Medicine University of ErlangenUlmenweg 18Erlangen 91054 Germany

Inflammatory bowel diseases (IBD) are chronic disorders of the intestine with increasing incidence in Europe, Northern America and asiatic countries such as china. Thus, we have putted together these topic highlight a... 详细信息

关键词： Inflammatory bowel disease Endoscopy endomicroscopy Confocal laser endomicroscopy Cytokines Immune system Colorectal cancer Postoperative recurrence

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Endoscopic tools for the diagnosis and evaluation of celiac disease

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World Journal of Gastroenterology 2013年第46期19卷 8562-8570页

作者： Gianluca Ianiro Antonio Gasbarrini Giovanni Cammarota Gastroenterology Unit "A. Gemelli" University Hospital Catholic University of Sacred Heart

Celiac disease(CD)is an autoimmune disease of the small bowel induced by ingestion of wheat,rye and *** guidelines indicate histological analysis on at least four duodenal biopsies as the only way to diagnose *** indications are based on the conception of the inability of standard endoscopy to make diagnosis of CD and/or to drive biopsy *** the last years,technology development of endoscopic devices has greatly ameliorated the accuracy of macroscopic evaluation of duodenal villous pattern,increasing the diagnostic power of endoscopy of *** aim of this paper is to review the new endoscopic tools and procedures proved to be useful in the diagnosis of CD,such as chromoendoscopy,Fujinon Intelligent Chromo Endoscopy,Narrow Band Imaging,Optical Coherence Tomography,Water-Immersion Technique,confocal laser endomicroscopy,high-resolution magnification endoscopy,capsule endoscopy and I-Scan technology.

关键词： Celiac disease Malabsorption syndrome Duodenum Diagnostic techniques and proceduresEndoscopy Chromoendoscopy Fujinon intelligent chromo endoscopy Narrow band imaging Optical coherence tomography Water-immersion technique Confocal laser endomicroscopy High-resolution mag-nification endoscopy Capsule endoscopy I-scan tech-nology

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