Advanced imaging and therapeutic endoscopy

From the early days of gastrointestinal endoscopy, there has been remarkable progress in imaging technology. High-definition endoscopes are now part of the standard armamentarium and a variety of other advanced imaging modalities jostle for space. However, the objective of each of these remains much the same; the enablement of the endoscopist to accurately characterize early gastrointestinal mucosal lesions, which are beyond the capability of standard devices. The benefit of doing so, may be manifold. First, during surveillance of gastrointestinal malignancy, the endoscopist may choose to eschew random biopsies in favor of targeted ones from areas of suspicious mucosa. Second, early mucosal lesions may be detected, which are typically amenable to endoscopic therapy. The ultimate result is improved clinical outcomes and in many cases, the avoidance of surgery. The goal of this review is to summarize for the reader, the most important technologies in advanced endoscopic imaging and their applicability to clinical practice with emphasis on their functioning, implementation, and effect on therapeutic endoscopy.