Advances in colonic imaging: new endoscopic imaging methods

There is a need for better endoscopic visualization in specific circumstances like detection of flat colorectal lesions and dysplasia-screening in ulcerative colitis. Chromoendoscopy is a technique with proven success, but many more, novel endoscopic techniques are currently under investigation. In this article different point measurement and still imaging methods are discussed: Raman spectroscopy, elastic (light) scattering spectroscopy, fluorescence spectroscopy, optical coherence tomography and confocal laser microscopy. Furthermore, real-time endoscopic imaging methods are discussed. These include narrow band imaging, fluorescence imaging and endocytoscopy. The results of fluoroscence imaging might be improved by application of photosensitizers; or coupling of fluorescent dyes to tumour-related antigens (Immunoscopy). Most of these techniques still have to be developed further and are not yet available for routine use. In our opinion, a combination of a red-flag technique and a microscopic technique carries an enormous potential.