Preface

Abstract

Over the last half of the century, innovative endoscopic technologies aiming to improve mucosal visualization have revolutionized endoscopy. They have allowed modern endoscopists to detect, characterize, and provide real-time optical diagnosis, thus guiding the management’ decisions. This all started in the 1970 s, when the use of dye-spray to stain the mucosa called “chromoendoscopy” was introduced to aid in diagnosing and detecting mucosal abnormalities. Subsequently, improvements in image resolution, software processing, and optical filter technology have led to commercial availability of high-definition endoscopy with series of “push-button” optical contrast broad field techniques such as narrow-band imaging, flexible spectral imaging color enhancement, and i-scan. This has led to better detection and characterization of any mucosal abnormalities in the upper and lower gastrointestinal tract. Along with small field techniques such as endocytoscopy and confocal laser endomicroscopy, these techniques have complemented and enhanced traditional white light endoscopy and dye-based chromoendoscopy. They can serve as red-flag techniques to improve the detection of mucosal abnormalities and allow optical diagnosis and virtual histology of any detected lesions. Nevertheless, to be effective, all the imaging technologies require devoted endoscopists with appropriate training. Neural networks for computer-aided diagnosis and endoscopic pattern recognition have been introduced in the field of upper and lower gastrointestinal disorders. They are the new future at the horizon in assessing disease activity accurately, recognizing lesions, and supporting decision-making processes. In this issue of Techniques and Innovations in Gastrointestinal Endoscopy, leading gastroenterologists in endoscopic imaging provide an overview of advances endoscopic imaging techniques, their clinical applicability, and current status in detecting, characterizing, and diagnosing various mucosal abnormalities of the upper and lower gastrointestinal tract. Cadman Leggett et al highlight the application of narrow-spectrum technologies to diagnose and characterize a wide range of upper gastrointestinal disorders, emphasizing the diagnostic performance of validated classification systems. Kerry Dunbar and Benjamin Elsbernd discuss the volumetric laser endomicroscopy application and its current status in Barrett's esophagus evaluation. Maria Pellise et al review fundamental concepts, benefits, limitations, and practical applications of image enhancement techniques-chromoendoscopy in colorectal cancer screening in average and high-risk populations. Marietta Iaccucci et al outline the most recent literature on the narrow-spectrum technologies and dye-based chromoendoscopy and their applications in inflammatory bowel disease, assessing mucosal healing, detection, and characterization of dysplasia in IBD. Ralf Kiesslich discusses the role of confocal endomicroscopy as small field techniques in upper and lower gastrointestinal disorders. Simultaneously, Helmut Neumann and Asma Alkandari review endocytoscopy techniques and their role in diagnosis various mucosal abnormalities of the gastrointestinal tract. Timo Rath et al discussed molecular imaging, a field emerging as a new and innovative field combining clinical endoscopy with methods used in basic science and discussed possible and evolving clinical applications on molecular imaging within the entire GI tract. Finally, Michael Wallace and Sanne Hoogenboom review the training for advanced endoscopic imaging in gastrointestinal disorders and the role of artificial image enhancement technologies I hope readers find this edition an invaluable practical endoscopic guide to advanced endoscopic imaging techniques. I sincerely thank the authors, editorial staff, and editorial board for making this special issue come to fruition.