Light provides a broad range of colors in the visible and near-infrared (400–900 nm) spectrum that can be used to transmit information about molecular expression in normal and diseased tissues. The absorbance spectrum of hemoglobin, the primary chromophore in tissue, is shown in Fig. 1A. Genetic changes that occur in cancer transformation can be heterogeneous, and several signaling pathways may be activated concurrently.1 Moreover, molecular activity levels may vary between individual patients, at different time points, and within the tumor. Thus, a single genetic mutation is unlikely to characterize most disease processes over a general population. Unfortunately, most endoscopic imaging methods are sensitive to only one molecular parameter.2 Thus, a methodology that can image multiple molecular targets simultaneously is better suited to address the heterogeneity of cancer and achieve disease detection with high sensitivity and specificity desired for efficient surveillance. In addition, these multiplexed strategies can potentially visualize the interactions between signaling pathways and allow for better understanding of disease pathogenesis on a systems level. Figure 1 A) The visible and near-infrared spectrum of light provides a broad range of colors to generate molecular images from digestive tract mucosa that can be collected with a B) 1.6 mm diameter multispectral scanning fiber endoscope. C) Excitation is delivered ... Recently, significant progress has been made in advancing new methods of endoscopic imaging to target disease in the digestive tract, including the development of novel instruments and specific contrast agents.3 In this video journal, we aim to demonstrate the application of a novel, multispectral endoscope that uses a scanning fiber to image multiple targets at the same time. Fluorescence imaging can be achieved with high target-to-background ratios, and allow us to see the different target expression patterns in an Apc-mutation dependent mouse model of spontaneous colorectal adenomas using multiple peptides as targeting ligands.4
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