Advanced Imaging in Gastrointestinal Endoscopy: A Literature Review of the Current State of the Art

Abstract

<b><i>Background and Aims:</i></b> Gastrointestinal (GI) endoscopy has known a great evolution in the last decades. Imaging techniques evolved from imaging with only standard white light endoscopes toward high-definition resolution endoscopes and the use of multiple color enhancement techniques, over to automated endoscopic assessment systems based on artificial intelligence. This narrative literature review aimed to provide a detailed overview on the latest evolutions within the field of advanced GI endoscopy, mainly focusing on the screening, diagnosis, and surveillance of common upper and lower GI pathology. <b><i>Methods:</i></b> This review comprises only literature about screening, diagnosis, and surveillance strategies using advanced endoscopic imaging techniques published in (inter)national peer-reviewed journals and written in English. Studies with only adult patients included were selected. A search was performed using MESH terms: dye-based chromoendoscopy, virtual chromoendoscopy, video enhancement technique, upper GI tract, lower GI tract, Barrett’s esophagus, esophageal squamous cell carcinoma, gastric cancer, colorectal polyps, inflammatory bowel disease, artificial intelligence. This review does not elaborate on the therapeutic application or impact of advanced GI endoscopy. <b><i>Conclusions:</i></b> Focusing on current and future applications and evolutions in the field of both upper and lower GI advanced endoscopy, this overview is a practical but detailed projection of the latest developments. Within this review, an active leap toward artificial intelligence and its recent developments in GI endoscopy was made. Additionally, the literature is weighted against the current international guidelines and assessed for its potential positive future impact.

Advances in Endohepatology

“…More specifically, over the past decades, EUS has evolved from a mere diagnostic to an additional mature therapeutic modality incorporating novel skill sets, evolving techniques, and revolutionary device platforms (e.g., improved tissue sampling tools, lumen-apposing metal stents, and radiofrequency ablation needles). The addition of advanced imaging (e.g., chromoendoscopy, confocal laser endomicroscopy, and artificial intelligence), resection/dissection techniques (e.g., endoscopic mucosal resection, endoscopic submucosal dissection, “third-space endoscopy”), transmural drainage options, and vascular interventions has only expanded the horizon for interventional endoscopists (3–6). The largest and fastest growing integration hereof is currently established in the management of patients with advanced gastrointestinal and biliopancreatic disorders (3–6).…”

“…The addition of advanced imaging (e.g., chromoendoscopy, confocal laser endomicroscopy, and artificial intelligence), resection/dissection techniques (e.g., endoscopic mucosal resection, endoscopic submucosal dissection, “third-space endoscopy”), transmural drainage options, and vascular interventions has only expanded the horizon for interventional endoscopists (3–6). The largest and fastest growing integration hereof is currently established in the management of patients with advanced gastrointestinal and biliopancreatic disorders (3–6). Not surprisingly, these advanced gastrointestinal applications have also opened the window toward the adjacent liver because the rapidly evolving liver disease landscape is also confronted with the need for optimized diagnostics and interventions (1–5).…”