Advances in Imaging of Inflammation, Fibrosis, and Cancer in the Gastrointestinal Tract

Abstract

Gastrointestinal disease is prevalent and broad, manifesting itself in a variety of ways, including inflammation, fibrosis, infection, and cancer. However, historically, diagnostic technologies have exhibited limitations, especially with regard to diagnostic uncertainty. Despite development of newly emerging technologies such as optoacoustic imaging, many recent advancements have focused on improving upon pre-existing modalities such as ultrasound, computed tomography, magnetic resonance imaging, and endoscopy. These advancements include utilization of machine learning models, biomarkers, new technological applications such as diffusion weighted imaging, and new techniques such as transrectal ultrasound. This review discusses assessment of disease processes using imaging strategies for the detection and monitoring of inflammation, fibrosis, and cancer in the context of gastrointestinal disease. Specifically, we include ulcerative colitis, Crohn’s disease, diverticulitis, celiac disease, graft vs. host disease, intestinal fibrosis, colorectal stricture, gastric cancer, and colorectal cancer. We address some of the most recent and promising advancements for improvement of gastrointestinal imaging, including unique discussions of such advancements with regard to imaging of fibrosis and differentiation between similar disease processes.

Dynamic 2-deoxy-D-glucose-enhanced multispectral optoacoustic tomography for assessing metabolism and vascular hemodynamics of breast cancer

“…Further, given the link between hypoxia and tumor response to radiation therapy, oxygen-sensitive MRI could also assist in response monitoring and outcome prediction during radiation therapy [62] . Similarly, oxygen-enhanced MSOT (OE-MSOT) and other hypoxia-sensitive MSOT techniques [37] , [63] , [64] demonstrated comparable capabilities to monitor tumor oxygenation in real-time, and the unique strengths of MSOT, including portability, high spatiotemporal resolution, etc., potentiates its application in certain clinical settings infeasible for MRI and other imaging modalities. It should, however, be noted that the labeling of 2-DG with IRDye800 alters the metabolism of 2-DG and may not dynamically reflect glucose metabolism, in contrast to MRI technologies that require no labeling for dynamic imaging, e.g., chemical exchange saturation transfer (CEST) MRI [65] .…”

Oral Administration of Platinum Nanoparticles with SOD/CAT Cascade Catalytic Activity to Alleviate Ulcerative Colitis

“…Moreover, it plays a crucial role in guiding the modification and implementation of treatment strategies for intestinal diseases [49,50]. The endoscopic results demonstrated that Pt NP treatment significantly reduced colon mucosal congestion, edema, and ulceration in the UC mouse model (Figure 6I).…”

Radiology of fibrosis part II: abdominal organs

“…Furthermore, it makes use of oral contrast agents to visualize the extent of bowel wall abnormalities and evaluate inflammatory activities [ 65 , 70 ]. Recent development in the field of artificial intelligence has allowed for the realization of CT-based deep learning models which have proven to outperform human interpreters with increased accuracy and objectivity [ 73 ]. This technology’s main limitation, however, is that of exposure to ionizing radiation [ 65 , 68 ].…”