Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia
Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia
复制标题
DOI：
10.1016/j.cgh.2014.08.004
复制
发表时间：
2014-11-01
影响因子：
12.6
通讯作者：
Anandasabapathy, Sharmila
中科院分区：
文献类型：
--
作者：
Louie, Justin S.;Richards-Kortum, Rebecca;Anandasabapathy, Sharmila
高分辨率显微内窥镜 (HRME) 是一种新型成像方式，可实现亚细胞分辨率的实时上皮成像。这种便携式、低成本的“光学活检”技术与任何标准内窥镜配合使用，能够在手术过程中提供细胞形态的图像。该技术已成为许多研究的主题，调查其在一系列胃肠道肿瘤筛查和监测中的应用，包括食管腺癌、食管鳞状细胞癌、结直肠肿瘤和肛门肿瘤。这些研究表明，HRME 是一种能够在不同疾病中持续提供高特异性、阴性预测值和准确性的方法。此外，他们还表明，HRME 用户可以在短时间内相对轻松地接受培训，并且用户表现出可靠的评估者间可靠性。这些功能使 HRME 成为高清白光成像、窄带成像和其他危险信号技术的潜在补充，以促进实时临床诊断、内窥镜治疗和边缘确定。需要进一步的临床验证来确定这是否会减少手术时间、病理成本和后续手术。最后，与其他同类技术相比，HRME 的设计相对简单，使其便于携带、维护简单且成本低廉。这可以让 HRME 设备在高级护理环境以及资源和专业支持系统较少的地方发挥作用。总体而言，HRME设备表现出了良好的性能、低成本和便携式结构，并且其在不同条件和环境下的应用前景广阔。
The high-resolution microendoscope (HRME) is a novel imaging modality that allows real-time epithelial imaging at subcellular resolution. Used in concert with any standard endoscope, this portable, low cost, "optical biopsy" technology has the ability to provide images of cellular morphology during a procedure. This technology has been the subject of a number of studies investigating its use in screening and surveillance of a range of gastrointestinal neoplasias, including esophageal adenocarcinoma, esophageal squamous cell cancer, colorectal neoplasia, and anal neoplasia. These studies have shown that HRME is a modality that consistently provides high specificity, negative predictive value, and accuracy across different diseases. In addition, they have illustrated that HRME users can be relatively easily trained in a short period of time, and that users have demonstrated solid inter-rater reliability. These features make HRME a potential complement to high-definition white-light imaging, narrow-band imaging, and other red flag technologies in facilitating real-time clinical diagnosis, endoscopic therapy, and margin determination. Further clinical validation is needed to determine whether this translates to reduced procedure times, pathology costs, and follow-up procedures. Finally, the HRME has a relatively simple design compared with other similar technologies, making it portable, simple to maintain, and low cost. This may allow the HRME device to function in both advanced care settings as well as in places with less resources and specialized support systems. As a whole, the HRME device has shown good performance along with low cost and portable construction, and its application in different conditions and settings has been promising.