Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

James E. East; Jasper L. Vleugels; Philip Roelandt; Pradeep Bhandari; Raf Bisschops; Evelien Dekker; Cesare Hassan; Gareth Horgan; Ralf Kiesslich; Gaius Longcroft-Wheaton; Ana Wilson; Jean-Marc Dumonceau

doi:10.1055/s-0042-118087

Endoscopy, Table of Contents

Endoscopy 2016; 48(11): 1029-1045
DOI: 10.1055/s-0042-118087

Guideline

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

James E. East

¹Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, United Kingdom

,

Jasper L. Vleugels

²Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.

,

Philip Roelandt

³Gastroenterology Department, University Hospital Leuven, Leuven, Belgium

,

Pradeep Bhandari

⁴Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth, United Kingdom

,

Raf Bisschops

³Gastroenterology Department, University Hospital Leuven, Leuven, Belgium

,

Evelien Dekker

²Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.

,

Cesare Hassan

⁵Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy

,

Gareth Horgan

⁶Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin, Ireland

,

Ralf Kiesslich

⁷Klinik für Innere Medizin II, Dr Horst Schmidt Kliniken GmbH, Wiesbaden, Germany.

,

Gaius Longcroft-Wheaton

⁴Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth, United Kingdom

,

Ana Wilson

⁸Wolfson Unit for Endoscopy, St. Mark’s Hospital, London, United Kingdom

,

Jean-Marc Dumonceau

⁹Gedyt Endoscopy Center, Buenos Aires, Argentina

› Author Affiliations

Abstract

Background and aim: This technical review is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the utilization of advanced endoscopic imaging in gastrointestinal (GI) endoscopy.

Methods: This technical review is based on a systematic literature search to evaluate the evidence supporting the use of advanced endoscopic imaging throughout the GI tract. Technologies considered include narrowed-spectrum endoscopy (narrow band imaging [NBI]; flexible spectral imaging color enhancement [FICE]; i-Scan digital contrast [I-SCAN]), autofluorescence imaging (AFI), and confocal laser endomicroscopy (CLE). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendation and the quality of evidence.

Main recommendations:

1. We suggest advanced endoscopic imaging technologies improve mucosal visualization and enhance fine structural and microvascular detail. Expert endoscopic diagnosis may be improved by advanced imaging, but as yet in community-based practice no technology has been shown consistently to be diagnostically superior to current practice with high definition white light. (Low quality evidence.) 2. We recommend the use of validated classification systems to support the use of optical diagnosis with advanced endoscopic imaging in the upper and lower GI tracts (strong recommendation, moderate quality evidence). 3. We suggest that training improves performance in the use of advanced endoscopic imaging techniques and that it is a prerequisite for use in clinical practice. A learning curve exists and training alone does not guarantee sustained high performances in clinical practice. (Weak recommendation, low quality evidence.)

Conclusion: Advanced endoscopic imaging can improve mucosal visualization and endoscopic diagnosis; however it requires training and the use of validated classification systems.

Full Text

References

References
1 Tada M, Katoh S, Kohli Y et al. On the dye spraying method in colonofiberscopy. Endoscopy 1977; 8: 70-74
2 Togashi K, Konishi F, Ishizuka T et al. Efficacy of magnifying endoscopy in the differential diagnosis of neoplastic and non-neoplastic polyps of the large bowel. Dis Colon Rectum 1999; 42: 1602-1608
3 Subramanian V, Ragunath K. Advanced endoscopic imaging: a review of commercially available technologies. Clin Gastroenterol Hepatol 2014; 12: 368-376
4 Kaminski MF, Hassan C, Bisschops R et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2014; 46: 435-449
5 Atkins D, Best D, Briss PA et al. Grading quality of evidence and strength of recommendations. BMJ 2004; 328 (7454) 1490
6 Gono K, Obi T, Yamaguchi M et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 2004; 9: 568-577
7 Machida H, Sano Y, Hamamoto Y et al. Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study. Endoscopy 2004; 36: 1094-1098
8 Pohl J, May A, Rabenstein T et al. Computed virtual chromoendoscopy: a new tool for enhancing tissue surface structures. Endoscopy 2007; 39: 80-83
9 Parra-Blanco A, Jimenez A, Rembacken B et al. Validation of Fujinon intelligent chromoendoscopy with high definition endoscopes in colonoscopy. World J Gastroenterol 2009; 15: 5266-5273
10 Kodashima S, Fujishiro M. Novel image-enhanced endoscopy with i-scan technology. World J Gastroenterol 2010; 16: 1043-1049
11 Kara MA, Peters FP, ten Kate FJW et al. Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett’s esophagus. Gastrointest Endosc 2005; 61: 679-685
12 Kiesslich R, Burg J, Vieth M et al. Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo. Gastroenterology 2004; 127: 706-713
13 Goetz M, Watson A, Kiesslich R. Confocal laser endomicroscopy in gastrointestinal diseases. J Biophotonics 2011; 4: 498-508
14 Liu J, Dlugosz A, Neumann H. Beyond white light endoscopy: the role of optical biopsy in inflammatory bowel disease. World J Gastroenterol 2013; 19: 7544-7551
15 Neumann H, Kiesslich R, Wallace MB et al. Confocal laser endomicroscopy: technical advances and clinical applications. Gastroenterology 2010; 139: 388-92, 392
16 Kiesslich R, Canto MI. Confocal laser endomicroscopy. Gastrointest Endosc Clin N Am 2009; 19: 261-272
17 Wang TD, Friedland S, Sahbaie P et al. Functional imaging of colonic mucosa with a fibered confocal microscope for real-time in vivo pathology. Clin Gastroenterol Hepatol 2007; 5: 1300-1305
18 Neumann H, Kiesslich R. Endomicroscopy and endocytoscopy in IBD. Gastrointest Endosc Clin N Am 2013; 23: 695-705
19 Wallace MB, Meining A, Canto MI et al. The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. Aliment Pharmacol Ther 2010; 31: 548-552
20 Atreya R, Neumann H, Neufert C et al. In vivo imaging using fluorescent antibodies to tumor necrosis factor predicts therapeutic response in Crohn’s disease. Nat Med 2014; 20: 313-318
21 Kaneko K, Oono Y, Yano T et al. Effect of novel bright image enhanced endoscopy using blue laser imaging (BLI). Endosc Int Open 2014; 2: E212-E219
22 Yoshida N, Hisabe T, Inada Y et al. The ability of a novel blue laser imaging system for the diagnosis of invasion depth of colorectal neoplasms. J Gastroenterol 2014; 49: 73-80
23 Yoshida N, Yagi N, Inada Y et al. Ability of a novel blue laser imaging system for the diagnosis of colorectal polyps. Dig Endosc 2014; 26: 250-258
24 Inoue H, Kaga M, Ikeda H et al. Magnification endoscopy in esophageal squamous cell carcinoma: a review of the intrapapillary capillary loop classification. Ann Gastroenterol 2015; 28: 41-48
25 Sato H, Inoue H, Ikeda H et al. Utility of intrapapillary capillary loops seen on magnifying narrow-band imaging in estimating invasive depth of esophageal squamous cell carcinoma. Endoscopy 2015; 47: 122-128
26 Santi EG, Inoue H, Ikeda H et al. Microvascular caliber changes in intramucosal and submucosally invasive esophageal cancer. Endoscopy 2013; 45: 585-588
27 Sharma P, Bansal A, Mathur S et al. The utility of a novel narrow band imaging endoscopy system in patients with Barrett’s esophagus. Gastrointest Endosc 2006; 64: 167-175
28 Kara MA, Ennahachi M, Fockens P et al. Detection and classification of the mucosal and vascular patterns (mucosal morphology) in Barrett’s esophagus by using narrow band imaging. Gastrointest Endosc 2006; 64: 155-166
29 Singh R, Anagnostopoulos GK, Yao K et al. Narrow-band imaging with magnification in Barrett’s esophagus: validation of a simplified grading system of mucosal morphology patterns against histology. Endoscopy 2008; 40: 457-463
30 Silva FB, Dinis-Ribeiro M, Vieth M et al. Endoscopic assessment and grading of Barrett’s esophagus using magnification endoscopy and narrow-band imaging: accuracy and interobserver agreement of different classification systems (with videos). Gastrointest Endosc 2011; 73: 7-14
31 Sharma P, Bergman JJ, Goda K et al. Development and validation of a classification system to identify high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus using narrow-band imaging. Gastroenterology 2016; 150: 591-598
32 Uedo N, Ishihara R, Iishi H et al. A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy. Endoscopy 2006; 38: 819-824
33 Pimentel-Nunes P, Dinis-Ribeiro M, Soares JB et al. A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions. Endoscopy 2012; 44: 236-246
34 Hirata M, Tanaka S, Oka S et al. Evaluation of microvessels in colorectal tumours by narrow band imaging (NBI) magnification. Gastrointest Endosc 2007; 66: 945-952
35 Chiu HM, Chang CY, Chen CC et al. A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia. Gut 2006; 56: 373-379
36 Su MY, Hsu CM, Ho YP et al. Comparative study of conventional colonoscopy, chromoendoscopy, and narrow-band imaging systems in differential diagnosis of neoplastic and nonneoplastic colonic polyps. Am J Gastroenterol 2006; 101: 2711-2716
37 Tischendorf JJ, Wasmuth HE, Koch A et al. Value of magnifying chromoendoscopy and narrow band imaging (NBI) in classifying colorectal polyps: a prospective controlled study. Endoscopy 2007; 39: 1092-1096
38 Hayashi N, Tanaka S, Hewett DG et al. Endoscopic prediction of deep submucosal invasive carcinoma: validation of the narrow-band imaging international colorectal endoscopic (NICE) classification. Gastrointest Endosc 2013; 78: 625-632
39 Hewett DG, Kaltenbach T, Sano Y et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143: 599-607
40 Sano Y, Tanaka S, Kudo SE et al. NBI magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team (JNET). Dig Endosc 2016; 28: 526-533
41 East JE, Vieth M, Rex DK. Serrated lesions in colorectal cancer screening: detection, resection, pathology and surveillance. Gut 2015; 64: 991-1000
42 IJspeert JE, Bastiaansen BA, van Leerdam ME et al. Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps. Gut 2016; 65: 963-970
43 Bouwens MW, de Ridder R, Masclee AA et al. Optical diagnosis of colorectal polyps using high-definition i-scan: an educational experience. World J Gastroenterol 2013; 19: 4334-4343
44 Teixeira CR, Torresini RS, Canali C et al. Endoscopic classification of the capillary-vessel pattern of colorectal lesions by spectral estimation technology and magnifying zoom imaging. Gastrointest Endosc 2009; 69: 750-756
45 Dos Santos CE, Perez HJ, Monkemuller K et al. Observer agreement for diagnosis of colorectal lesions with analysis of the vascular pattern by image-enhanced endoscopy. Endosc Int Open 2015; 3: E240-E245
46 Repici A, Ciscato C, Correale L et al. Narrow-band imaging International Colorectal Endoscopic classification to predict polyp histology: REDEFINE (with videos). Gastrointest Endosc 2016; 84: 479-486.e3 Epub 2016 Feb 27
47 van den Broek FJ, van Soest EJ, Naber AH et al. Combining autofluorescence imaging and narrow-band imaging for the differentiation of adenomas from non-neoplastic colonic polyps among experienced and non-experienced endoscopists. Am J Gastroenterol 2009; 104: 1498-1507
48 Mannath J, Subramanian V, Telakis E et al. An inter-observer agreement study of autofluorescence endoscopy in Barrett’s esophagus among expert and non-expert endoscopists. Dig Dis Sci 2013; 58: 465-470
49 Kuiper T, Kiesslich R, Ponsioen C et al. The learning curve, accuracy, and interobserver agreement of endoscope-based confocal laser endomicroscopy for the differentiation of colorectal lesions. Gastrointest Endosc 2012; 75: 1211-1217
50 Wallace M, Lauwers GY, Chen Y et al. Miami classification for probe-based confocal laser endomicroscopy. Endoscopy 2011; 43: 882-891
51 Wallace MB, Sharma P, Lightdale C et al. Preliminary accuracy and interobserver agreement for the detection of intraepithelial neoplasia in Barrett’s esophagus with probe-based confocal laser endomicroscopy. Gastrointest Endosc 2010; 72: 19-24
52 De Palma GD, Staibano S, Siciliano S et al. In vivo characterisation of superficial colorectal neoplastic lesions with high-resolution probe-based confocal laser endomicroscopy in combination with video-mosaicing: a feasibility study to enhance routine endoscopy. Dig Liver Dis 2010; 42: 791-797
53 Xue H, Gong S, Shen Y et al. The learning effect of a training programme on the diagnosis of oesophageal lesions by narrow band imaging magnification among endoscopists of varying experience. Dig Liver Dis 2014; 46: 609-615
54 Baldaque-Silva F, Marques M, Lunet N et al. Endoscopic assessment and grading of Barrett’s esophagus using magnification endoscopy and narrow band imaging: impact of structured learning and experience on the accuracy of the Amsterdam classification system. Scand J Gastroenterol 2013; 48: 160-167
55 Dias-Silva D, Pimentel-Nunes P, Magalhaes J et al. The learning curve for narrow-band imaging in the diagnosis of precancerous gastric lesions by using Web-based video. Gastrointest Endosc 2014; 79: 910-920
56 Liu J, Li M, Li Z et al. Learning curve and interobserver agreement of confocal laser endomicroscopy for detecting precancerous or early-stage esophageal squamous cancer. PLoS One 2014; 9: e99089
57 Pittayanon R, Rerknimitr R, Wisedopas N et al. The learning curve of gastric intestinal metaplasia interpretation on the images obtained by probe-based confocal laser endomicroscopy. Diagn Ther Endosc 2012; 2012: 278045 Epub 2012 Dec 1
58 Raghavendra M, Hewett DG, Rex DK. Differentiating adenomas from hyperplastic colorectal polyps: narrow-band imaging can be learned in 20 minutes. Gastrointest Endosc 2010; 72: 572-576
59 Ignjatovic A, Thomas-Gibson S, East JE et al. Development and validation of a training module on the use of narrow-band imaging in differentiation of small adenomas from hyperplastic colorectal polyps. Gastrointest Endosc 2011; 73: 128-133
60 Dai J, Shen YF, Sano Y et al. Evaluation of narrow-band imaging in the diagnosis of colorectal lesions: is a learning curve involved?. Dig Endosc 2013; 25: 180-188
61 Higashi R, Uraoka T, Kato J et al. Diagnostic accuracy of narrow-band imaging and pit pattern analysis significantly improved for less-experienced endoscopists after an expanded training program. Gastrointest Endosc 2010; 72: 127-135
62 Rastogi A, Rao DS, Gupta N et al. Impact of a computer-based teaching module on characterization of diminutive colon polyps by using narrow-band imaging by non-experts in academic and community practice: a video-based study. Gastrointest Endosc 2014; 79: 390-398
63 Patel SG, Rastogi A, Austin G et al. Gastroenterology trainees can easily learn histologic characterization of diminutive colorectal polyps with narrow band imaging. Clin Gastroenterol Hepatol 2013; 11: 997-1003
64 Neumann H, Vieth M, Fry LC et al. Learning curve of virtual chromoendoscopy for the prediction of hyperplastic and adenomatous colorectal lesions: a prospective 2-center study. Gastrointest Endosc 2013; 78: 115-120
65 Buchner AM, Gomez V, Heckman MG et al. The learning curve of in vivo probe-based confocal laser endomicroscopy for prediction of colorectal neoplasia. Gastrointest Endosc 2011; 73: 556-560
66 Tischendorf JJ, Gross S, Winograd R et al. Computer-aided classification of colorectal polyps based on vascular patterns: a pilot study. Endoscopy 2010; 42: 203-207
67 Andre B, Vercauteren T, Buchner AM et al. Software for automated classification of probe-based confocal laser endomicroscopy videos of colorectal polyps. World J Gastroenterol 2012; 18: 5560-5569
68 Gross S, Trautwein C, Behrens A et al. Computer-based classification of small colorectal polyps by using narrow-band imaging with optical magnification. Gastrointest Endosc 2011; 74: 1354-1359
69 Hafner M, Liedlgruber M, Uhl A et al. Color treatment in endoscopic image classification using multi-scale local color vector patterns. Med Image Anal 2012; 16: 75-86
70 Takemura Y, Yoshida S, Tanaka S et al. Computer-aided system for predicting the histology of colorectal tumors by using narrow-band imaging magnifying colonoscopy (with video). Gastrointest Endosc 2012; 75: 179-185
71 Varnavas A, Ignjatovic A, Barath A et al. Classification of colon images using the magnitude of orientation dominance. Proceedings of the 5th UKRI PG Conference in Biomedical Engineering and Medical Physics 2009; 1: 13-14
72 Ganz M, Xiaoyun Y, Slabaugh G. Automatic segmentation of polyps in colonoscopic narrow-band imaging data. IEEE Trans Biomed Eng 2012; 59: 2144-2151
73 Al-Mammari S, Selvarajah U, East JE et al. Narrow band imaging facilitates detection of inlet patches in the cervical oesophagus. Dig Liver Dis 2014; 46: 716-719
74 Chai TH, Jin XF, Li SH et al. A tandem trial of HD-NBI versus HD-WL to compare neoplasia miss rates in esophageal squamous cell carcinoma. Hepatogastroenterology 2014; 61: 120-124
75 Li YX, Shen L, Yu HG et al. Fujinon intelligent color enhancement for the diagnosis of early esophageal squamous cell carcinoma and precancerous lesion. Turk J Gastroenterol 2014; 25: 365-369
76 Suzuki H, Saito Y, Ikehara H et al. Evaluation of visualization of squamous cell carcinoma of esophagus and pharynx using an autofluorescence imaging videoendoscope system. J Gastroenterol Hepatol 2009; 24: 1834-1839
77 Yoshida Y, Goda K, Tajiri H et al. Assessment of novel endoscopic techniques for visualizing superficial esophageal squamous cell carcinoma: autofluorescence and narrow-band imaging. Dis Esophagus 2009; 22: 439-446
78 Pech O, Rabenstein T, Manner H et al. Confocal laser endomicroscopy for in vivo diagnosis of early squamous cell carcinoma in the esophagus. Clin Gastroenterol Hepatol 2008; 6: 89-94
79 Prueksapanich P, Pittayanon R, Rerknimitr R et al. Value of probe-based confocal laser endomicroscopy (pCLE) and dual focus narrow-band imaging (dNBI) in diagnosing early squamous cell neoplasms in esophageal Lugol’s voiding lesions. Endosc Int Open 2015; 3: E281-E288
80 Hoffman A, Korczynski O, Tresch A et al. Acetic acid compared with i-scan imaging for detecting Barrett’s esophagus: a randomized, comparative trial. Gastrointest Endosc 2014; 79: 46-54
81 Pohl J, May A, Rabenstein T et al. Comparison of computed virtual chromoendoscopy and conventional chromoendoscopy with acetic acid for detection of neoplasia in Barrett’s esophagus. Endoscopy 2007; 39: 594-598
82 Boerwinkel DF, Holz JA, Kara MA et al. Effects of autofluorescence imaging on detection and treatment of early neoplasia in patients with Barrett’s esophagus. Clin Gastroenterol Hepatol 2014; 12: 774-781
83 Xiong YQ, Ma SJ, Zhou JH et al. A meta-analysis of confocal laser endomicroscopy for the detection of neoplasia in patients with Barrett’s esophagus. J Gastroenterol Hepatol 2015;
84 Sharma P, Wani S, Bansal A et al. A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease. Gastroenterology 2007; 133: 454-464
85 Lee YC, Lin JT, Chiu HM et al. Intraobserver and interobserver consistency for grading esophagitis with narrow-band imaging. Gastrointest Endosc 2007; 66: 230-236
86 Kang HS, Hong SN, Kim YS et al. The efficacy of i-SCAN for detecting reflux esophagitis: a prospective randomized controlled trial. Dis Esophagus 2013; 26: 204-211
87 Wang W, Uedo N, Yang Y et al. Autofluorescence imaging endoscopy for predicting acid reflux in patients with gastroesophageal reflux disease. J Gastroenterol Hepatol 2014; 29: 1442-1448
88 Peery AF, Cao H, Dominik R et al. Variable reliability of endoscopic findings with white-light and narrow-band imaging for patients with suspected eosinophilic esophagitis. Clin Gastroenterol Hepatol 2011; 9: 475-480
89 Neumann H, Vieth M, Atreya R et al. First description of eosinophilic esophagitis using confocal laser endomicroscopy (with video). Endoscopy 2011; 43 UCTN E66
90 Kikuste I, Marques-Pereira R, Monteiro-Soares M et al. Systematic review of the diagnosis of gastric premalignant conditions and neoplasia with high-resolution endoscopic technologies. Scand J Gastroenterol 2013; 48: 1108-1117
91 Kikuste I, Stirna D, Liepniece-Karele I et al. The accuracy of flexible spectral imaging colour enhancement for the diagnosis of gastric intestinal metaplasia: do we still need histology to select individuals at risk for adenocarcinoma?. Eur J Gastroenterol Hepatol 2014; 26: 704-709
92 So J, Rajnakova A, Chan YH et al. Endoscopic tri-modal imaging improves detection of gastric intestinal metaplasia among a high-risk patient population in Singapore. Dig Dis Sci 2013; 58: 3566-3575
93 Choi KS, Jung HY. Confocal laser endomicroscopy and molecular imaging in barrett esophagus and stomach. Clin Endosc 2014; 47: 23-30
94 Li Z, Zuo XL, Yu T et al. Confocal laser endomicroscopy for in vivo detection of gastric intestinal metaplasia: a randomized controlled trial. Endoscopy 2014; 46: 282-290
95 Li CQ, Li Y, Zuo XL et al. Magnified and enhanced computed virtual chromoendoscopy in gastric neoplasia: a feasibility study. World J Gastroenterol 2013; 19: 4221-4227
96 Jung SW, Lim KS, Lim JU et al. Flexible spectral imaging color enhancement (FICE) is useful to discriminate among non-neoplastic lesion, adenoma, and cancer of stomach. Dig Dis Sci 2011; 56: 2879-2886
97 Kato M, Kaise M, Yonezawa J et al. Trimodal imaging endoscopy may improve diagnostic accuracy of early gastric neoplasia: a feasibility study. Gastrointest Endosc 2009; 70: 899-906
98 Li WB, Zuo XL, Li CQ et al. Diagnostic value of confocal laser endomicroscopy for gastric superficial cancerous lesions. Gut 2011; 60: 299-306
99 Qi QQ, Zuo XL, Li CQ et al. High-definition magnifying endoscopy with i-scan in the diagnosis of Helicobacter pylori infection: a pilot study. J Dig Dis 2013; 14: 579-586
100 Kiesslich R, Goetz M, Burg J et al. Diagnosing Helicobacter pylori in vivo by confocal laser endoscopy. Gastroenterology 2005; 128: 2119-2123
101 Ji R, Li YQ, Gu XM et al. Confocal laser endomicroscopy for diagnosis of Helicobacter pylori infection: a prospective study. J Gastroenterol Hepatol 2010; 25: 700-705
102 Ianiro G, Gasbarrini A, Cammarota G. Endoscopic tools for the diagnosis and evaluation of celiac disease. World J Gastroenterol 2013; 19: 8562-8570
103 Leong RW, Nguyen NQ, Meredith CG et al. In vivo confocal endomicroscopy in the diagnosis and evaluation of celiac disease. Gastroenterology 2008; 135: 1870-1876
104 Cammarota G, Ianiro G, Sparano L et al. Image-enhanced endoscopy with I-scan technology for the evaluation of duodenal villous patterns. Dig Dis Sci 2013; 58: 1287-1292
105 Lopez-Ceron M, van den Broek FJ, Mathus-Vliegen EM et al. The role of high-resolution endoscopy and narrow-band imaging in the evaluation of upper GI neoplasia in familial adenomatous polyposis. Gastrointest Endosc 2013; 77: 542-550
106 Uchiyama Y, Imazu H, Kakutani H et al. New approach to diagnosing ampullary tumours by magnifying endoscopy combined with a narrow band imaging system. J Gastroenterol 2006; 41: 483-490
107 Bakhru MR, Sethi A, Jamidar PA et al. Interobserver agreement for confocal imaging of ampullary lesions: a multicenter single-blinded study. J Clin Gastroenterol 2013; 47: 440-442
108 Sato Y, Sagawa T, Hirakawa M et al. Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions. Endosc Int Open 2014; 2: E80-E87
109 Gupta T, Ibrahim M, Deviere J et al. Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding. World J Gastroenterol 2011; 17: 4590-4595
110 Wanders LK, East JE, Uitentuis SE et al. Diagnostic performance of narrowed spectrum endoscopy, autofluorescence imaging, and confocal laser endomicroscopy for optical diagnosis of colonic polyps: a meta-analysis. Lancet Oncol 2013; 14: 1337-1347
111 Abu Dayyeh BK, Thosani N, Konda V et al. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc 2015; 81: 502
112 Ket SN, Bird-Lieberman E, East JE. Electronic imaging to enhance lesion detection at colonoscopy. Gastrointest Endosc Clin N Am 2015; 25: 227-242
113 Laine L, Kaltenbach T, Barkun A et al. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. Gastroenterology 2015; 148: 639-651
114 Annese V, Daperno M, Rutter MD et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis 2013; 7: 982-1018
115 van den Broek FJC, Fockens P, van Eeden S et al. Endoscopic tri-modal imaging for surveillance in ulcerative colitis: Randomized comparison of high resolution endoscopy and autofluorescence imaging for neoplasia detection; and evaluation of narrow band imaging for classification of lesions. Gut 2008; 57: 1083-1089
116 Kiesslich R, Hoffman A, Goetz M et al. In vivo diagnosis of collagenous colitis by confocal endomicroscopy. Gut 2006; 55: 591-592
117 Zambelli A, Villanacci V, Buscarini E et al. Collagenous colitis: a case series with confocal laser microscopy and histology correlation. Endoscopy 2008; 40: 606-608
118 Neumann H, Grauer M, Vieth M et al. In vivo diagnosis of lymphocytic colitis by confocal laser endomicroscopy. Gut 2013; 62: 333-334
119 Danese S, Fiorino G, Angelucci E et al. Narrow-band imaging endoscopy to assess mucosal angiogenesis in inflammatory bowel disease: a pilot study. World J Gastroenterol 2010; 1619: 2396-2400
120 Iacucci M, Fort GM, Hassan C et al. Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings. Endoscopy 2015; 47: 726-734
121 Kiesslich R, Duckworth CA, Moussata D et al. Local barrier dysfunction identified by confocal laser endomicroscopy predicts relapse in inflammatory bowel disease. Gut 2012; 61: 1146-1153
122 Mace V, Ahluwalia A, Coron E et al. Confocal laser endomicroscopy: a new gold standard for the assessment of mucosal healing in ulcerative colitis. J Gastroenterol Hepatol 2015; 30: 85-92
123 Ladabaum U, Fioritto A, Mitani A et al. Real-time optical biopsy of colon polyps with narrow band imaging in community practice does not yet meet key thresholds for clinical decisions. Gastroenterology 2013; 144: 81-91
124 Paggi S, Rondonotti E, Amato A et al. Narrow-band imaging in the prediction of surveillance intervals after polypectomy in community practice. Endoscopy 2015; 47: 808-814
125 Soetikno R, Koay D, Kaltenbach T. Implementing endoscopic optical diagnosis into practice: a green light at the horizon. Endoscopy 2015; 47: 771-2
126 Travis SP, Schnell D, Krzeski P et al. Reliability and initial validation of the ulcerative colitis endoscopic index of severity. Gastroenterology 2013; 145: 987-995