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Endoscopy 2000; 32(12): 977-985
DOI: 10.1055/s-2000-9628
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© Georg Thieme Verlag Stuttgart · New York

Fluorescence Diagnosis in GI Endoscopy

M. Sackmann
  • Department of Medicine II, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany
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Publication Date:
31 December 2000 (online)

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Introduction

Undoubtedly, diagnostic gastrointestinal endoscopy faces a challenge from new methods, e. g. magnetic resonance imaging and computerized tomographic techniques. Because of the discomfort associated with endoscopy, noninvasive alternatives for diagnostic procedures are welcome. Colonoscopy is still superior to double-contrast barium enema in detecting colonic polyps [1]. However, computerization has already resulted in fascinating reports on virtual colonoscopy [2] [3] . The sensitivity and specificity of magnetic resonance cholangiopancreatography now approach those of endoscopic retrograde cholangiopancreatography [4]. Hence, conventional diagnostic gastrointestinal endoscopy is challenged by stimulating alternatives. Only if the detection of early carcinoma, dysplasia, or of other precancerous lesions can be improved will diagnostic gastrointestinal endoscopy survive this confrontation.

Several new technologies have recently been introduced to improve the capability of conventional endoscopy for subtle diagnostics. Chromoendoscopy, optical coherence tomography, Raman spectroscopy, elastic scattering spectroscopy, and fluorescence endoscopy have all been studied recently. Among these new techniques, diagnostic fluorescence endoscopy is the method which has been investigated most intensively, and is reviewed here. Since photodynamic therapy has been summarized recently in Endoscopy [5] , this technique will not be covered here.

Fluorescence detection is an exciting new tool which has only recently gained much interest from gastroenterologists (Figure [1]). Interestingly, reports on photodynamic therapy preceded papers on diagnostic approaches using fluorescence [6]. Hence, the search for improved therapeutic procedures may have resulted in the development of a new diagnostic method. Colonic tissue [7] [8] [9] [10] [11] [12] [13] was examined earlier than the upper gastrointestinal tract [13] [14] [15] [16] [17] [18] [19] [20] . The bile ducts were examined by fluorescence endoscopy only recently [21], while photodynamic treatment of bile-duct cancer had been described earlier [22] [23] .

Figure 1Results of literature search for papers on diagnostic fluorescence endoscopy in gastroenterology