Clin Endosc.  2013 Nov;46(6):620-626.

Optical Molecular Imaging for Diagnosing Intestinal Diseases

• Kim SY
• Myung SJ

Abstract

Real-time visualization of the molecular signature of cells can be achieved with advanced targeted imaging techniques using molecular probes and fluorescence endoscopy. This molecular optical imaging in gastrointestinal endoscopy is promising for improving the detection of neoplastic lesions, their characterization for patient stratification, and the assessment of their response to molecular targeted therapy and radiotherapy. In inflammatory bowel disease, this method can be used to detect dysplasia in the presence of background inflammation and to visualize inflammatory molecular targets for assessing disease severity and prognosis. Several preclinical and clinical trials have applied this method in endoscopy; however, this field has just started to evolve. Hence, many problems have yet to be solved to enable the clinical application of this novel method.

Keyword

Molecular imaging; Endoscopy; Fluorescence probe; Intestinal diseases

MeSH Terms

Endoscopy
Endoscopy, Gastrointestinal
Fluorescence
Humans
Inflammation
Inflammatory Bowel Diseases
Intestinal Diseases*
Molecular Imaging*
Molecular Probes
Molecular Targeted Therapy
Optical Imaging
Prognosis
Radiotherapy
Molecular Probes

Figure

• 

  Fig. 1 Images under wide-field endoscopy videos after topical administration of fluorescence-labeled peptides. The left and right columns represent frames from white light and fluorescence, respectively. (A) The fluorescent-labeled target peptide FITC-Ahx-QPIHPNNM shows positive binding to multiple adenomas and (B) a single adenoma. (C) The control peptide shows minimal binding. (D) The target peptide also shows minimal binding to the lumen of the control mouse lacking Cre recombinase transgene and (E) the hyperplastic epithelium in a mutant K-ras mouse model. White arrows identify adenomas. Adapted from Miller et al. PLoS One 2011;6:e17384.21

• 

  Fig. 2 γ-Glutamyl hydroxymethyl rhodamine green (gGlu-HMRG) fluorescence-guided tissue biopsy confirmed the presence of neoplastic lesions histologically. (A) gGlu-HMRG fluorescence-guided tissue biopsy under fluorescence colonoscopy. (B) Histology obtained by tissue biopsy. (C) Chronic microscopic colitis did not show detectable gGlu-HMRG fluorescence. Adapted from Mitsunaga et al. Gut 2013;62:1179-1186, with permission from BMJ Publishing Group Ltd.26 WL, white light image; BL, blue excitation light image; FL, fluorescence image.

• 

  Fig. 3 Histology and near-infrared fluorescence (NIRF) imaging using an matrix metalloproteinase (MMP)-activatable probe in the AOM/DSS model. (A, B) Representative images of colons from BALB/c mice treated with AOM/DSS after injecting an MMP-activatable probe (A) or normal saline (B). (C) Histology and NIRF findings in BALB/c mice treated with AOM/DSS. Adapted from Yoon et al. Gut Liver 2010;4:488-497.29 IHC, immunohistochemistry; NIR, near infrared.

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