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Hépato-Gastro & Oncologie Digestive

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Chromoscopy and novel endoscopic techniques Volume 20, issue 7, Septembre 2013

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Author
CHU Hôtel-Dieu, Institut des maladies de l’appareil digestif, 1 place Ricordeau, Nantes Cedex 44093, France ; Unité Inserm 913, 1 place Ricordeau, Nantes Cedex 44093, France

The vast majority of endoscopic examinations are currently performed using white-light endoscopy. Despite recent advances that greatly improved the image quality, in particular in terms of image resolution, this ‘conventional’ endoscopy is still facing two important unmet needs: 1) detecting flat areas of high grade dysplasia, for instance in Barrett's esophagus or in inflammatory bowel diseases is very difficult, 2) the lack of possibility to predict and characterize final histology with high-confidence level. This characterization is of pivotal importance in order to guide on-site and real-time treatment of lesions, and perhaps to replace standard histology in the future. Chromoscopy and other techniques, including confocal endomicroscopy can be used alone or in combination in order to improve detection, characterization and staging of neoplastic and preneoplastic lesions of the digestive tract. Among technologies over the last decade, narrow band imaging and confocal endomicroscopy are the most attractive ones, and are already available in most expert centers. The efficacy as well as the impact of these technologies in routine practice needs to be determined, even though the learning curve seems to be surprisingly short. This article aims at summarizing among most widely available methods the ones that are useful as well as their main results in clinical applications.