Advanced Endoscopic Imaging

It was in the late 18th century when the American essayist, poet, and philosopher Henry David Thoreau quoted " It's not what you look at that matters, it's what you see. " Indeed, more than 200 years later, this phrase is still valid and relevant, especially in the field of gastrointestinal (GI) endoscopy. Endoscopists in the whole world are working hard to improve diagnosis and therapy of our patients. Despite these efforts, we are still confronted with some limitations of GI endoscopy including the lack of detection of colon polyps (i.e., significant adenoma miss rates), delayed diagnosis, and difficult areas to access, like the pancreatobiliary tract or the small bowel. In the attempt to overcome these limitations, new endo-scopic techniques are constantly being introduced. New endoscopic imaging techniques now allow for a more detailed analysis of mucosal and submucosal structures and include virtual chromoendoscopy, magnification endoscopy, and endocytoscopy. Various studies have shown the usefulness of these imaging techniques for conditions such as Barrett's esophagus, colon polyps, and early neoplasias of the luminal GI tract. Moreover, the recently introduced confocal laser endomicroscopy (CLE) system allows us to analyze structures at the cellular and subcellular layer thereby obtaining an optical biopsy during ongoing endoscopy. Besides, CLE has the potential to visualize fluorescence labeled structures against specific epitopes, that is, in gastrointestinal cancer or inflammatory bowel disease, thus adding molecular imaging to the field of endoscopic research. Furthermore, with the development of balloon-assisted endoscopy and capsule endoscopy, the endoscopist is now able to visualize the entire small bowel. Lastly, visualization beyond the mucosa is also important. This is accomplished with endoscopic ultrasonography (EUS). EUS plays now a pivotal role for the management and therapy of various diseases. Through EUS, the " eye " of the endoscopist is extended beyond the lumen allowing for a detailed examination of most adjacent structures to the luminal GI tract. This special issue focuses on the exiting new developments of GI endoscopy. We are proud to present original articles and state-of-the-art reviews on the latest developments in the field of advanced endoscopic imaging. We are aware that it is impossible to cover the entire spectrum of advanced endoscopy in only one issue. The presented topics, however, highlight some of the most current aspects, controversies, and recommendations in selected areas of advanced GI imaging. B. E. Bluen and coworkers analyzed the impact of EUS-FNA on patient management. Files from …