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Applications and Advancements in the Use of High-resolution Microendoscopy for Detection of Gastrointestinal Neoplasia.
[esophageal adenocarcinoma]
The
high
-resolution
microendoscope
(
HRME
)
is
a
novel
imaging
modality
that
allows
real-time
epithelial
imaging
at
subcellular
resolution
.
Used
in
concert
with
any
standard
endoscope
,
this
portable
,
low
cost
,
"
optical
biopsy
"
technology
has
the
ability
to
provide
images
of
cellular
morphology
during
a
procedure
.
This
technology
has
been
the
subject
of
a
number
of
studies
investigating
its
use
in
screening
and
surveillance
of
a
range
of
gastrointestinal
neoplasias
,
including
esophageal
adenocarcinoma
,
esophageal
squamous
cell
cancer
,
colorectal
neoplasia
,
and
anal
neoplasia
.
These
studies
have
shown
that
HRME
is
a
modality
that
consistently
provides
high
specificity
,
negative
predictive
value
,
and
accuracy
across
different
diseases
.
In
addition
,
they
have
illustrated
that
HRME
users
can
be
relatively
easily
trained
in
a
short
period
of
time
,
and
that
users
have
demonstrated
solid
inter-rater
reliability
.
These
features
make
HRME
a
potential
complement
to
high
-definition
white
-light
imaging
,
narrow
-band
imaging
,
and
other
red
flag
technologies
in
facilitating
real-time
clinical
diagnosis
,
endoscopic
therapy
,
and
margin
determination
.
Further
clinical
validation
is
needed
to
determine
whether
this
translates
to
reduced
procedure
times
,
pathology
costs
,
and
follow-up
procedures
.
Finally
,
the
HRME
has
a
relatively
simple
design
compared
with
other
similar
technologies
,
making
it
portable
,
simple
to
maintain
,
and
low
cost
.
This
may
allow
the
HRME
device
to
function
in
both
advanced
care
settings
as
well
as
in
places
with
less
resources
and
specialized
support
systems
.
As
a
whole
,
the
HRME
device
has
shown
good
performance
along
with
low
cost
and
portable
construction
,
and
its
application
in
different
conditions
and
settings
has
been
promising
.
Diseases
Validation
Diseases presenting
"neoplasia"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
carcinoma of the gallbladder
cholangiocarcinoma
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
hodgkin lymphoma, classical
liposarcoma
lymphangioleiomyomatosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
pleomorphic liposarcoma
primary effusion lymphoma
pyomyositis
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
This symptom has already been validated