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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
"narrow-band imaging"
symptom
esophageal adenocarcinoma
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