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Clinical Molecular Imaging in the Gastrointestinal Tract

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Abstract

Introduction – Greater sensitivity and specificity for the clinical detection of disease in the gastrointestinal tract, including esophagus, stomach, small bowel, and colon, may be achieved with use of exogenous probes that target molecular markers of neoplasia. These probes can be labeled with fluorescent dyes and detected endoscopically during routine screening, and guide tissue biopsy for early detection of cancer, assessment of sub-mucosal invasion, and monitoring response to therapy. There has been a great deal of research that demonstrates the use of molecular probes to target neoplasia. For example, monoclonal antibodies have been investigated for tumor detection and drug delivery because of their high specificity;1 however, their use in vivo has been limited by immunogenicity and challenges associated with reagent development and production in quantity. Recently, a number of near infrared fluorescent imaging probes have been developed to detect neoplasia with fluorescence endoscopy. The molecular targets for detection have included proteolytic enzymes, matrix metalloproteinases, endothelial-specific markers, and apoptosis reporters.2-5 Thus, methods of targeted detection are promising, and further development is needed to improve the detection rate for flat dysplasia that cannot be appreciated on standard white light endoscopy as well as for polypoid adenomas.

© 2008 Optical Society of America

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