Download PDF
Endoscopy 2000; 32(12): 977-985
DOI: 10.1055/s-2000-9628
Review
© Georg Thieme Verlag Stuttgart · New York

Fluorescence Diagnosis in GI Endoscopy

M. Sackmann
  • Department of Medicine II, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
    Permissions and Reprints

Introduction

Undoubtedly, diagnostic gastrointestinal endoscopy faces a challenge from new methods, e. g. magnetic resonance imaging and computerized tomographic techniques. Because of the discomfort associated with endoscopy, noninvasive alternatives for diagnostic procedures are welcome. Colonoscopy is still superior to double-contrast barium enema in detecting colonic polyps [1]. However, computerization has already resulted in fascinating reports on virtual colonoscopy [2] [3] . The sensitivity and specificity of magnetic resonance cholangiopancreatography now approach those of endoscopic retrograde cholangiopancreatography [4]. Hence, conventional diagnostic gastrointestinal endoscopy is challenged by stimulating alternatives. Only if the detection of early carcinoma, dysplasia, or of other precancerous lesions can be improved will diagnostic gastrointestinal endoscopy survive this confrontation.

Several new technologies have recently been introduced to improve the capability of conventional endoscopy for subtle diagnostics. Chromoendoscopy, optical coherence tomography, Raman spectroscopy, elastic scattering spectroscopy, and fluorescence endoscopy have all been studied recently. Among these new techniques, diagnostic fluorescence endoscopy is the method which has been investigated most intensively, and is reviewed here. Since photodynamic therapy has been summarized recently in Endoscopy [5] , this technique will not be covered here.

Fluorescence detection is an exciting new tool which has only recently gained much interest from gastroenterologists (Figure [1]). Interestingly, reports on photodynamic therapy preceded papers on diagnostic approaches using fluorescence [6]. Hence, the search for improved therapeutic procedures may have resulted in the development of a new diagnostic method. Colonic tissue [7] [8] [9] [10] [11] [12] [13] was examined earlier than the upper gastrointestinal tract [13] [14] [15] [16] [17] [18] [19] [20] . The bile ducts were examined by fluorescence endoscopy only recently [21], while photodynamic treatment of bile-duct cancer had been described earlier [22] [23] .

Figure 1Results of literature search for papers on diagnostic fluorescence endoscopy in gastroenterology

References

  • 1 Winawer S J, Stewart E T, Zauber A G, et al. A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy. National Polyp Study Work Group.  N Engl J Med. 2000;  342 1766-1772
    CrossrefPubMedGoogle Scholar
  • 2 Johnson C D, Hara A K, Reed J E. Computed tomographic colonography (virtual colonoscopy): a new method for detecting colorectal neoplasms.  Endoscopy. 1997;  29 454-461
    PubMedGoogle Scholar
  • 3 Fenlon H M, Nunes D P, Schroy P C, et al. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps.  N Engl J Med. 1999;  341 1496-1503
    CrossrefPubMedGoogle Scholar
  • 4 Sackmann M, Beuers U, Helmberger T. Biliary imaging: magnetic resonance cholangiography versus endoscopic retrograde cholangiography.  J Hepatol. 1999;  30 334-338
    CrossrefPubMedGoogle Scholar
  • 5 Ell C. Clinical photodynamic therapy: where is it heading?.  Endoscopy. 1998;  30 408-411
    PubMedGoogle Scholar
  • 6 Wagnieres G A, Star W M, Wilson B C. In vivo fluorescence spectroscopy and imaging for oncological applications.  Photochem Photobiol. 1998;  68 603-632
    CrossrefPubMedGoogle Scholar
  • 7 Berk J E. Fluorescence techniques in the diagnosis of malignant lesions of the gastrointestinal tract.  Gastrointest Endosc. 1967;  14 102-105
    PubMedGoogle Scholar
  • 8 Barr H, Tralau C J, Boulos P B, et al. The contrasting mechanisms of colonic collagen damage between photodynamic therapy and thermal injury.  Photochem Photobiol. 1987;  46 795-800
    PubMedGoogle Scholar
  • 9 Cothren R M, Richards-Kortum R, Sivak M V, et al. Gastrointestinal tissue diagnosis by laser-induced fluorescence spectroscopy at endoscopy.  Gastrointest Endosc. 1990;  36 105-111
    PubMedGoogle Scholar
  • 10 Kapadia C R, Cutruzzola F W, O'Brien K M, et al. Laser-induced fluorescence spectroscopy of human colonic mucosa. Detection of adenomatous transformation.  Gastroenterology. 1990;  99 150-157
    PubMedGoogle Scholar
  • 11 Bjorkman D J, Samowitz W S, Brigham E J, et al. Fluorescence localization of early colonic cancer in the rat by hematoporphyrin derivative.  Lasers Surg Med. 1991;  11 263-270
    PubMedGoogle Scholar
  • 12 Richards-Kortum R, Rava R P, Petras R E, et al. Spectroscopic diagnosis of colonic dysplasia.  Photochem Photobiol. 1991;  53 777-786
    CrossrefPubMedGoogle Scholar
  • 13 Regula J, MacRobert A J, Gorchein A, et al. Photosensitisation and photodynamic therapy of oesophageal, duodenal, and colorectal tumours using 5 aminolaevulinic acid induced protoporphyrin IX - a pilot study.  Gut. 1995;  36 67-75
    PubMedGoogle Scholar
  • 14 Sibille A, Lambert R, Souquet J C, et al. Long-term survival after photodynamic therapy for esophageal cancer.  Gastroenterology. 1995;  108 337-344
    PubMedGoogle Scholar
  • 15 Vo-Dinh T, Panjehpour M, Overholt B F, et al. In vivo cancer diagnosis of the esophagus using differential normalized fluorescence (DNF) indices.  Lasers Surg Med. 1995;  16 41-47
    PubMedGoogle Scholar
  • 16 Panjehpour M, Overholt B F, Schmidhammer J L, et al. Spectroscopic diagnosis of esophageal cancer: new classification model, improved measurement system.  Gastrointest Endosc. 1995;  41 577-581
    PubMedGoogle Scholar
  • 17 Overholt B F, Panjehpour M. Barrett's esophagus: photodynamic therapy for ablation of dysplasia, reduction of specialized mucosa, and treatment of superficial esophageal cancer.  Gastrointest Endosc. 1995;  42 64-70
    PubMedGoogle Scholar
  • 18 Overholt B F, Panjehpour M. Photodynamic therapy in Barrett's esophagus: reduction of specialized mucosa, ablation of dysplasia, and treatment of superficial esophageal cancer.  Semin Surg Oncol. 1995;  11 372-376
    PubMedGoogle Scholar
  • 19 Lightdale C J, Heier S K, Marcon N E, et al. Photodynamic therapy with porfimer sodium versus thermal ablation therapy with Nd:YAG laser for palliation of esophageal cancer: a multicenter randomized trial.  Gastrointest Endosc. 1995;  42 507-512
    CrossrefPubMedGoogle Scholar
  • 20 Laukka M A, Wang K K. Initial results using low-dose photodynamic therapy in the treatment of Barrett's esophagus.  Gastrointest Endosc. 1995;  42 59-63
    CrossrefPubMedGoogle Scholar
  • 21 Izuishi K, Tajiri H, Ryu M et al. Detection of bile duct cancer by autofluorescence cholangioscopy: a pilot study.  Hepatogastroenterology. 1999;  46 804-807
    PubMedGoogle Scholar
  • 22 McCaughan J S, Mertens B F, Cho C, et al. Photodynamic therapy to treat tumors of the extrahepatic biliary ducts. A case report.  Arch Surg. 1991;  126 111-113
    CrossrefPubMedGoogle Scholar
  • 23 Ortner M A, Liebetruth J, Schreiber S, et al. Photodynamic therapy of nonresectable cholangiocarcinoma.  Gastroenterology. 1998;  114 536-542
    Google Scholar
  • 24 Betz V, Schneckenburger H, Alleroeder H P, et al. Evaluation of changes in the NADH level between carcinogenic and normal tissue samples by use of fluorescence spectroscopy.  SPIE. 1994;  2324 284-291
    PubMedGoogle Scholar
  • 25 Stepp H, Sroka R, Baumgartner R. Fluorescence endoscopy of gastrointestinal diseases: basic principles, techniques, and clinical experience.  Endoscopy. 1998;  30 379-386
    PubMedGoogle Scholar
  • 26 DaCosta. R S, Wilson B C, Marcon N E. Light-induced fluorescence endoscopy of the gastrointestinal tract.  Gastrointest Endosc Clin N Am. 2000;  10 37-69
    PubMedGoogle Scholar
  • 27 Lipson R L, Baldes E J, Gray M J. Hematoporphyrin derivative: a new aid for endoscopic detection of malignant disease.  J Thorac Cardiovasc Surg. 1961;  42 623-629
    PubMedGoogle Scholar
  • 28 Lipson R L, Baldes E J, Olsen A M. Hematoporphyrin derivative for detection and management of cancer.  Cancer. 1967;  2 2255-2257
    PubMedGoogle Scholar
  • 29 Alfano R R, Tang G C, Pradhan A, et al. Fluorescence spectra from cancerous and normal human breast and lung tissues.  IEEE J Quantum Electronics. 1987;  23 1806-1811
    CrossrefPubMedGoogle Scholar
  • 30 Alfano R R, Tata D B, Cordero J J, et al. Laser induced fluorescence spectroscopy from native cancerous and normal tissue.  IEEE J Quantum Electron. 1984;  20 1507-1511
    CrossrefPubMedGoogle Scholar
  • 31 Marchesini R, Brambilla M, Pignoli E, et al. Light-induced fluorescence spectroscopy of adenomas, adenocarcinomas and non-neoplastic mucosa in human colon. I. In vitro measurements.  J Photochem Photobiol B. 1992;  14 219-230
    CrossrefPubMedGoogle Scholar
  • 32 Yang Y L, Ye Y M, Li F M, et al. Characteristic autofluorescence for cancer diagnosis and its origin.  Lasers Surg Med. 1987;  7 528-532
    CrossrefPubMedGoogle Scholar
  • 33 Yuanlong Y, Yanming Y, Fuming L, et al. Characteristic autofluorescence for cancer diagnosis and its origin.  Lasers Surg Med. 1987;  7 528-532
    CrossrefPubMedGoogle Scholar
  • 34 Schomacker K T, Frisoli J K, Compton C C, et al. Ultraviolet laser-induced fluorescence of colonic tissue: basic biology and diagnostic potential.  Lasers Surg Med. 1992;  12 63-78
    PubMedGoogle Scholar
  • 35 Bottiroli G, Croce A C, Locatelli D, et al. Natural fluorescence of normal and neoplastic human colon: a comprehensive “ex vivo” study.  Lasers Surg Med. 1995;  16 48-60
    PubMedGoogle Scholar
  • 36 Wang T D, Van Dam J, Crawford J M, et al. Fluorescence endoscopic imaging of human colonic adenomas.  Gastroenterology. 1996;  111 1182-1191
    PubMedGoogle Scholar
  • 37 Sroka R, Baumgartner R, Buser A, et al. Laser assisted detection of endogenous porphyrins in malignant diseases.  SPIE. 1992;  1641 99-106
    PubMedGoogle Scholar
  • 38 Pradhan A, Pal P, Durocher G, et al. Steady state and time-resolved fluorescence properties of metastatic and non-metastatic malignant cells from different species.  J Photochem Photobiol B. 1995;  31 101-112
    CrossrefPubMedGoogle Scholar
  • 39 Römer T J, Fitzmaurice M, Cothren R M, et al. Laser-induced fluorescence microscopy of normal colon and dysplasia in colonic adenomas: implications for spectroscopic diagnosis.  Am J Gastroenterol. 1995;  90 81-87
    PubMedGoogle Scholar
  • 40 Izuishi K, Tajiri H, Fujii T, et al. The histological basis of detection of adenoma and cancer in the colon by autofluorescence endoscopic imaging.  Endoscopy. 1999;  31 511-516
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Zonios G I, Cothren R M, Arendt J T, et al. Morphological model of human colon tissue fluorescence.  IEEE Trans Biomed Eng. 1996;  43 113-122
    CrossrefPubMedGoogle Scholar
  • 42 Stepp H, Baumgartner R, Beyer W, et al. Fluorescence imaging and spectroscopy of ALA-induced protoporphyrin IX preferentially accumulated in tumour tissue.  SPIE. 1995;  2627 13-25
    PubMedGoogle Scholar
  • 43 DaCosta R S, Lilge L, Kost J, et al. Confocal fluorescence microscopy, microspectrofluorimetry and modeling studies of laser induced fluorescence endoscopy (LIFE) of human colon tissue.  SPIE. 1997;  2975 98-107
    PubMedGoogle Scholar
  • 44 Marchesini R, Pignoli E, Tomatis S, et al. Ex vivo optical properties of human colon tissue.  Lasers Surg Med. 1994;  15 351-357
    PubMedGoogle Scholar
  • 45 Andersson-Engels S, Klinteberg C, Svanberg K, Svanberg S. In vivo fluorescence imaging for tissue diagnostics.  Phys Med Biol. 1997;  42 815-824
    CrossrefPubMedGoogle Scholar
  • 46 Messmann H. 5-Aminolevulinic acid-induced protoporphyrin IX for the detection of gastrointestinal dysplasia.  Gastrointest Endosc Clin N Am. 2000;  10 497-512
    PubMedGoogle Scholar
  • 47 Messmann H. Fluorescence endoscopy in gastroenterology.  Z Gastroenterol. 2000;  38 21-30
    PubMedGoogle Scholar
  • 48 Malik Z, Lugaci H. Destruction of erythroleukaemic cells by photoactivation of endogenous porphyrins.  Br J Cancer. 1987;  56 589-595
    PubMedGoogle Scholar
  • 49 Batlle A M. Porphyrins, porphyrias, cancer and photodynamic therapy - a model for carcinogenesis.  J Photochem Photobiol B. 1993;  20 5-22
    CrossrefPubMedGoogle Scholar
  • 50 Peng Q, Warloe T, Berg K, et al. 5-Aminolevulinic acid-based photodynamic therapy. Clinical research and future challenges.  Cancer. 1997;  79 2282-2308
    CrossrefPubMedGoogle Scholar
  • 51 Peng Q, Berg K, Moan J, et al. 5-Aminolevulinic acid-based photodynamic therapy: principles and experimental research.  Photochem Photobiol. 1997;  65 235-251
    CrossrefPubMedGoogle Scholar
  • 52 Orenstein A, Kostenich G, Roitman L, et al. A comparative study of tissue distribution and photodynamic therapy selectivity of chlorin e6, Photofrin II and ALA-induced protoporphyrin IX in a colon carcinoma model.  Br J Cancer. 1996;  73 937-944
    PubMedGoogle Scholar
  • 53 Bohorfoush A G. Tissue spectroscopy for gastrointestinal diseases.  Endoscopy. 1996;  28 372-380
    PubMedGoogle Scholar
  • 54 Rick K, Sroka R, Stepp H, et al. Pharmacokinetics of 5-aminolevulinic acid-induced protoporphyrin IX in skin and blood.  J Photochem Photobiol B. 1997;  40 313-319
    CrossrefPubMedGoogle Scholar
  • 55 Mlkvy P, Messmann H, Regula J, et al. Sensitization and photodynamic therapy (PDT) of gastrointestinal tumors with 5-aminolaevulinic acid (ALA) induced protoporphyrin IX (PPIX). A pilot study.  Neoplasma. 1995;  42 109-113
    PubMedGoogle Scholar
  • 56 Loh C S, MacRobert A J, Bedwell J, et al. Oral versus intravenous administration of 5-aminolaevulinic acid for photodynamic therapy.  Br J Cancer. 1993;  68 41-51
    PubMedGoogle Scholar
  • 57 Loh C S, Vernon D, MacRobert A J, et al. Endogenous porphyrin distribution induced by 5-aminolaevulinic acid in the tissue layers of the gastrointestinal tract.  J Photochem Photobiol B. 1993;  20 47-54
    CrossrefPubMedGoogle Scholar
  • 58 Webber J, Kessel D, Fromm D. Plasma levels of protoporphyrin IX in humans after oral administration of 5-aminolevulinic acid.  J Photochem Photobiol B. 1997;  37 151-153
    CrossrefPubMedGoogle Scholar
  • 59 Gossner L, Stolte M, Sroka R, et al. Photodynamic ablation of high-grade dysplasia and early cancer in Barrett's esophagus by means of 5-aminolevulinic acid.  Gastroenterology. 1998;  114 448-455
    PubMedGoogle Scholar
  • 60 Vonarx V, Eleouet S, Carre J, et al. Potential efficacy of a delta 5-aminolevulinic acid bioadhesive gel formulation for the photodynamic treatment of lesions of the gastrointestinal tract in mice.  J Pharm Pharmacol. 1997;  49 652-656
    PubMedGoogle Scholar
  • 61 Webber J, Kessel D, Fromm D. Side effects and photosensitization of human tissues after aminolevulinic acid.  J Surg Res. 1997;  68 31-37
    CrossrefPubMedGoogle Scholar
  • 62 Gossner L, May A, Sroka R, et al. Photodynamic destruction of high grade dysplasia and early carcinoma of the esophagus after the oral administration of 5-aminolevulinic acid.  Cancer. 1999;  86 1921-1928
    CrossrefPubMedGoogle Scholar
  • 63 Messmann H, Knuchel R, Baumler W, et al. Endoscopic fluorescence detection of dysplasia in patients with Barrett's esophagus, ulcerative colitis, or adenomatous polyps after 5-aminolevulinic acid-induced protoporphyrin IX sensitization.  Gastrointest Endosc. 1999;  49 97-101
    PubMedGoogle Scholar
  • 64 Alian W, Andersson-Engels S, Svanberg K, Svanberg S. Laser-induced fluorescence studies of meso-tetra(hydroxyphenyl)chlorin in malignant and normal tissues in rats.  Br J Cancer. 1994;  70 880-885
    PubMedGoogle Scholar
  • 65 Mlkvy P, Messmann H, Debinski H, et al. Photodynamic therapy for polyps in familial adenomatous polyposis - a pilot study.  Eur J Cancer. 1995;  31 1160-1165
    CrossrefPubMedGoogle Scholar
  • 66 Wooten R S, Smith K C, Ahlquist D A, et al. Prospective study of cutaneous phototoxicity after systemic hematoporphyrin derivative.  Lasers Surg Med. 1988;  8 294-300
    PubMedGoogle Scholar
  • 67 Overholt B F, Panjehpour M, Haydek J M. Photodynamic therapy for Barrett's esophagus: follow-up in 100 patients.  Gastrointest Endosc. 1999;  49 1-7
    CrossrefPubMedGoogle Scholar
  • 68 Dougherty T J, Cooper M T, Mang T S. Cutaneous phototoxic occurrences in patients receiving Photofrin.  Lasers Surg Med. 1990;  10 485-488
    PubMedGoogle Scholar
  • 69 von Holstein C S, Nilsson A M, Andersson-Engels S, et al. Detection of adenocarcinoma in Barrett's oesophagus by means of laser induced fluorescence.  Gut. 1996;  39 711-716
    PubMedGoogle Scholar
  • 70 Gaullier J M, Berg K, Peng Q, et al. Use of 5-aminolevulinic acid esters to improve photodynamic therapy on cells in culture.  Cancer Res. 1997;  57 1481-1486
    PubMedGoogle Scholar
  • 71 Bornhop D J, Hubbard D S, Houlne M P, et al. Fluorescent tissue site-selective lanthanide chelate, Tb-PCTMB for enhanced imaging of cancer.  Anal Chem. 1999;  71 2607-2615
    CrossrefPubMedGoogle Scholar
  • 72 Wittman I. On the diagnostic value of the fluorescence phenomenon in endoscopy.  Dtsch Z Verdau Stoffwechselkr. 1968;  28 75
    PubMedGoogle Scholar
  • 73 Sanderson D R, Fontana R S, Lipson R L, Baldes E J. Hematoporphyrin as a diagnostic tool. A preliminary report of new techniques.  Cancer. 1972;  30 1368-1372
    PubMedGoogle Scholar
  • 74 Profio A E, Doiron D R, King E G. Laser fluorescence bronchoscope for localization of occult lung tumors.  Med Phys. 1979;  6 523-525
    PubMedGoogle Scholar
  • 75 Bown S G. Phototherapy in tumors.  World J Surg. 1983;  7 700-709
    CrossrefPubMedGoogle Scholar
  • 76 Kato H, Aizawa K, Ono J, et al. Clinical measurement of tumor fluorescence using a new diagnostic system with hematoporphyrin derivative, laser photoradiation, and a spectroscope.  Lasers Surg Med. 1984;  4 49-58
    PubMedGoogle Scholar
  • 77 Andersson P S, Montan S, Persson T, et al. Fluorescence endoscopy instrumentation for improved tissue characterization.  Med Phys. 1987;  14 633-636
    CrossrefPubMedGoogle Scholar
  • 78 Baumgartner R, Fisslinger H, Jocham D, et al. A fluorescence imaging device for endoscopic detection of early stage cancer - instrumental and experimental studies.  Photochem Photobiol. 1987;  46 759-763
    PubMedGoogle Scholar
  • 79 Nishioka N S. Laser-induced fluorescence spectroscopy.  Gastrointest Endosc Clin N Am. 1994;  4 313-326
    PubMedGoogle Scholar
  • 80 Fulljames C, Stone N, Bennett D, Barr H. Beyond white light endoscopy - the prospect for endoscopic optical biopsy.  Ital J Gastroenterol Hepatol. 1999;  31 695-704
    PubMedGoogle Scholar
  • 81 Marcon N E. Is light-induced fluorescence better than the endoscopist's eye?.  Can J Gastroenterol. 1999;  13 417-421
    PubMedGoogle Scholar
  • 82 Webber J, Kessel D, Fromm D. On-line fluorescence of human tissues after oral administration of 5-aminolevulinic acid.  J Photochem Photobiol B. 1997;  38 209-214
    CrossrefPubMedGoogle Scholar
  • 83 Cothren R M, Sivak M V, Van Dam J, et al. Detection of dysplasia at colonoscopy using laser-induced fluorescence: a blinded study.  Gastrointest Endosc. 1996;  44 168-176
    PubMedGoogle Scholar
  • 84 Vo-Dinh T, Panjehpour M, Overholt B F. Laser-induced fluorescence for esophageal cancer and dysplasia diagnosis.  Ann N Y Acad Sci. 1998;  838 116-122
    CrossrefPubMedGoogle Scholar
  • 85 Panjehpour M, Overholt B F, Vo-Dinh T, et al. Endoscopic fluorescence detection of high-grade dysplasia in Barrett's esophagus.  Gastroenterology. 1996;  111 93-101
    CrossrefPubMedGoogle Scholar
  • 86 Wang T D, Crawford J M, Feld M S, et al. In vivo identification of colonic dysplasia using fluorescence endoscopic imaging.  Gastrointest Endosc. 1999;  49 447-455
    PubMedGoogle Scholar
  • 87 Haringsma J, Tytgat G N. The value of fluorescence techniques in gastrointestinal endoscopy: better than the endoscopist's eye. I: The European experience.  Endoscopy. 1998;  30 416-418
    PubMedGoogle Scholar
  • 88 Panjehpour M, Overholt B F, Haydek J M. Light sources and delivery devices for photodynamic therapy in the gastrointestinal tract.  Gastrointest Endosc Clin N Am. 2000;  10 513-532
    PubMedGoogle Scholar
  • 89 van den Bergh H. On the evolution of some endoscopic light delivery systems for photodynamic therapy.  Endoscopy. 1998;  30 392-407
    PubMedGoogle Scholar
  • 90 Abe S, Izuishi K, Tajiri H, et al. Correlation of in vitro autofluorescence endoscopy images with histopathologic findings in stomach cancer.  Endoscopy. 2000;  32 281-286
    Article in Thieme ConnectPubMedGoogle Scholar
  • 91 Sheyhedin I, Okunaka T, Kato H, et al. Localization of experimental submucosal esophageal tumor in rabbits by using mono-L-aspartyl chlorin e6 and long-wavelength photodynamic excitation.  Lasers Surg Med. 2000;  26 83-89
    CrossrefPubMedGoogle Scholar
  • 92 Messmann H, Endlicher E, Knuechel R, Schoelmerich J. Endoscopic fluorescence detection of high and low grade dysplasia in Barrett's esophagus after sensitization with 5-aminolevulinic acid [abstract].  Gastroenterology. 1999;  116 A252
    PubMedGoogle Scholar
  • 93 Brand S, Wang T D, Schomacker K T, et al. Diagnosis of high-grade dysplasia in Barrett's esophagus using 5-aminolevulinic acid [abstract].  Gastroenterology. 1999;  116 A381
    PubMedGoogle Scholar
  • 94 Haringsma J, Prawirodirdjo W, Tytgat G NJ. Accuracy of fluorescence imaging of dysplasia in Barrett's esophagus [abstract].  Gastroenterology. 1999;  116 A418
    PubMedGoogle Scholar
  • 95 Yano H, Iishi H, Tatsuta M. Diagnosis of early gastric cancers by an endoscopic autofluorescence imaging system [abstract].  Gastrointest Endosc. 2000;  51 AB65
    PubMedGoogle Scholar
  • 96 Tajiri H, Kobayashi M. Detection of early gastric cancer by a realtime autofluorescence imaging system [abstract].  Gastrointest Endosc. 2000;  51 AB92
    PubMedGoogle Scholar
  • 97 Mayinger B, Reh H, Hochberger J, Hahn E G. Endoscopic photodynamic diagnosis: oral aminolevulinic acid is a marker of GI cancer and dysplastic lesions.  Gastrointest Endosc. 1999;  5 242-246
    PubMedGoogle Scholar
  • 98 Eker C, Montan S, Jaramillo E, et al. Clinical spectral characterisation of colonic mucosal lesions using autofluorescence and delta aminolevulinic acid sensitisation.  Gut. 1999;  44 511-518
    PubMedGoogle Scholar
  • 99 Mycek M A, Schomacker K T, Nishioka N S. Colonic polyp differentiation using time-resolved autofluorescence spectroscopy.  Gastrointest Endosc. 1998;  48 390-394
    PubMedGoogle Scholar
  • 100 Schomacker K T, Frisoli J K, Compton C C, et al. Ultraviolet laser-induced fluorescence of colonic polyps.  Gastroenterology. 1992;  102 1155-1160
    PubMedGoogle Scholar
  • 101 Brand S, Stepp H, Ochsenkuhn T, et al. Detection of colonic dysplasia by light-induced fluorescence endoscopy: a pilot study.  Int J Colorectal Dis. 1999;  14 63-68
    CrossrefPubMedGoogle Scholar
  • 102 Ott S J, Ochsenkuehn T, Stepp H, et al. Detection of colonic dysplasia by laser-induced fluorescence endoscopy (LIFE) with and without 5-aminolaevulinic acid [abstract].  Gastrointest Endosc. 2000;  51 AB95
    PubMedGoogle Scholar
  • 103 Endlicher E, Knuechel R, Schoelmerich J, Messmann H. Photodynamic diagnosis of dysplasia in longstanding ulcerative colitis after sensitization with 5-aminolevulinic acid [abstract].  Gastroenterology. 1999;  116 A399
    PubMedGoogle Scholar
  • 104 Messmann H, Kullmann F, Wild T, et al. Detection of dysplastic lesions by fluorescence in a model of colitis in rats after previous photosensitization with 5-aminolaevulinic acid.  Endoscopy. 1998;  30 333-338
    PubMedGoogle Scholar
  • 105 Flotte T R, Beck S E, Chesnut K, et al. A fluorescence video-endoscopy technique for detection of gene transfer and expression.  Gene Ther. 1998;  5 166-173
    CrossrefPubMedGoogle Scholar
  • 106 Marcon N E, Wilson B C. The value of fluorescence techniques in gastrointestinal endoscopy - better than the endoscopist's eye? II: The North American experience.  Endoscopy. 1998;  30 419-421
    PubMedGoogle Scholar

M. Sackmann,M.D. 

II Dept. of Medicine Klinikum Grosshadern Ludwig-Maximilians University

81366 Munich Germany

Fax: Fax:+ 49-89-7004418

Email: E-mail:misa@med2.med.uni-muenchen.de

      >