In this publication, the emergence of novel molecular probes and endoscopic instruments for performing targeted imaging of neoplasia in the digestive tract is discussed. The digestive tract is an ideal place to develop these emerging methods, in particular for clinical applications because these hollow organs are easy to access with endoscopy and exogenous probes can be topically applied safely. The role of imaging is becoming ever more important as a clinical tool for assessing cancer biomarkers. Spatial information provides a powerful resource to guide tissue biopsy, stratify risk patients, monitor therapeutic response and assess tumor recurrence. Moreover, we have recently experienced greater understanding of the sequence of genetic and molecular changes that lead to clonal selection and growth advantages for cancerous cells in the digestive tract.
This research has revealed the timing of expression of key molecular targets so that earlier detection of diagnostic cancer biomarkers with imaging methods can be performed. We are now beginning to see a convergence in our knowledge of molecular biology, development of affinity probes and performance of imaging instruments. These factors are interdependent and must develop together as we head in the direction of personalized medicine.
Currently, physicians make clinical decisions to diagnose and stage cancer based primarily on structural abnormalities, including mass effect, texture variations and interval change. If effective methods of imaging to target early cancer biomarkers can be adequately developed, we may see a new paradigm emerge for prevention, screening and management of cancer in the digestive tract.