ABSTRACT
The goal of endoscopy is to decrease the morbidity and mortality of cancer and other chronic diseases in the world. In 2004, the World Health Organization recorded 59 million deaths worldwide with 13 million due to cardiovascular diseases (coronary heart disease and stroke) (WHO 2009b) and 8 million due to cancer (WHO 2009a). As more of the world’s population lives past 70 years of age, most deaths are due to these two common chronic diseases. As we seek to decrease morbidity and mortality
8.1 Background and Importance ........................................................................ 103 8.1.1 Cancer Screening and Detection ...................................................... 105 8.1.2 Endoscopy in Screening and Diagnosis ........................................... 105 8.1.3 Endoscopic Optical Technologies in Screening and Diagnosis........ 107
8.2 Contrast Agents ............................................................................................ 109 8.2.1 Topical Contract Agents ................................................................... 109 8.2.2 Systemic Contrast Agents ................................................................. 110 8.2.3 Molecular Contrast Agents ............................................................... 110
8.3 Instruments for Endoscopic Confocal Microscopy ...................................... 112 8.3.1 Classes of Instrumentation ............................................................... 113
8.3.1.1 Proximal Scanning............................................................. 113 8.3.1.2 Distal Scanning .................................................................. 114
8.3.2 Contrast Limits of Proximal Scanning ............................................. 115 8.3.3 Contrast Modes: Reflectance and Fluorescence ............................... 116 8.3.4 Resolution ......................................................................................... 117
8.4 Review of the Clinical Literature ................................................................. 117 8.5 Quantitative Image Analysis ........................................................................ 122 References .............................................................................................................. 126
in the world by developing applicable technologies (keeping cost-effectiveness, local resources, and infrastructure in mind) we will allow these applications to be relevant to high, middle, and low-income countries. Both of these leading causes of death are chronic diseases, that is, they develop over a lifetime (often over 20-30 years), and so there is an almost equal time interval during which interventions are possible (Khanavkar 1998; Palcic 1991; BCCA 2005; Lane 2006; Rosin 2000, 2002; Zhang 1997; Heintzmann 2001).
