Optical biopsy using tissue spectroscopy and optical coherence tomography.

'Optical biopsy' or 'optical diagnostics' is a technique whereby light energy is used to obtain information about the structure and function of tissues without disrupting them. In fluorescence spectroscopy, light energy (usually provided by a laser) is used to excite tissues and the resulting fluorescence provides information about the target tissue. Its major gastrointestinal application has been in the evaluation of colonic polyps, in which it can reliably distinguish malignant from benign lesions. Optical coherence tomography (OCT) has been used in the investigation of Barrett's epithelium (and dysplasia), although a variety of other applications are feasible. For example, OCT could assist in the identification and staging of mucosal and submucosal neoplasms, the grading of inflammation in the stomach and intestine, the diagnosis of biliary tumours and the assessment of villous architecture. OCT differs from endoscopic ultrasound, a complementary modality, in that it has a much higher resolution but lesser depth of penetration. The images correlate with the histopathological appearance of tissues, and the addition of Doppler methods may enable it to evaluate the vascularity of tumours and the amount of blood flow in varices. Refinements in these new optical techniques will likely make them valuable in clinical practice, although their specific roles have yet to be determined.