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A modular video endoscope is developed and tested to allow imaging in different modalities. This systemincorporates white light imaging (WLI), cross-polarized imaging (CPI), and vital-dye fluorescence imaging (VFI),using interchangeable filter modules. CPI and VFI are novel endoscopic modalities that probe mucosal featuresassociated with Barrett's neoplasia. CPI enhances vasculature, while VFI enhances glandular architecture. Inthis pilot study, we demonstrate the integration of these modalities by imaging areas of Barrett's metaplasiaand neoplasia in an esophagectomy specimen. We verify that those key image features are also observed duringan in vivo surveillance procedure. CPI images demonstrate improved visualization of branching blood vessels associatedwith neoplasia. VFI images show glandular architecture with increased glandular effacement associated withneoplasia. Results suggests that important pathologic features seen in CPI and VFI are not visible during standardendoscopic white light imaging, and thus the modalities may be useful in future in vivo studies for discriminatingneoplasia from Barrett's metaplasia. We further demonstrate that the integrated WLI/CPI/VFI endoscope is compatiblewith complementary high-resolution endomicroscopy techniques such as the high-resolution microendoscope,potentially enabling two-step (“red-flag” widefield plus confirmatory high-resolution imaging) protocols tobe enhanced

Modular video endoscopy forin vivocross-polarized and vital-dye fluorescence imaging of Barrett’s-associated neoplasia