Current status of autofluorescence endoscopy

White light imaging has limitations in the surveillance of neoplasms using conventional endoscopy. However, autofluorescence imaging (AFI) is expected to improve the detection rate of lesions. Detection of early gastric cancer using AFI is not easy, because AFI has low specificity due to inflammatory changes and regenerative changes in the gastric mucosa. Trimodal imaging with magnifying endoscopy using narrow band imaging improved the high false positive rate and low sensitivity. AFI is useful for detection of colonic neoplasms; however, it has not been established whether AFI is useful for differentiation between adenomas and hyperplastic polyps. AFI is useful for surveillance of ulcerative colitis; however, it is not easy to detect dysplasia if inflammation of the mucosa occurs similar to inflammation of the gastric mucosa. AFI is useful for detection of dysplasia in patients with Barrett's esophagus; however, AFI is not superior to random biopsy. In the near future, development of real-time computer-assisted analysis of AFI images are expected to reduce the false-positive rate and improve the accuracy rate of detection of the lesions.