Multi-contrast laser endoscopy for in vivo gastrointestinal imaging

White light endoscopy is the clinical gold standard for detecting diseases in the gastrointestinal tract. Most applications involve identifying visual abnormalities in tissue color, texture, and shape. Unfortunately, the contrast of these features is often subtle, causing many clinically relevant cases to go undetected. To overcome this challenge, we introduce Multi-contrast Laser Endoscopy (MLE): a platform for widefield clinical imaging with rapidly tunable spectral, coherent, and directional illumination. We demonstrate three capabilities of MLE: enhancing tissue chromophore contrast with multispectral diffuse reflectance, quantifying blood flow using laser speckle contrast imaging, and characterizing mucosal topography using photometric stereo. We validate MLE with benchtop models, then demonstrate MLE in vivo during clinical colonoscopies. MLE images from 31 polyps demonstrate an approximate three-fold improvement in contrast and a five-fold improvement in color difference compared to white light and narrow band imaging. With the ability to reveal multiple complementary types of tissue contrast while seamlessly integrating into the clinical environment, MLE shows promise as an investigative tool to improve gastrointestinal imaging.