A multimodality imaging system including ultrasound, optical coherence tomography (OCT), photoacoustic (PA) imaging, florescence imaging and endoscopic catheter for imaging inside the gastrointestinal tract with real-time automatic image co-registration capability, including: an ultrasound subsystem for imaging; an optical coherence tomography (OCT) subsystem for imaging, a PA microscopy or tomography subsystem for imaging and a florescence imaging subsystem for imaging. An invasive interventional imaging device is included with an instrumentality to take a tissue biopsy from a location visible on the ultrasound subsystem for imaging, on the optical coherence tomography (OCT) subsystem for imaging, photoacoustic (PA) subsystem for imaging and florescence subsystem for imaging. The instrumentality takes a tissue biopsy from a visible location simultaneously with the visualization of the tissue about to be biopsied so that the tissue biopsy location is visualized before, during and after the biopsy.