Confocal Endomicroscopy of Colorectal Polyps

Abstract

Confocal laser endomicroscopy (CLE) is one of several novel methods that provide real-time, high-resolution imaging at a micron scale via endoscopes. CLE has the potential to be a disruptive technology in that it can change the current algorithms that depend on biopsy to perform surveillance of high-risk conditions. Furthermore, it allows on-table decision making that has the potential to guide therapy in real time and reduce the need for repeated procedures. CLE and related technologies are often termed “virtual biopsy” as they simulate the images seen in traditional histology. However, the imaging of living tissue allows more than just pragmatic convenience; it also allows imaging of living tissue such as active capillary circulation, cellular death, and vascular and endothelial translocation, thus extending beyond what is capable in traditional biopsy. Immediate potential applications of CLE are to guide biopsy sampling in Barrett's esophagus and inflammatory bowel disease surveillance, evaluation of colorectal polyps, and intraductal imaging of the pancreas and bile duct. Data on these applications is rapidly emerging, and more is needed to clearly demonstrate the optimal applications of CLE. In this paper, we will focus on the role of CLE as applied to colorectal polyps detected during colonoscopy.

Submucosal Lipoma of the Rectum Presenting as Rectal Prolapse and Appearing as Adenomatous Polyp on Confocal Laser Endomicroscopy: a Case Report and Literature Review

“…CLE is particularly useful for diagnosing polyploidal lesions of the colorectum. The expected main advantage of CLE over white light endoscopy is that of non reliance on histology, to cut down undesirable costs and avoid removal of lesions with no or little malignant potential [17]. However, CLE appearances in cases of colorectal lipomas have not been documented till date.…”

Laparoscopic Confocal Laser Microscopy Without Fluorescent Injection

“…Our CLM images of nonmalignant and cancer mucosa show similar quality compared with previously published images of endoscopic laser microscopy. [18][19][20][21] Recent endoscopic studies Figure 4. Characteristics of nonmalignant, adenoma, and cancer mucosa.…”

Tethered confocal endomicroscopy capsule for diagnosis and monitoring of eosinophilic esophagitis

“…Both configurations use fluorescent dyes, applied either systemically or topically, to visualize cellular features. Investigators have used CLE to study several gastrointestinal tract disorders such as esophageal dysplasia and carcinoma in Barrett's esophagus [4], colon aberrant crypt foci [5], colorectal polyps [6], and colonic mucosa in patients with ulcerative colitis [7]. Recently [8,9], pCLE has been used to identify eosinophils in patients with EoE disease.…”