Detection of Cholangiocarcinoma In Vivo Using Miniprobe-Based Confocal Fluorescence Microscopy

Meining, Alexander; Frimberger, E; Becker, Valentin; Delius, Stefan von; Weyhern, Claus Hann von; Schmid, Roland M.; Prinz, Christian

doi:10.1016/j.cgh.2008.04.014

Cited by 125 publications

(109 citation statements)

References 16 publications

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“…The first study from an expert center to evaluate biliary strictures has found a sensitivity of 83% for pCLE as compared to 50% for histology. Although image quality was lower in the biliary tree than in mucosal imaging in the GI tract, the presence of neoplasia was suggested by irregular, dilated vessels [59]. Lower accuracy rates were reported from a follow-up trial [60].…”

Section: Intrabiliary Imagingmentioning

confidence: 99%

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Goetz

2012

ISRN Pathology

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Confocal laser endomicroscopy (CLE) is a novel tool in the endoscopist's armamentarium. It allows on-site histological information. The ability of gastroenterologists to interpret such microscopic information has been demonstrated in multiple studies from the upper and lower gastrointestinal tract. Recently, the field of application has expanded to provide hepatobiliary and intra-abdominal CLE imaging. CLE allows "smart," targeted biopsies and is able to guide endoscopic interventions. But CLE is also translational in its approach and permits functional imaging that significantly impacts on our understanding of gastrointestinal diseases. Molecular imaging with CLE allows detection and characterization of lesions and may even be used for prediction of response to targeted therapy. This paper provides a comprehensive review over current applications of CLE in clinical applications and translational science.

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Section: Intrabiliary Imagingmentioning

confidence: 99%

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Goetz

2012

ISRN Pathology

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“…33,41 In their study of 14 patients, pCLE exhibited an overall accuracy of 86% (compared to histopathology's diagnostic accuracy of 79%), based on patterns such as: large clumps of decreased fluorescent dye uptake, saccular vessels, and the loss of a reticular pattern of epithelium. 33,40 Sensitivity of histopathology alone was 50%, relative to 83% when using pCLE. 33,40 Kahaleh et al 39 also showed pCLE diagnoses aligned with that based on cytology or histopathology with a Kappa coefficient of 0.8 (P ≤ 0.0001) in their evaluation in 18 patients.…”

Section: Confocal Laser Endomicroscopymentioning

confidence: 99%

“…33,40 Sensitivity of histopathology alone was 50%, relative to 83% when using pCLE. 33,40 Kahaleh et al 39 also showed pCLE diagnoses aligned with that based on cytology or histopathology with a Kappa coefficient of 0.8 (P ≤ 0.0001) in their evaluation in 18 patients. An extensive literature review by Almadi and Neumann 41 found CLE in combination with endoscopic retrograde cholangiopancreatography (ERCP) for the assessment of indeterminate ductal strictures increased the sensitivity to 98% relative to 45% with ERCP alone, but resulted in a lower specificity (67% vs 100%).…”

Section: Confocal Laser Endomicroscopymentioning

confidence: 99%

“…Despite use of brush cytology to aid in endoscopic diagnosis, sensitivity remains less than ideal, often not exceeding 70%. 33,39 Meining et al 40 reported one of the first studies evaluating pCLE in the evaluation of pancreatobiliary duct strictures of indeterminate etiology. 33,41 In their study of 14 patients, pCLE exhibited an overall accuracy of 86% (compared to histopathology's diagnostic accuracy of 79%), based on patterns such as: large clumps of decreased fluorescent dye uptake, saccular vessels, and the loss of a reticular pattern of epithelium.…”

Section: Confocal Laser Endomicroscopymentioning

confidence: 99%

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Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Luthra

Mishra

2017

Int J Gastrointest Interv

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“…Based on the microvascular pattern, pCLE during endoscopic retrograde cholangiopancreatography detected cholangiocarcinoma with sensitivity of 83%, specificity of 88%, and accuracy of 86% in 14 patients with biliary strictures compared to 50%, 100%, and 79%, respectively for histologic biopsy. 34 The authors did not compare the sensitivity to biliary brush cytology.…”

Section: Hepatobiliary/pancreasmentioning

confidence: 99%

Confocal Laser Endomicroscopy: A Primer for Pathologists

Paull¹,

Hyatt²,

Wassef³

et al. 2011

Archives of Pathology &Amp; Laboratory Medicine

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N Context.-The advent of new endoscopic optical techniques is likely to change pathologists' role in diagnosis.Objective.-To describe how confocal laser endomicroscopy (CLE) works, show its advantages and limitations compared to cytohistologic biopsy, and explore how it may affect the practice of pathology.Data Sources.-Literature review.Conclusions.-Confocal laser endomicroscopy is proving its ability to provide histology-like images of tissues in vivo to help avoid risks and costs of conventional biopsies. Confocal imaging restricts light to 1 plane, emulating a paraffin section, and topical or systemic optical contrast agents allow subcellular resolution. New contrast agents could theoretically permit molecular characterization. In vivo imaging has begun to demonstrate novel, dynamic types of diagnostic features. Decreased histologic biopsies can be anticipated for a few scenarios. Significant limitations of CLE include the inability to create a tissue archive for broad molecular classification, suboptimal contrast agents, small fields of view and shallow penetration, paucity of clinical validation studies, and problems with reimbursement. Confocal laser endomicroscopy exposes new opportunities for pathologists: CLE technologies can be exploited in pathology, and diagnostic criteria expanded based on endoscopists' discoveries. Potential synergy exists between CLE and cytology, allowing the low-magnification diagnostic architectural changes by CLE and cytomorphology to emulate the full diagnostic information in a histologic biopsy while providing an archive of material for molecular or immunohistochemical studies. Confocal laser endomicroscopy will decrease some types of biopsies, but offers an opportunity for pathologists to find new ways to provide value and improve patient care.

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Detection of Cholangiocarcinoma In Vivo Using Miniprobe-Based Confocal Fluorescence Microscopy

Cited by 125 publications

References 16 publications

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Confocal Laser Endomicroscopy: Applications in Clinical and Translational Science—A Comprehensive Review

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Confocal Laser Endomicroscopy: A Primer for Pathologists

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