Optical biopsy in gastroenterology: Focus on confocal laser endomicroscopy

Nabi, Zaheer; Reddy, D. Nageshwar

doi:10.1007/s12664-019-00986-z

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…Unlike SRH, CLE does not require the tissue to be excised, and its results can be interpreted in vivo. CLE involves the placement of a light-emitting probe on the tissue of interest, which recaptures the reflected light on a specific plane [78,79]. In combination with fluorescence, recent studies have demonstrated promising results when compared to those of standard pathological diagnosis [80].…”

Section: Confocal Microscopementioning

confidence: 99%

Advances in Intraoperative Glioma Tissue Sampling and Infiltration Assessment

Al-Adli,

Young,

Scotford

et al. 2023

Brain Sciences

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Gliomas are infiltrative brain tumors that often involve functional tissue. While maximal safe resection is critical for maximizing survival, this is challenged by the difficult intraoperative discrimination between tumor-infiltrated and normal structures. Surgical expertise is essential for identifying safe margins, and while the intraoperative pathological review of frozen tissue is possible, this is a time-consuming task. Advances in intraoperative stimulation mapping have aided surgeons in identifying functional structures and, as such, has become the gold standard for this purpose. However, intraoperative margin assessment lacks a similar consensus. Nonetheless, recent advances in intraoperative imaging techniques and tissue examination methods have demonstrated promise for the accurate and efficient assessment of tumor infiltration and margin delineation within the operating room, respectively. In this review, we describe these innovative technologies that neurosurgeons should be aware of.

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Section: Confocal Microscopementioning

confidence: 99%

Advances in Intraoperative Glioma Tissue Sampling and Infiltration Assessment

Al-Adli,

Young,

Scotford

et al. 2023

Brain Sciences

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“…Probe-based CLE enables the visualization of live mucosal tissue at a cellular level and has been particularly established in mucosal diagnostics of the gastrointestinal tract in the last decade [ 6 ]. CLE has been broadly studied in identification of dysplasia in Barret’s esophagus, gastric and colorectal polyps [ 7 , 8 ]. Furthermore, it has been shown to be beneficial due to its dynamic in-vivo examination in the assessment of disease activity and development of dysplasia in inflammatory bowel disease and celiac disease [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma

Sievert

Aubreville

Gostian

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose Confocal laser endomicroscopy (CLE) allows imaging of the laryngeal mucosa in a thousand-fold magnification. This study analyzes differences in tissue homogeneity between healthy mucosa and squamous cell carcinoma (SCC) via CLE. Materials and methods We included five SCC patients with planned total laryngectomy in this study between October 2020 and February 2021. We captured CLE scans of the tumor and healthy mucosa. Analysis of image homogeneity to diagnose SCC was performed by measuring the signal intensity in four regions of interest (ROI) in each frame in a total of 60 sequences. Each sequence was assigned to the corresponding histological pattern, derived from hematoxylin and eosin staining. In addition, we recorded the subjective evaluation of seven investigators regarding tissue homogeneity. Results Out of 3600 images, 1620 (45%) correlated with benign mucosa and 1980 (55%) with SCC. ROIs of benign mucosa and SCC had a mean and standard deviation (SD) of signal intensity of, respectively, 232.1 ± 3.34 and 467.3 ± 9.72 (P < 0.001). The mean SD between the four different ROIs was 39.1 ± 1.03 for benign and 101.5 ± 2.6 for SCC frames (P < 0.001). In addition, homogeneity yielded a sensitivity and specificity of 81.8% and 86.2%, respectively, regarding the investigator-dependent analysis. Conclusions SCC shows a significant tissue inhomogeneity in comparison to the healthy epithelium. The results support this feature’s importance in identifying malignant mucosa areas during CLE examination. However, the examiner-dependent evaluation emphasizes that homogeneity is a sub-criterion that must be considered in a broad context.

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“…The device emits focused laser light via a probe into the tissue and recaptures emanating light from the focal plane while rejecting light from outside the focused spot. 1 This enables visualization of an area of interest on a specific focal plane in a tissue, hence "confocal." Images can be obtained not only in the x-and y-axes but also in the z-axis as z-stacks (an automated recording of a user-defined range of images relative to the current focal plane).…”

mentioning

confidence: 99%

Intraoperative imaging of brain tumors with fluorescein: confocal laser endomicroscopy in neurosurgery. Clinical and user experience

Höhne¹,

Schebesch²,

Zoubaa³

et al. 2021

Neurosurgical Focus

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OBJECTIVEConfocal laser endomicroscopy (CLE) is an established tool in basic research for tissue imaging at the level of microstructures. Miniaturization and refinement of the technology have made this modality available for operative imaging with a handheld device. Sufficient image contrast is provided by the preoperative application of fluorescein sodium. The authors report their first experiences in a clinical case series using the new confocal laser endomicroscope.METHODSHandling, operative workflow, and visualization of the CLE were critically evaluated in 12 cases of different CNS tumors. Three different imaging positions in relation to the tumor were chosen: the tumor border (I), tumor center (II), and perilesional zone (III). Respective diagnostic sampling with H & E staining and matching intraoperative neuronavigation and microscope images are provided.RESULTSCLE was found to be beneficial in terms of high-quality visualization of fine structures and for displaying hidden anatomical details. The handling of the device was good, and the workflow was easy.CONCLUSIONSHandling ergonomics and image acquisition are intuitive. The endomicroscope allows excellent additional visualization of microstructures in the surgical field with a minimally invasive technique and could improve safety and clinical outcomes. The new confocal laser endomicroscope is an advanced tool with the potential to change intracranial tumor surgery. Imaging of these microstructures is novel, and research with comparative validation with traditional neuropathological assessments is needed.

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Optical biopsy in gastroenterology: Focus on confocal laser endomicroscopy

Cited by 4 publications

References 34 publications

Advances in Intraoperative Glioma Tissue Sampling and Infiltration Assessment

Advances in Intraoperative Glioma Tissue Sampling and Infiltration Assessment

Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma

Intraoperative imaging of brain tumors with fluorescein: confocal laser endomicroscopy in neurosurgery. Clinical and user experience

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