Status of confocal laser endomicroscopy in gastrointestinal disease

Humphris, Jeremy L.; Swartz, David; Egan, Brian; Leong, Rupert W.

doi:10.7869/tg.2012.3

Cited by 22 publications

(15 citation statements)

References 79 publications

(73 reference statements)

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“…In addition acriflavine could be administered topically providing staining of cell nuclei, not stained by fluorescein. Established CLE applications include the diagnosis of Barrett's oesophagus, gastric intestinal metaplasia coeliac disease, and microscopic colitis [61]. There is very few data regarding the use of CLE in GI acute GVHD.…”

Section: Endoscopic Examinationmentioning

confidence: 99%

New Insight for the Diagnosis of Gastrointestinal Acute Graft-versus-Host Disease

Malard

Mohty

2014

Mediators of Inflammation

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Allogeneic stem cell transplantation (allo-SCT) is a curative therapy for different life-threatening malignant and nonmalignant hematologic disorders. Graft-versus-host disease (GVHD) remains a major source of morbidity and mortality following allo-SCT, which limits the use of this treatment in a broader spectrum of patients. Early diagnostic of GVHD is essential to initiate treatment as soon as possible. Unfortunately, the diagnosis of GVHD may be difficult to establish, because of the nonspecific nature of the associated symptoms and of the numerous differential diagnosis. This is particularly true regarding gastrointestinal (GI) acute GVHD. In the recent years many progress has been made in medical imaging test and endoscopic techniques. The interest of these different techniques in the diagnosis of GI acute GVHD has been evaluated in several studies. With this background we review the contributions, limitations, and future prospect of these techniques in the diagnosis of GI acute GVHD.

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Section: Endoscopic Examinationmentioning

confidence: 99%

New Insight for the Diagnosis of Gastrointestinal Acute Graft-versus-Host Disease

Malard

Mohty

2014

Mediators of Inflammation

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“…The lateral resolution is 0.7 μm, and the axial resolution is 7 μm. eCLE can produce conventional white-light endoscopic images and confocal images at the same time, with a pixel density of 1,024 pixels ×512 pixels at an acquisition rate of 1.6 frames per second or 1 ,024 pixels × 1,024 pixels at 0.8 frames per second 94,95…”

Section: Virtual Chromoendoscopymentioning

confidence: 99%

State of the art in advanced endoscopic imaging for the detection and evaluation of dysplasia and early cancer of the gastrointestinal tract

Coda¹,

Thillainayagam²

2014

CEG

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Ideally, endoscopists should be able to detect, characterize, and confirm the nature of a lesion at the bedside, minimizing uncertainties and targeting biopsies and resections only where necessary. However, under conventional white-light inspection – at present, the sole established technique available to most of humanity – premalignant conditions and early cancers can frequently escape detection. In recent years, a range of innovative techniques have entered the endoscopic arena due to their ability to enhance the contrast of diseased tissue regions beyond what is inherently possible with standard white-light endoscopy equipment. The aim of this review is to provide an overview of the state-of-the-art advanced endoscopic imaging techniques available for clinical use that are impacting the way precancerous and neoplastic lesions of the gastrointestinal tract are currently detected and characterized at endoscopy. The basic instrumentation and the physics behind each method, followed by the most influential clinical experience, are described. High-definition endoscopy, with or without optical magnification, has contributed to higher detection rates compared with white-light endoscopy alone and has now replaced ordinary equipment in daily practice. Contrast-enhancement techniques, whether dye-based or computed, have been combined with white-light endoscopy to further improve its accuracy, but histology is still required to clarify the diagnosis. Optical microscopy techniques such as confocal laser endomicroscopy and endocytoscopy enable in vivo histology during endoscopy; however, although of invaluable assistance for tissue characterization, they have not yet made transition between research and clinical use. It is still unknown which approach or combination of techniques offers the best potential. The optimal method will entail the ability to survey wide areas of tissue in concert with the ability to obtain the degree of detailed information provided by microscopic techniques. In this respect, the challenging combination of autofluorescence imaging and confocal endomicroscopy seems promising, and further research is awaited.

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“…Intracellular as well as nuclear staining of the uppermost mucosa can be achieved by using topical contrast agents. They are easily applied and do not regularly carry the risk of systemic side effects, yet no agent is officially licensed for in-vivo use in humans and they typically do not penetrate deeply into the mucosa [3]. The most commonly used agent is acriflavine [22][23][24], which stains the nuclei and is typically applied as acriflavine hydrochloride 0.05%.…”

Section: Fluorescent Contrast Agents For Confocal Laser Endomicroscopymentioning

confidence: 99%

“…CLE allows high-resolution, microanatomical analysis of tissue ('optical biopsies') in real time during endoscopy [1,2]. The utility of this new technology is highlighted by its capacity to differentiate tissue types and entities on the basis of histologic characteristics of the mucosa and submucosal vasculature [3]. These findings could serve to reduce unnecessary biopsies and identify lesions needing further treatment.…”

Section: Introductionmentioning

confidence: 99%

Confocal laser endomicroscopy in head and neck cancer

Volgger¹,

Conderman

Betz³

2013

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of reviewConfocal laser endomicroscopy (CLE) is a novel, noninvasive technique used to obtain microanatomical images of the inner lining of hollow organs. It has been used in a variety of clinical specialties to aid in the diagnosis and treatment planning of inflammatory and neoplastic processes. Our intent is to provide an up-to-date review of the literature in the setting of head and neck diseases as well as describing our own initial results and areas of future research. Recent findingsWith increasing experience using CLE in the upper aerodigestive tract (UADT), evidence is mounting that this method can be a useful adjunct to standard endoscopy and other diagnostic techniques. Recent publications have shown that by using CLE, microanatomical structures of healthy and diseased mucosa can easily be identified, allowing for a differentiation of dysplastic/neoplastic and benign mucosal lesions. Standardized diagnostic protocols as well as clinically relevant classification systems for the UADT have not yet been described. SummaryCLE is an imaging modality that allows real-time visualization of mucosal cellular architecture and other histologic characteristics. First reports on its use in the UADT have yielded promising results, but the true value of this method is yet to be determined.

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Status of confocal laser endomicroscopy in gastrointestinal disease

Cited by 22 publications

References 79 publications

New Insight for the Diagnosis of Gastrointestinal Acute Graft-versus-Host Disease

New Insight for the Diagnosis of Gastrointestinal Acute Graft-versus-Host Disease

State of the art in advanced endoscopic imaging for the detection and evaluation of dysplasia and early cancer of the gastrointestinal tract

Confocal laser endomicroscopy in head and neck cancer

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