Endoscopic confocal microscopy

Purpose of review Endoscopic confocal microscopy is a new endoscopic imaging technology that produces high-magnification cross-sectional images of the gastrointestinal epithelium during endoscopy. These high-magnification images might allow the endoscopist to make a tissue diagnosis during endoscopy without biopsy and histopathology. The purpose of this article is to review the salient features of endoscopic confocal microscopy, describe current clinical research areas using the technology, and depict its potential role in the management of gastrointestinal diseases. This review includes an overview of the technology, a review of recent publications describing its function, and a discussion of potential applications. Recent findings Endoscopic confocal microscopy has been technologically feasible only for a short time; therefore, the published experience is limited. Studies describing the use of endoscopic confocal microscopy for the detection of dysplastic tissue have been limited to a single paper in which endoscopic confocal microscopy was reported to be highly sensitive and specific for the detection of colonic dysplasia in a general screening population. Active areas of investigation include detecting dysplasia in ulcerative colitis and Barrett's esophagus. A recent case report detailed the ability of endoscopic confocal microscopy to detect gastric Helicobacter pylori in vivo. Summary Endoscopic confocal microscopy is a new imaging technology that produces high-magnification cross-sectional images of the gastrointestinal tract. Its role in detecting and managing diseases of the gastrointestinal tract has been studied in colon cancer screening and is currently being evaluated in a variety of premalignant conditions.

[1]  T. Wilson,et al.  Confocal endoscopy via structured illumination. , 2006, Scanning.

[2]  A. Polglase,et al.  Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo. , 2004, Gastroenterology.

[3]  Thomas D. Wang,et al.  Optical biopsy: a new frontier in endoscopic detection and diagnosis. , 2004, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[4]  Masahiro Yamaguchi,et al.  Appearance of enhanced tissue features in narrow-band endoscopic imaging. , 2004, Journal of biomedical optics.

[5]  S. Kudo,et al.  Virtual histology of colorectal lesions using laser-scanning confocal microscopy. , 2003, Endoscopy.

[6]  K. Hiroshima,et al.  High magnification bronchovideoscopy combined with narrow band imaging could detect capillary loops of angiogenic squamous dysplasia in heavy smokers at high risk for lung cancer , 2003, Thorax.

[7]  Thomas D. Wang,et al.  Dual-axis confocal microscope for high-resolution in vivo imaging. , 2003, Optics letters.

[8]  T Joshua Pfefer,et al.  Temporally and spectrally resolved fluorescence spectroscopy for the detection of high grade dysplasia in Barrett's esophagus , 2003, Lasers in surgery and medicine.

[9]  Wendy J. McLaren,et al.  In Vivo Detection of Morphological and Microvascular Changes of the Colon in Association with Colitis Using Fiberoptic Confocal Imaging (FOCI) , 2002, Digestive Diseases and Sciences.

[10]  Fritjof Helmchen,et al.  Miniaturization of Fluorescence Microscopes Using Fibre Optics , 2002, Experimental physiology.

[11]  Brian C Wilson,et al.  New optical technologies for earlier endoscopic diagnosis of premalignant gastrointestinal lesions , 2002, Journal of gastroenterology and hepatology.

[12]  M. Sivak,et al.  Methylene blue staining of dysplastic and nondysplastic Barrett's esophagus: an in vivo and ex vivo study. , 2001, Endoscopy.

[13]  J K Greenson,et al.  Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. , 2001, Human pathology.

[14]  M F Dixon,et al.  The Vienna classification of gastrointestinal epithelial neoplasia , 2000, Gut.

[15]  J M Poneros.  Gastrointestinal and hepatobiliary pathophysiology , 2000, Gastroenterology.

[16]  M. Harris,et al.  Fibre optic confocal imaging (FOCI) for subsurface microscopy of the colon in vivo. , 1994, Journal of anatomy.

[17]  B E Bouma,et al.  Diagnosis of specialized intestinal metaplasia by optical coherence tomography. , 2001, Gastroenterology.