Confocal Laser Endomicroscopy and Molecular Imaging in Barrett Esophagus and Stomach

Choi, Kyeong‐Hee; Jung, Hwoon‐Yong

doi:10.5946/ce.2014.47.1.23

Cited by 5 publications

(4 citation statements)

References 42 publications

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“…3, • " Video 1) detected more patients with intestinal metaplasia than did WLE (26/38 vs. 13/38, P = 0.011), in a prospective, randomized crossover trial that included 65 patients [92]. CLE consistently outperformed WLE in the detection of intestinal metaplasia and its diagnostic performance is similar to that of magnification-NBI [93]. However in a parallel group randomized controlled trial of CLE vs. WLE in 168 patients for the diagnosis of intestinal metaplasia, the difference in rates was not significant on a per-patient basis (45 % and 31 %, respectively, P = 0.074) [94].…”

Section: Stomachmentioning

confidence: 83%

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

et al. 2016

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! quality evidence.) Conclusion: Advanced endoscopic imaging can improve mucosal visualization and endoscopic diagnosis; however it requires training and the use of validated classification systems. Blue laser imaging (BLI) Fujifilm Lasereo Japan, China, South America, Asian-Pacific Processor VP-4450HD, Laser Light Source LL-4450 and L590 series endoscopes Autofluorescence imaging (AFI) Olympus Lucera Spectrum Japan, UK Video System Center (CV-260SL), CFH260 colonoscope AZL Confocal laser endoscopy (CLE) Pentax Worldwide Pentax ISC-1000 endomicroscopy system; EC3870K endoscope Mauna Kea Cellvizio Worldwide Cellvizio 100 series system; GastroFlex and ColoFlex UHD probes

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Section: Stomachmentioning

confidence: 83%

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

et al. 2016

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“…On the other hand, pCLE’s greatest disadvantage is its high cost, which can be a significant barrier to widespread clinical implementation. Other disadvantages can relate to availability, physician training in image interpretation, the extra time needed to view the images during endoscopy, and the role of the pathologist [ 58 , 59 , 60 ]. Using pCLE also could have a side effect in cases of allergy to the contrast agent, fluorescein, which is used to stain the tissues [ 61 , 62 ].…”

Section: Advantages and Disadvantagesmentioning

confidence: 99%

The Use of Confocal Laser Endomicroscopy in Diagnosing Barrett’s Esophagus and Esophageal Adenocarcinoma

et al. 2022

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Confocal laser endomicroscopy (CLE) is a diagnostic technique that enables real-time microscopic imaging during microscopic examination and evaluation of epithelial structures with 1000-fold magnification. CLE can be used in the diagnosis of various pathologies, in pneumology, and in urology, and it is very widely utilized in gastroenterology, most importantly in the diagnosis of Barrett’s esophagus (BE), esophageal adenocarcinoma (EAC), biliary strictures, and cystic pancreatic lesions. A literature search was made in MEDLINE/PubMed and Google Scholar databases while focusing on diagnostics using CLE of BE and EAC. We then examined randomized and observational studies, systematic reviews, and meta-analyses relating to the utilization of CLE in BE and EAC diagnostics. Here, we discuss whether CLE can be a suitable diagnostic method for surveillance of BE. Even though many studies have proven that CLE increases diagnostic accuracy in detecting neoplastic transformation of BE, CLE is still not used as a standard diagnostic tool in BE surveillance due to a deficiency of scientific evidence. More studies and data are needed if CLE is to find a place as a new technique in BE surveillance.

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“…Even though pCLE has been tested in several studies with promising results, it is not considered as a standard method for histopathological diagnosis, and its present role is rather ancillary. [5][6][7][8] Several studies have shown that pCLE may provide comparable or even better diagnostic accuracy compared with standard biopsies in patients with oesophageal adenocarcinoma (AC), [9][10][11] oesophageal squamous-cell cancer (SCC) 12,13 or gastric AC. 14,15 pCLE increases sensitivity and diagnostic accuracy for dysplasia or AC, if added up on high-definition endoscopy (with narrow-band imaging (NBI)) in patients with Barrett's oesophagus (BO).…”

Section: Introductionmentioning

confidence: 99%

“…pCLE can be used in the diagnostics through the entire gastrointestinal (GI) tract. Even though pCLE has been tested in several studies with promising results, it is not considered as a standard method for histopathological diagnosis, and its present role is rather ancillary 5–8 . Several studies have shown that pCLE may provide comparable or even better diagnostic accuracy compared with standard biopsies in patients with oesophageal adenocarcinoma (AC), 9–11 oesophageal squamous‐cell cancer (SCC) 12,13 or gastric AC 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Probe‐based confocal laser endomicroscopy versus biopsies in the diagnostics of oesophageal and gastric lesions: A prospective, pathologist‐blinded study

et al. 2020

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Background and aim Probe-based confocal laser endomicroscopy (pCLE) provides real-time microscopic visualisation. Our aim was to compare the diagnostic accuracy of pCLE with standard biopsies in patients with visible oesophageal or gastric lesions. Methods This was a single-centre, prospective, pathologist-blinded study. Patients underwent high-resolution endoscopy, and lesions were examined by pCLE followed by standard biopsies. A definitive diagnosis was determined from resection specimen. Main outcomes were overall diagnostic accuracy, sensitivity, specificity and positive and negative predictive values. Results We examined 74 lesions in 67 patients. Definitive diagnoses revealed 34 malignant and 40 non-malignant lesions. pCLE diagnosis was correct in 89.2% (66/74), while diagnosis based on biopsy was correct in 85% (57/67; p = 0.6). The overall diagnostic accuracy of biopsies was 85% (76–94%) and that of pCLE was 89% (79–96%). pCLE correctly diagnosed malignant lesions, comprising oesophageal adenocarcinoma, oesophageal squamous-cell cancer or gastric adenocarcinoma, in 88.2% (30/34) of cases, while biopsy was correctly diagnosed in 75.9% (22/29; p = 0.3). Sensitivity and specificity to diagnose a malignant lesion were 75.9% (95% confidence interval (CI) 56–89%) and 100% (95% CI 90–100%) for biopsies and 88.2% (95% CI 72–97%) and 92% (95% CI 79–98%) for pCLE. No differences between biopsies and pCLE were found with regard to sensitivity, specificity to diagnose dysplastic and benign lesions ( p > 0.2). Conclusion pCLE provides satisfactory diagnostic accuracy comparable with standard biopsies in patients with oesophageal or gastric lesions. ClinicalTrials.gov identifier: NCT0292049)

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Confocal Laser Endomicroscopy and Molecular Imaging in Barrett Esophagus and Stomach

Cited by 5 publications

References 42 publications

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

The Use of Confocal Laser Endomicroscopy in Diagnosing Barrett’s Esophagus and Esophageal Adenocarcinoma

Probe‐based confocal laser endomicroscopy versus biopsies in the diagnostics of oesophageal and gastric lesions: A prospective, pathologist‐blinded study

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