In vivo diagnosis of acute intestinal graft-versus-host disease by confocal endomicroscopy

Bojarski, Christian; Günther, Ute; Rieger, Kathrin; Heller, Frank; Loddenkemper, Christoph; Grünbaum, Maria; Uharek, L.; Zeitz, M.; Hoffmann, Jörg

doi:10.1055/s-0029-1214604

Cited by 39 publications

(42 citation statements)

References 18 publications

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“…C onfocal laser endomicroscopy (CLE) is a novel technique for imaging live cells during endoscopy [1][2][3][4][5][6][7][8]. Upon systemic administration of the dye fluorescein, CLE can be performed in vivo during ongoing endoscopy and permits real-time subsurface imaging of cellular and subcellular structures in the mucosa.…”

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confidence: 99%

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Confocal laser endomicroscopy for diagnosing lung cancerin vivo

et al. 2012

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Confocal laser endomicroscopy is a novel endoscopic technique that may allow imaging of living cells in lung tissue in vivo. We assessed the potential of this technique for the detection of histology during screening bronchoscopy for lung cancer.32 patients with suspected malignancies underwent bronchoscopy with endomicroscopy using acriflavine hydrochloride. Standardised areas and localised lesions were analysed by in vivo confocal imaging during bronchoscopy and biopsies were taken. Confocal images were graded and correlated prospectively with conventional histology from biopsies.Acriflavine hydrochloride yielded high-quality confocal images and strongly labelled airway epithelial cells. No side-effects were noted. 75 522 confocal images from 56 different locations were compared prospectively with histological data from biopsy specimens. Endomicroscopy allowed subsurface imaging with detailed analysis of cellular and subcellular structures. Neoplastic changes could be predicted with high accuracy (sensitivity 96.0%, specificity 87.1%, accuracy 91.0%).Confocal laser endomicroscopy with acriflavine is a novel diagnostic tool for the analysis of living cells during bronchoscopy and permits virtual histology of neoplastic changes in the airways with high accuracy. This technique may enable the rapid diagnosis of neoplasia during ongoing endoscopy in patients with suspected lung cancer.

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confidence: 99%

“…It was found that high-quality in vivo imaging could be performed and CLE was utilised for rapid diagnosis and for the targeting of biopsies. In addition, CLE was shown to predict neoplasia in the stomach, oesophagus and colon with high accuracy [1][2][3][4][5][6][7][8].…”

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confidence: 99%

Confocal laser endomicroscopy for diagnosing lung cancerin vivo

et al. 2012

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“…In a recent trial, eCLE was able to diagnose and to grade GvHD during ongoing endoscopy with high accuracy based on the presence of inflammation, and epithelial apoptosis could be documented for diagnosis [56]. CLE has not been extensively studied in infectious colitis, but a case report has shown visualization of intestinal spirochaetosis by CLE [57].…”

Section: Endomicroscopy In Colitismentioning

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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“…Therefore, for grades 2-4 there was a strong correlation between endomicrosopy and conventional histology with a sensitivity of 74% and specificity of 100%. 76 The early promise of CLE in GVHD may provide a real-time diagnosis of GVHD to be made allowing intensification of immunosuppression or at least targeting of areas of active disease with fewer biopsies and reduced risk of biopsy related complications.…”

Section: Graft-versus-host Disease (Gvhd)mentioning

confidence: 99%

Status of confocal laser endomicroscopy in gastrointestinal disease

Humphris

Swartz

Egan

et al. 2012

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Confocal laser endomicroscopy (CLE) is an advanced imaging technique which combines conventional white light endoscopy (WLE) with an integrated or probe based confocal microscope. This allows microscopic examination of the surface epithelium and in vivo diagnosis during endoscopy. Established CLE applications include the diagnosis of Barrett's oesophagus, gastric intestinal metaplasia, coeliac disease and microscopic colitis. CLE can differentiate hyperplastic from adenomatous polyps in the colon and may obviate the need to biopsy all polyps at endoscopy. CLE is particularly helpful in surveillance endoscopy in inflammatory bowel disease where it has been shown to reduce the number of biopsies required and improve the detection of dysplasia. The future of CLE may be with new contrast agents to allow for molecular tagging and improved endoscopic diagnoses. The aim of this review is to describe the technology and techniques involved in CLE, and discuss the evolving applications in obtaining "virtual biopsy" throughout the GI tract.

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In vivo diagnosis of acute intestinal graft-versus-host disease by confocal endomicroscopy

Abstract: CEM improves rapid diagnosis of acute intestinal GvHD with high accuracy while performing endoscopy. Platelet transfusions and unnecessary biopsy acquisition can be avoided once acute intestinal GvHD has been diagnosed in vivo.

Cited by 39 publications

References 18 publications

Confocal laser endomicroscopy for diagnosing lung cancerin vivo

Confocal laser endomicroscopy for diagnosing lung cancerin vivo

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

Status of confocal laser endomicroscopy in gastrointestinal disease

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