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Confocal laser endomicroscopy

Yoshio Naya, Natsuki Takaha, Takako Okubo, Koji Shiota, Issei Hayashi, Masaru Mori, Seiki Date, Tsuneharu Miki, Osamu Ukimura
Background: Cystoscopy using white light is a standard procedure for diagnosing bladder cancer; however, white light can result in missed lesions that are present, but not visible, such as in cases of carcinoma in situ (CIS). In this case report, we describe observing the nuclei of urothelial carcinoma cells in situ that were not visible with cystoscopy under white light using probe-based confocal laser endomicroscopy (pCLE) with acrinol and fluorescein during transurethral resection of a bladder tumor (TURBT)...
2018: Journal of Endourology Case Reports
Guanjun Kou, Jing Guo, Xiuli Zuo, Changqing Li, Chao Liu, Rui Ji, Han Liu, Xiao Wang, Yanqing Li
BACKGROUND: Celiac disease (CD) is a chronic inflammatory enteropathy with a symptom spectrum similar to that of irritable bowel syndrome (IBS). CD is a common, but largely undiagnosed, condition in Western countries. However, it is extremely rare among Chinese people, and few studies have evaluated its prevalence in China. OBJECTIVE: To determine the prevalence of CD in IBS patients diagnosed using the Rome III criteria in North China. METHODS: This was a single-center, prospective, controlled cohort study performed in Qilu Hospital involving 246 IBS patients and 246 healthy controls...
February 16, 2018: Journal of Digestive Diseases
Esmee Iml Liem, Jan Erik Freund, Joyce Baard, D Martijn de Bruin, M Pilar Laguna Pes, C Dilara Savci-Heijink, Ton G van Leeuwen, Theo M de Reijke, Jean Jmch de la Rosette
BACKGROUND: Visual confirmation of a suspicious lesion in the urinary tract is a major corner stone in diagnosing urothelial carcinoma. However, during cystoscopy (for bladder tumors) and ureterorenoscopy (for tumors of the upper urinary tract) no real-time histopathologic information can be obtained. Confocal laser endomicroscopy (CLE) is an optical imaging technique that allows for in vivo high-resolution imaging and may allow real-time tumor grading of urothelial lesions. OBJECTIVE: The primary objective of both studies is to develop descriptive criteria for in vivo CLE images of urothelial carcinoma (low-grade, high-grade, carcinoma in situ) and normal urothelium by comparing CLE images with corresponding histopathology...
February 7, 2018: JMIR Research Protocols
Murat Akarsu, Cevher Akarsu
Gastrointestinal (GI) tumors are the most commonly diagnosed cancers worldwide and the second leading cause of cancer-related death. Endoscopy is the gold standard for diagnosis of GI cancers. Early diagnosis of GI tumors by endoscopy at the precancerous or early stage may decrease the prevalence and mortality rate of GI cancers. The preventive role of endoscopic interventions and the limitations of conventional white-light endoscopy have given rise to myriad innovations. Chromoendoscopy with dye injection can be used to detect lesions at an early stage...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Feng Li, Ahmad Malli, Zobeida Cruz-Monserrate, Darwin L Conwell, Somashekar G Krishna
Increases in the quality as well as utilization of cross-sectional imaging have led to rising diagnoses of pancreatic cystic lesions (PCL). Accurate presurgical diagnosis enables appropriate triage of PCLs. Unfortunately, current diagnostic approaches have suboptimal accuracy and may lead to unnecessary surgical resections or missed diagnoses of advanced neoplasia. Additionally, early detection represents an opportunity for intervention to prevent the progression to pancreatic adenocarcinoma. Our aim for this review is to systematically review the current literature on confocal endomicroscopy and molecular biomarkers in the evaluation of PCLs...
January 16, 2018: World Journal of Gastrointestinal Endoscopy
Roy Huynh, Matthew Ip, Jeff Chang, Craig Haifer, Rupert W Leong
Background and study aims:  Confocal laser endomicroscopy (CLE) allows mucosal barrier defects along the intestinal epithelium to be visualized in vivo during endoscopy. Training in CLE interpretation can be achieved didactically or through self-directed learning. This study aimed to compare the effectiveness of expert-led didactic with self-directed audiovisual teaching for training inexperienced analysts on how to recognize mucosal barrier defects on endoscope-based CLE (eCLE). Materials and methods:  This randomized controlled study involved trainee analysts who were taught how to recognize mucosal barrier defects on eCLE either didactically or through an audiovisual clip...
January 2018: Endoscopy International Open
John Gásdal Karstensen, Tatiana Cârţână, Codruţa Constantinescu, Silviu Dumitrașcu, Bojan Kovacevic, Pia Klausen, Hazem Hassan, Tobias Wirenfeldt Klausen, Helga Bertani, Manoop S Bhutani, Adrian Săftoiu, Peter Vilmann
Background and study aims:  Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is a keystone in diagnosing and staging of pancreatic masses. Recently, a microfiber that can pass through a 19-gauge needle has been introduced for confocal laser endomicroscopy (nCLE). The aims of this study were to evaluate the diagnostic value and the reproducibility of nCLE criteria for solid malignant lesions. Patients and methods:  This prospective dual-center study included patients with pancreatic masses suspicious of malignancy referred for EUS-FNA...
January 2018: Endoscopy International Open
Haibo Wang, Shuxin Wang, Jinhua Li, Siyang Zuo
Probe-based confocal laser endomicroscopy has a high potential to be a promising tool that can provide intraoperative high-resolution in vivo morphological imaging at cellular and subcellular levels for thyroidectomy, and allow real-time assessment of tumor margins. However, the typical images acquired with this technique cover a very small area limited by the field of view of the probe, accompanied by tissue deformation and inconsistent probe-tissue contact when operated manually. In this paper, a novel compact robotic device for large area scanning has been developed...
January 16, 2018: Annals of Biomedical Engineering
Bethany Mills, Ahsan R Akram, Emma Scholefield, Mark Bradley, Kevin Dhaliwal
Improving the speed and accuracy of bacterial detection is important for patient stratification and to ensure the appropriate use of antimicrobials. To achieve this goal, the development of diagnostic techniques to recognize bacterial presence in real-time at the point-of-care is required. Optical imaging for direct identification of bacteria within the host is an attractive approach. Several attempts at chemical probe design and validation have been investigated, however none have yet been successfully translated into the clinic...
November 29, 2017: Journal of Visualized Experiments: JoVE
Yi-Quan Xiong, Shu-Juan Ma, Hao-Yue Hu, Jing Ge, Li-Zhi Zhou, Shu-Ting Huo, Min Qiu, Qing Chen
AIMS: Barrett's esophagus (BE) predisposes to the development of esophageal neoplasia, including high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). A systematic literature review and meta-analysis were performed to assess the accuracy of within-patient comparisons of narrow band imaging (NBI) and confocal laser endomicroscopy (CLE) for diagnosis of HGD/EAC in patients with BE. METHODS: The following databases were examined up to April 2016 without language restriction: PubMed, Embase, Medline, Web of Science and the Cochrane Library...
December 22, 2017: Clinics and Research in Hepatology and Gastroenterology
Tibor Kovács, Domokos Máthé, András Fülöp, Katalin Jemnitz, Attila Bátai-Konczos, Zsuzsanna Veres, György Török, Dániel Sándor Veres, Ildikó Horváth, Krisztián Szigeti, László Homolya, Attila Szijártó
Selective portal vein ligation (PVL) allows the two-stage surgical resection of primarily unresectable liver tumours by generating the atrophy and hypertrophy of portally ligated (LL) and non-ligated lobes (NLL), respectively. To evaluate critically important underlying functional alterations, present study characterised in vitro and vivo liver function in male Wistar rats (n = 106; 210-250 g) before, and 24/48/72/168/336 h after PVL. Lobe weights and volumes by magnetic resonance imaging confirmed the atrophy-hypertrophy complex...
December 22, 2017: Scientific Reports
Jessica R Perez, Norma Ybarra, Frederic Chagnon, Monica Serban, Gabriel Pare, Olivier Lesur, Jan Seuntjens, Issam El Naqa
Radiation-induced pulmonary fibrosis (RIPF) is a debilitating side effect of radiation therapy (RT) of several cancers including lung and breast cancers. Current clinical methods to assess and monitor RIPF involve diagnostic computed tomography (CT) imaging, which is restricted to anatomical macroscopic changes. Confocal laser endomicroscopy (CLE) or fluorescence endomicroscopy (FE) in combination with a fibrosis-targeted fluorescent probe allows to visualize RIPF in real-time at the microscopic level. However, a major limitation of FE imaging is the lack of anatomical localization of the endomicroscope within the lung...
December 19, 2017: Scientific Reports
Jintao Guo, Manoop S Bhutani, Marc Giovannini, Zhaoshen Li, Zhendong Jin, Aiming Yang, Guoqiang Xu, Guiqi Wang, Siyu Sun
New applications of confocal laser endomicroscopy (CLE) have been developed, such as needle-based CLE (nCLE) for pancreatic masses, pancreatic cystic tumors, and lymph nodes. nCLE is feasible during endoscopic ultrasound (EUS) examination, and preliminary results are very encouraging and suggest this technology may be used in future as a useful adjunct in cases of inconclusive EUS-guided fine-needle aspiration. The aim of this paper is to give an update in this new technology and to define its place in the diagnosis of pancreatic masses and mediastinal diseases...
November 2017: Endoscopic Ultrasound
Cristian Gheorghe, Gabriel Becheanu, Razvan Iacob, Bogdan Cotruta, Anca Dimitriu
No abstract text is available yet for this article.
December 2017: Endoscopy
Gábor Bari, Szilárd Szűcs, Dániel Érces, Melinda Ugocsai, Noémi Bozsó, Dóra Balog, Mihály Boros, Gabriella Varga
INTRODUCTION: Pericardial tamponade (PT) is a life-threatening condition, with low cardiac output. The hemodynamic consequences of PT can severely affect the circulation of all tissues, including the microcirculation of the kidneys and the intestinal mucosa. Our aim was to develop a hemodynamically stable and controllable large animal model of PT to study the consequences of cardiogenic shock. METHODS: Two groups of anesthetized vietnamese minipigs (n = 6, both groups) were used...
December 2017: Magyar Sebészet
Claude Le Pen, Laurent Palazzo, Bertrand Napoléon
Background and study aims:  The low sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), especially for the diagnosis of serous cystadenomas (SCAs), can be associated with diagnostic uncertainty that can regularly lead to unnecessary surgical procedures. Needle-based confocal laser endomicroscopy (nCLE) used with EUS-FNA improves diagnostic accuracy, helping to reduce unnecessary surgery and patient follow-up. This study was conducted to evaluate the economic benefit of EUS-FNA + nCLE...
October 2017: Endoscopy International Open
S Aeishen, Y Dawood, S Papadoukakis, M Horstmann
White light cystoscopy (WL) is the gold standard for the detection of bladder cancer. It can be performed using a rigid or flexible urethrocystoscope. With the more recent introduction of high definition (HD) techniques, WL cystoscopy has been decisively improved. Supplementary optical techniques are also used to improve the detection of bladder cancer. Among these are photodynamic diagnosis (PDD), narrow-band imaging (NBI), S‑technologies of IMAGE1 S, optical coherence tomography (OCT), confocal laser endomicroscopy (CLE), and Raman spectroscopy...
November 6, 2017: Der Urologe. Ausg. A
Gian Eugenio Tontini, Jonas Mudter, Michael Vieth, Claudia Günther, Valentina Milani, Raja Atreya, Timo Rath, Andreas Nägel, Giorgia Hatem, Giacomo Carlo Sturniolo, Maurizio Vecchi, Markus F Neurath, Peter R Galle, Andrea Buda, Helmut Neumann
BACKGROUND AND AIMS: Assessment of prognostic factors in patients with Crohn's disease (CD) is of pivotal importance for early intervention and "treat-to-target" strategies. Confocal laser endomicroscopy (CLE) enables on-demand in vivo characterization of mucosal inflammatory and architectural changes during endoscopy. We prospectively assessed the value of CLE for prediction of clinical outcome parameters in CD. METHODS: Consecutive patients with CD undergoing colonoscopy were included in a multicenter study...
November 3, 2017: Gastrointestinal Endoscopy
Tim D G Belderbos, Martijn G H van Oijen, Leon M G Moons, Peter D Siersema
Background and aims:  Probe-based confocal laser endomicroscopy (pCLE) is used to differentiate between neoplastic and non-neoplastic colorectal polyps during colonoscopy. We aimed to assess the accuracy of two endoscopists starting to use real-time pCLE for differentiation of colorectal polyps and to determine the negative predictive value (NPV) for neoplasia in polyps ≤ 5 mm. Methods:  Patients undergoing colonoscopy in a tertiary hospital were included in this prospective trial...
November 2017: Endoscopy International Open
Tsuyoshi Takahashi, Rie Nakatsuka, Hisashi Hara, Shigeyoshi Higashi, Kouji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Shuji Takiguchi, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
BACKGROUND: Intestinal ischemia can lead to fatal complications if left unrecognized during surgery. The current techniques of intraoperative microvascular assessment remain subjective. Probe-based confocal laser endomicroscopy (pCLE) has the potential to objectively evaluate microvascular blood flow in real-time setting. The present study evaluated the technical feasibility of real-time intestinal bloodstream evaluation using pCLE in a porcine intestinal ischemia model. METHODS: Seven pigs were used...
October 24, 2017: Surgical Endoscopy
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