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Reduced Intravenous Fluorescein Dose for Upper and Lower Gastrointestinal Tract Probe-Based Confocal Laser Endomicroscopy
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Kazuya Inoki, Seiichiro Abe, Yusaku Tanaka, Koji Yamamoto, Daisuke Hihara, Ryoji Ichijima, Yukihiro Nakatani, HsinYu Chen, Hiroyuki Takamaru, Masau Sekiguchi, Masayoshi Yamada, Taku Sakamoto, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Ichiro Oda, Takahisa Matsuda, Yutaka Saito
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Clin Endosc 2021;54(3):363-370. Published online September 8, 2020
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DOI: https://doi.org/10.5946/ce.2020.058
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 Abstract
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- Background
/Aims: Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE.
Methods
Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in the study. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination of the optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by three endoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were not deemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated.
Results
A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to 0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLE with IV fluorescein at 0.5 mg/kg.
Conclusions
In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both the upper and lower GI tract.
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Citations
Citations to this article as recorded by  - Prospective assessment of probe‐based confocal laser endomicroscopy under direct cholangioscopic visualization for biliary strictures that could not be definitively diagnosed using endoscopic retrograde cholangiopancreatography (with video)
Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Ryuichi Watanabe, Ryo Sato, Tomoaki Tashima, Yumi Mashimo
DEN Open.2025;[Epub] CrossRef - Precision endoscopy in colorectal polyps' characterization and planning of endoscopic therapy
Francesco Vito Mandarino, Silvio Danese, Toshio Uraoka, Adolfo Parra‐Blanco, Yasuharu Maeda, Yutaka Saito, Shin‐Ei Kudo, Michael J. Bourke, Marietta Iacucci
Digestive Endoscopy.2024; 36(7): 761. CrossRef
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