Clinical Endoscopy

Case Report

High-Resolution Probe-Based Confocal Laser Endomicroscopy for Diagnosing Biliary Diseases: Hiroki Koda, Kazuo Hara, Okuno Nozomi, Takamichi Kuwahara, Mizuno Nobumasa, Shin Haba, Miyano Akira, Isomoto Hajime; Clin Endosc 2021;54(6):924-929. Published online March 15, 2021; DOI: https://doi.org/10.5946/ce.2020.191

Probe-based confocal laser endomicroscopy is an endoscopic technique that enables in vivo histological evaluation using fluorescent pigment. The ability to diagnostically differentiate between benign and malignant biliary disease using the “CholangioFlex^TM”, a dedicated biliary device, has been reported. However, the Miami and Paris classifications, used as diagnostic criteria, mainly evaluate findings in the submucosa, and visualizing the epithelium as the main site of lesions remains difficult. To address this problem, we verified the imaging findings and diagnostic ability of three types of probes: CholangioFlex^TM, GastroFlex^TM, and AlveoFlex^TM. With GastroFlex^TM, the clear mucosal epithelium was observed, and differential diagnoses as benign/malignant could be made based on epithelial findings. GastroFlex^TM may be a good first-choice probe for probe-based confocal laser endomicroscopy of biliary diseases, and a new diagnostic classification based on bile duct epithelial findings may provide useful criteria independent of the Miami or Paris classifications.

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Cholangioscopy-based convoluted neuronal network vs. confocal laser endomicroscopy in identification of neoplastic biliary strictures
Carlos Robles-Medranda, Jorge Baquerizo-Burgos, Miguel Puga-Tejada, Domenica Cunto, Maria Egas-Izquierdo, Juan Carlos Mendez, Martha Arevalo-Mora, Juan Alcivar Vasquez, Hannah Lukashok, Daniela Tabacelia
Endoscopy International Open.2024; 12(10): E1118. CrossRef

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Original Article

Confocal Laser Endomicroscopic Findings of Refractory Erosive Reflux Disease versus Non-Erosive Reflux Disease with Anti-Reflux Mucosectomy: An in vivo and ex vivo Study: Eunju Jeong, In Kyung Yoo, Abdullah Özgür Yeniova, Dong Keon Yon, Joo Young Cho; Clin Endosc 2021;54(1):55-63. Published online May 7, 2020; DOI: https://doi.org/10.5946/ce.2020.040

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: To date, there is no standard tool to diagnose gastroesophageal reflux disease (GERD). Typically, GERD is a non-erosive reflux disease (NERD) that does not present endoscopic abnormalities. Confocal laser endomicroscopy (CLE) has been shown to be an effective tool to identify and diagnose GERD. We aimed to investigate the cellular and vascular changes in vivo and ex vivo through CLE in patients with GERD.
Methods
Patients with refractory GERD who underwent mucosectomy were recruited. The distal esophagus was observed in vivo using CLE. Mucosectomy tissue was stained with acriflavine and CLE image was obtained ex vivo. We compared cellular and vascular changes in CLE between erosive reflux disease (ERD), NERD, and a control group.
Results
Eleven patients who underwent anti-reflux mucosectomy and five control patients were enrolled in the study. Patients with ERD and NERD presented greater dilated intercellular space than patients in the control group on CLE image. The diameter, number, and cross-sectional area of the intra-papillary capillary loops (IPCLs) were significantly larger in the ERD group than in the NERD group. The irregular shape of the IPCLs were observed in both patients with ERD and NERD.
Conclusions
The irregular shape of the IPCLs were significantly correlated with a positive diagnosis of GERD. CLE may diagnose NERD with high sensitivity and accuracy.

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Outcomes of Endoscopic Antireflux Mucosectomy for the Treatment of Gastroesophageal Reflux Disease
Martin Galvarini, Cristian A. Angeramo, Javier Kerman, Rubén Balmaceda, Ignacio Debes, Fernando A.M. Herbella, Francisco Schlottmann
Journal of Clinical Gastroenterology.2024; 58(9): 851. CrossRef
Gastroesophageal reflux disease: indications for antireflux surgery, outcomes, and side effects
Francisco Schlottmann, Sofia Bertona, Fernando A.M. Herbella, Marco G. Patti
Expert Review of Gastroenterology & Hepatology.2024; 18(11): 693. CrossRef
Efficacy and safety of antireflux mucosectomy versus radiofrequency ablation of the lower esophageal sphincter for the treatment of GERD: a systematic review and meta-analysis
Cristian A. Angeramo, Mateo Lendoire, Fernando A.M. Herbella, Francisco Schlottmann
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Anti-reflux mucosal resection for treatment of refractory gastro-oesophageal reflux disease: Efficacy and impact on perioperative indicators
Xing-Feng Ge, Xian Zhu, Fei Min, Jian-Wei Shen
World Chinese Journal of Digestology.2023; 31(4): 157. CrossRef

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Review

The Role of Needle-Based Confocal Laser Endomicroscopy in the Evaluation of Pancreatic Cystic Lesions: A Systematic Review: Yung Ka Chin, Clement Chun Ho Wu, Damien Meng Yew Tan; Clin Endosc 2021;54(1):38-47. Published online March 31, 2020; DOI: https://doi.org/10.5946/ce.2019.200-IDEN

Abstract PDF PubReader ePub

The prevalence of pancreatic cystic lesions (PCLs) has increased recently due to the increased use of cross-sectional abdominal imaging and the ageing global population. Current diagnostic techniques are inadequate to distinguish between PCLs that require surgery, close surveillance, or expectant management. This has resulted in increased morbidity from both inappropriately aggressive and conservative management strategies. Needle-based confocal laser endomicroscopy (nCLE) has allowed microscopic examination and visual delineation of the surface epithelium of PCLs. Landmark studies in this decade have correlated nCLE and histological findings and identified characteristics differentiating various types of PCLs. Subsequent studies have confirmed the high diagnostic yield of nCLE and its diagnostic utility in PCLs with an equivocal diagnosis. Moreover, nCLE has been shown to improve the diagnostic yield of PCLs. This will help avoid unnecessary pancreatic surgery, which carries significant morbidity and mortality risks. The early detection of high-grade dysplasia in PCLs will provide early surgical treatment and improve outcomes for pancreatic cancer. Despite the high upfront cost of nCLE, the improved diagnostic accuracy and resultant appropriate management have resulted in improved cost effectiveness. Refining the procedure technique and limiting the procedure length have significantly improved the safety of nCLE. A structured training program and device improvements to allow more complete mapping of the pancreatic cyst epithelium will be crucial for the widespread adoption of this promising technology.

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Molecular Pathology of Pancreatic Cystic Lesions with a Focus on Malignant Progression
Yan Hu, Dan Jones, Ashwini K. Esnakula, Somashekar G. Krishna, Wei Chen
Cancers.2024; 16(6): 1183. CrossRef
Applications and Prospects of Artificial Intelligence-Assisted Endoscopic Ultrasound in Digestive System Diseases
Jia Huang, Xiaofei Fan, Wentian Liu
Diagnostics.2023; 13(17): 2815. CrossRef
EUS-guided fine needle aspiration-based clues to mistaken or uncertain identity: serous pancreatic cysts
Michele T. Yip-Schneider, Rodica Muraru, Rachel C. Kim, Howard H. Wu, Stuart Sherman, Aditya Gutta, Mohammad A. Al-Haddad, John M. Dewitt, C. Max Schmidt
HPB.2023; 25(12): 1587. CrossRef
Current trends in the management of pancreatic cystic neoplasms in Korea: a national survey
Hyung Ku Chon, Sung Hoon Moon, Sang Wook Park, Woo Hyun Paik, Chang Nyol Paik, Byoung Kwan Son, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Jae Min Lee, Tae Joo Jeon, Chang-Hwan Park, Kwang Bum Cho, Dong Wook Lee
The Korean Journal of Internal Medicine.2022; 37(1): 63. CrossRef
Confocal Laser Endomicroscopy in the Diagnosis of Biliary and Pancreatic Disorders: A Systematic Analysis
Do Han Kim, Somashekar G. Krishna, Emmanuel Coronel, Paul T. Kröner, Herbert C. Wolfsen, Michael B. Wallace, Juan E. Corral
Clinical Endoscopy.2022; 55(2): 197. CrossRef
Accuracy and agreement of a large panel of endosonographers for endomicroscopy-guided virtual biopsy of pancreatic cystic lesions
Jorge D. Machicado, Bertrand Napoleon, Anne Marie Lennon, Samer El-Dika, Stephen P. Pereira, Damien Tan, Rahul Pannala, Mohit Girotra, Pradermchai Kongkam, Helga Bertani, Yunlu Feng, Hao Sijie, Ning Zhong, Vincent Valantin, Sarah Leblanc, Alice Hinton, So
Pancreatology.2022; 22(7): 994. CrossRef
Pancreatic Cystic Lesions: A Focused Review on Cyst Clinicopathological Features and Advanced Diagnostics
Wei Chen, Nehaal Ahmed, Somashekar G. Krishna
Diagnostics.2022; 13(1): 65. CrossRef
Diagnostic Value of Endomicroscopy for Gastrointestinal Diseases: New Possibilities and Concepts
Ralf Kiesslich
Techniques and Innovations in Gastrointestinal Endoscopy.2021; 23(1): 57. CrossRef

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Original Article

Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms: Piyapan Prueksapanich, Thanawat Luangsukrerk, Rapat Pittayanon, Anapat Sanpavat, Rungsun Rerknimitr; Clin Endosc 2019;52(2):144-151. Published online October 5, 2018; DOI: https://doi.org/10.5946/ce.2018.091

Abstract PDF PubReader ePub

Background
/Aims: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) and Lugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamous cell neoplasms (ESCNs) in patients with a history of head and neck cancer.
Methods
From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology has historically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined.
Results
Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelial neoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy of dNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively.
Conclusions
The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detecting esophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guided biopsy could reduce the number of unnecessary biopsies.

Citations

Citations to this article as recorded by

Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer
Wei Han, Rui Kong, Nan Wang, Wen Bao, Xinli Mao, Jie Lu
Cancers.2023; 15(3): 776. CrossRef
Usefulness of Probe-Based Confocal Laser Endomicroscopy for Esophageal Squamous Cell Neoplasm
Sang Kil Lee
Clinical Endoscopy.2019; 52(2): 91. CrossRef
Confocal Laser Endomicroscopy as a Guidance Tool for Pleural Biopsies in Malignant Pleural Mesothelioma
Lizzy Wijmans, Paul Baas, Thomas E. Sieburgh, Daniel M. de Bruin, Petra M. Ghuijs, Marc J. van de Vijver, Peter I. Bonta, Jouke T. Annema
Chest.2019; 156(4): 754. CrossRef

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Focused Review Series: Current Status of Endoscopy in the Management of Inflammatory Bowel Disease

Role of Advanced Endoscopic Imaging Techniques in the Management of Inflammatory Bowel Disease: Eun Soo Kim; Clin Endosc 2017;50(5):424-428. Published online September 29, 2017; DOI: https://doi.org/10.5946/ce.2017.143

Abstract PDF PubReader ePub

Endoscopy plays a crucial role in the management of inflammatory bowel disease (IBD) in terms of diagnosis, monitoring of mucosal status, and surveillance of colitis-associated neoplasia. Mucosal healing evaluated by endoscopy has been recognized as the target of treatment in the era of powerful biologics therapy. The optimal modality for identifying dysplasia in IBD has yet to be well defined. Increasing progress has recently been made in endoscopic technologies to more accurately assess mucosal inflammation and more effectively detect dysplasia. Here we review the data of advanced endoscopic imaging techniques such as chromoendoscopy, virtual chromoendoscopy, endocytoscopy, and confocal laser endomicroscopy in the management of IBD.

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Moxifloxacin promotes two-photon microscopic imaging for discriminating different stages of DSS-induced colitis on mice
Yingtong Chen, Xiaoyi Xu, Min Wang, Xiang Wang, Yan Wang, Yong Zhang, Jin Huang, Yuwen Tao, Wentao Fan, Lili Zhao, Li Liu, Zhining Fan
Photodiagnosis and Photodynamic Therapy.2024; 48: 104220. CrossRef
Meta-analysis of Virtual-based Chromoendoscopy Compared With Dye-spraying Chromoendoscopy Standard and High-definition White Light Endoscopy in Patients With Inflammatory Bowel Disease at Increased Risk of Colon Cancer
Mohammed El-Dallal, Ye Chen, Qianyun Lin, Shana Rakowsky, Lindsey Sattler, Joshua Foromera, Laurie Grossberg, Adam S Cheifetz, Joseph D Feuerstein
Inflammatory Bowel Diseases.2020; 26(9): 1319. CrossRef
Artificial intelligence‐assisted endoscopy changes the definition of mucosal healing in ulcerative colitis
Hiroshi Nakase, Takehiro Hirano, Kohei Wagatsuma, Tadashi Ichimiya, Tsukasa Yamakawa, Yoshihiro Yokoyama, Yuki Hayashi, Daisuke Hirayama, Tomoe Kazama, Shinji Yoshii, Hiro‐o Yamano
Digestive Endoscopy.2020;[Epub] CrossRef
Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease
Kyeong Ok Kim, Michael V. Chiorean
Intestinal Research.2020; 18(4): 438. CrossRef
Surgical Management of Dysplasia and Cancer in Inflammatory Bowel Disease
James Ansell, Fabian Grass, Amit Merchea
Surgical Clinics of North America.2019; 99(6): 1111. CrossRef

6,960 View
180 Download
6 Web of Science
5 Crossref

Review

Application and Efficacy of Super-Magnifying Endoscopy for the Lower Intestinal Tract: Naoki Hosoe, Haruhiko Ogata; Clin Endosc 2016;49(1):37-40. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.37

Abstract PDF PubReader ePub

Endoscopy plays a significant role in the diagnosis, management, and surveillance of colorectal cancer (CRC) and inflammatory bowel diseases (IBDs). Moreover, magnifying endoscopy and image-enhanced endoscopy has a crucial role in the clinical setting. Recently, a super-magnifying endoscope has been developed, and two devices, confocal laser endomicroscopy (CLE) and an endocytoscopy system (ECS), which allow in vivo microscopic inspection of the microstructural mucosal features of the gastrointestinal tract, are currently available. Studies on the use of ECS in CRC were reported by a Japanese group. Additionally, a few studies on the use of ECS in IBD have been reported. CLE has been shown to be reliable in assessing the activity of the disease in IBDs in both ulcerative colitis and Crohn’s disease. Various published studies evaluated the use of CLE during colonoscopy to distinguish colorectal polyp pathology and neoplasia. However, these studies are heterogeneous, and further evidence is necessary to confirm the efficacy of CLE.

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From clinical uncertainties to precision medicine: the emerging role of the gut barrier and microbiome in small bowel functional diseases
Wojciech Marlicz, Diana E Yung, Karolina Skonieczna-Żydecka, Igor Loniewski, Saskia van Hemert, Beata Loniewska, Anastasios Koulaouzidis
Expert Review of Gastroenterology & Hepatology.2017; 11(10): 961. CrossRef

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Focused Review Series: Image Enhanced Endoscopy

Usefulness and Future Prospects of Confocal Laser Endomicroscopy for Gastric Premalignant and Malignant Lesions: Sang Kil Lee; Clin Endosc 2015;48(6):511-515. Published online November 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.6.511

Abstract PDF PubReader ePub

Confocal laser endomicroscopy (CLE) is a new technology enabling endoscopists to visualize tissue at the cellular level. CLE has the fundamental potential to provide a histologic diagnosis, and may theoretically replace or reduce the need for performing biopsy for histology. The clinical benefits of CLE are more obvious in esophageal disease, including Barrett’s esophagus. Currently, this technology has been adapted to the diagnosis and surveillance of Barrett’s esophagus and related neoplasia. Standard white light endoscopy is the primary tool for gastric cancer screening. Currently, the only method available to precisely diagnose these lesions is upper endoscopy with an appropriate biopsy. A recent study showed that CLE could characterize dysplasia or cancer and identify the risk factors for gastric cancer, such as intestinal metaplasia and the presence of Helicobacter pylori in vivo, although fewer studies on CLE were performed on the stomach than on Barrett’s esophagus and other esophageal diseases. However, the application of CLE to routine clinical endoscopy continues to be refined. This review focused on the usefulness and future prospects of CLE for gastric premalignant and malignant lesions.

Citations

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Newly proposed quantitative criteria can assess chronic atrophic gastritis via probe-based confocal laser endomicroscopy (pCLE): a pilot study
Carlos Robles-Medranda, Miguel Puga-Tejada, Roberto Oleas, Jorge Baquerizo-Burgos, Juan Alcívar-Vásquez, Raquel Del Valle, Carlos Cifuentes-Gordillo, Haydee Alvarado-Escobar, Daniel Ponce-Velez, Jesenia Ospina-Arboleda, Hannah Pitanga-Lukashok
Endoscopy International Open.2022; 10(04): E297. CrossRef
Probe-Based Confocal Laser Endomicroscopy versus White-Light Endoscopy with Narrow-Band Imaging for Predicting and Collecting Residual Cancer Tissue in Patients with Gastric Cancer Receiving Chemotherapy
Yuna Kim, Hyunki Kim, Minkyu Jung, Sun Young Rha, Hyun Cheol Chung, Sang Kil Lee
Cancers.2022; 14(17): 4319. CrossRef
Usefulness of Probe-Based Confocal Laser Endomicroscopy for Esophageal Squamous Cell Neoplasm
Sang Kil Lee
Clinical Endoscopy.2019; 52(2): 91. CrossRef
High prevalence of gastric intestinal metaplasia detected by confocal laser endomicroscopy in Zambian adults
Violet Kayamba, Aaron Shibemba, Kanekwa Zyambo, Douglas C. Heimburger, Douglas R. Morgan, Paul Kelly, Esaki M. Shankar
PLOS ONE.2017; 12(9): e0184272. CrossRef

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Focused Review Series: Endoscopic and Molecular Imaging of Premalignant GI Lesions, Part II

Confocal Laser Endomicroscopy and Molecular Imaging in Barrett Esophagus and Stomach: Kwi-Sook Choi, Hwoon-Yong Jung; Clin Endosc 2014;47(1):23-30. Published online January 24, 2014; DOI: https://doi.org/10.5946/ce.2014.47.1.23

Abstract PDF PubReader ePub

Detection of premalignant lesions in the upper gastrointestinal tract may facilitate endoscopic treatment and improve survival. Despite technological advances in white light endoscopy, its ability to detect premalignant lesions remains limited. Early detection could be improved by using advanced endoscopic imaging techniques, such as magnification endoscopy, narrow band imaging, i-scanning, flexible spectral imaging color enhancement, autofluorescence imaging, and confocal laser endomicroscopy (CLE), as these techniques may increase the rate of detection of mucosal abnormalities and allow optical diagnosis. The present review focuses on advanced endoscopic imaging techniques based on the use of CLE for diagnosing premalignant lesions in Barrett esophagus and stomach.

Citations

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The Use of Confocal Laser Endomicroscopy in Diagnosing Barrett’s Esophagus and Esophageal Adenocarcinoma
Jitka Vaculová, Radek Kroupa, Zdeněk Kala, Jiří Dolina, Tomáš Grolich, Jakub Vlažný, David Said, Lydie Izakovičová Hollá, Petra Bořilová Linhartová, Vladimír Procházka, Marek Joukal, Petr Jabandžiev, Ondřej Slabý, Lumír Kunovský
Diagnostics.2022; 12(7): 1616. CrossRef
Probe‐based confocal laser endomicroscopy versus biopsies in the diagnostics of oesophageal and gastric lesions: A prospective, pathologist‐blinded study
Marek Kollar, Jana Krajciova, Lucia Prefertusova, Eva Sticova, Jana Maluskova, Zuzana Vackova, Jan Martinek
United European Gastroenterology Journal.2020; 8(4): 436. CrossRef

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Review

Recent Advances in Image-enhanced Endoscopy: Won Young Cho, Jae Young Jang, Don Haeng Lee, The Endoscopic Technology and Investigation Study Group; Clin Endosc 2011;44(2):65-75. Published online December 31, 2011; DOI: https://doi.org/10.5946/ce.2011.44.2.65

Abstract PDF PubReader ePub

The desire to better recognized such malignancies, which may be difficult to distinguish from inflammation or trauma, has accelerated the development of endoscopy with new optical technologies. Narrow-band imaging is a novel endoscopic technique that may enhance the accuracy of diagnosis using narrow-bandwidth filters in a red-green-blue sequential illumination system. Autofluorescence imaging is based on the detection of natural tissue fluorescence emitted by endogenous molecules. I-scan technology using a digital filter that modifies normal images through software functions, is the newly developed image-enhanced endoscopic technology from PENTAX. Flexible spectral imaging color enhancement enhances the visualization of mucosal structure and microcirculation by the selection of spectral transmittance with a dedicated wavelength. Confocal laser endomicroscopy images were collected with an argon beam with a scanning depth of 0 (epithelium) to 250 µm (lamina propria) and analyzed using the reflected light.

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A color‐based tumor segmentation method for clinical ex vivo breast tissue assessment utilizing a multi‐contrast brightfield imaging strategy
Roujia Wang, Lillian Ekem, Jennifer Gallagher, Rachel E. Factor, Allison Hall, Nimmi Ramanujam
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From Staining Techniques to Artificial Intelligence: A Review of Colorectal Polyps Characterization
Kareem Khalaf, Mary Raina Angeli Fujiyoshi, Marco Spadaccini, Tommy Rizkala, Daryl Ramai, Matteo Colombo, Alessandro Fugazza, Antonio Facciorusso, Silvia Carrara, Cesare Hassan, Alessandro Repici
Medicina.2024; 60(1): 89. CrossRef
Spectral Endoscopy: Technical Means and Methods
Vitold E. Pozhar
Light & Engineering.2022; (06-2022): 7. CrossRef
A survey of feature extraction and fusion of deep learning for detection of abnormalities in video endoscopy of gastrointestinal-tract
Hussam Ali, Muhammad Sharif, Mussarat Yasmin, Mubashir Husain Rehmani, Farhan Riaz
Artificial Intelligence Review.2020; 53(4): 2635. CrossRef
RESEARCH AND DEVELOPMENT OF METHODS FOR ENDOSCOPIC (MEDICAL) IMAGES ENHANCEMENT
N. A. Obukhova, A. A. Motyko, A. A. Pozdeev
Journal of the Russian Universities. Radioelectronics.2019; (2): 22. CrossRef
Surgical Management of Dysplasia and Cancer in Inflammatory Bowel Disease
James Ansell, Fabian Grass, Amit Merchea
Surgical Clinics of North America.2019; 99(6): 1111. CrossRef
Computer assisted gastric abnormalities detection using hybrid texture descriptors for chromoendoscopy images
Hussam Ali, Mussarat Yasmin, Muhammad Sharif, Mubashir Husain Rehmani
Computer Methods and Programs in Biomedicine.2018; 157: 39. CrossRef
Does the Numerical Colour Value (NCV) correlate with preneoplastic and neoplastic colorectal lesions?
Natalia Strzelczyk, Sebastian Kwiatek, Wojciech Latos, Aleksander Sieroń, Agata Stanek
Photodiagnosis and Photodynamic Therapy.2018; 23: 353. CrossRef
Method for Separation of Blood Vessels on the Three-Color Images of Biological Tissues
S. A. Lisenko
Journal of Applied Spectroscopy.2017; 84(3): 439. CrossRef
Image Quality Analysis of Various Gastrointestinal Endoscopes: Why Image Quality Is a Prerequisite for Proper Diagnostic and Therapeutic Endoscopy
Weon Jin Ko, Pyeong An, Kwang Hyun Ko, Ki Baik Hahm, Sung Pyo Hong, Joo Young Cho
Clinical Endoscopy.2015; 48(5): 374. CrossRef
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The Past, Present, and Future of Image-Enhanced Endoscopy
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Clinical Endoscopy.2015; 48(6): 466. CrossRef
Diagnostic Efficacy of Magnifying Endoscopy with Narrow-Band Imaging for Gastric Neoplasms: A Meta-Analysis
Xiuhe Lv, Chunhui Wang, Yan Xie, Zhaoping Yan, Robert L Schmidt
PLOS ONE.2015; 10(4): e0123832. CrossRef
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Mingjun Song, Tiing Leong Ang
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Molecular Imaging for Theranostics in Gastroenterology: One Stone to Kill Two Birds
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Ilze Kikuste, Raul Marques-Pereira, Matilde Monteiro-Soares, Pedro Pimentel-Nunes, Miguel Areia, Marcis Leja, Mário Dinis-Ribeiro
Scandinavian Journal of Gastroenterology.2013; 48(10): 1108. CrossRef
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Red-Flag Technologies in Gastric Neoplasia
Susana Gonzalez
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Original Article

Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms: Published online November 30, 1999

Abstract: Background
/Aims: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) and Lugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamous cell neoplasms (ESCNs) in patients with a history of head and neck cancer.
Methods
From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology has historically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined.
Results
Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelial neoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy of dNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively.
Conclusions
The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detecting esophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guided biopsy could reduce the number of unnecessary biopsies.

1,744 View
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