Abstract

Confocal laser endomicroscopy (CLE) is a novel microscope which enables real-time imaging with detailed mucosal and sub mucosal architectures throughout the gastrointestinal tract. New optical technology using the principle of light reflection, scattering and refocusing dramatically increases image resolution thus has the potential of real time optical biopsy. Two types of CLE system are commercially available; endoscope-based type (eCLE) which integrated CLE in the tip of scope and probe-based type (pCLE) which uses a probe through the accessory channel of a traditional endoscope. Clinical data applying CLE for the detection of neoplastic lesions in the gastrointestinal tract have been increasingly reported including esophagus, stomach and colon. The probe based system has a probe that can be used in the bile ducts to evaluate biliary strictures. More recently, a needle based CLE which passes through a fine-needle aspiration needle has been introduced into pancreatic cystic lesions. CLE has demonstrated promising in vivo data in various clinical arenas. Further validation regarding reproducible image classification, inter and intra observer variability, learning curve, and cost effectiveness remain to be demonstrated.

Keywords: Confocal laser endomicroscopy; Chromoendoscopy; Barrett’s esophagus; Esophageal cancer; Colon cancer; Endoscopic ultrasonography; Biliary stricture; Pancreatic cystic neoplasia