Mo1521 Endomicroscopy: Interobserver Agreement and Accuracy in Prediction of Intraepithelial Neoplasia in the Upper and Lower GI-Tract

In vivo endomicroscopy improves detection of Barrett’s esophagus–related neoplasia: a multicenter international randomized controlled trial

Background Confocal laser endomicroscopy (CLE) enables in vivo microscopic imaging of the GI tract mucosa. However, there are limited data on endoscope-based CLE (eCLE) for imaging Barrett's esophagus (BE). Objective To compare high-definition white-light endoscopy (HDWLE) alone with random biopsy (RB) and HDWLE + eCLE and targeted biopsy (TB) for diagnosis of BE neoplasia. Design Multicenter, randomized, controlled trial. Setting Academic medical centers. Patients Adult patients with BE undergoing routine surveillance or referred for early neoplasia. Intervention Patients were randomized to HDWLE + RB (group 1) or HDWLE + eCLE + TB (group 2). Real-time diagnoses and management plans were r…

1136 In Vivo Endoscope-Based Confocal Laser Endomicroscopy (eCLE) Improves Detection of Unlocalized Barrett's Esophagus-Related Neoplasia Over High Resolution White Light Endoscopy: an International Multicenter Randomized Controlled Trial

Simultaneous confocal laser endomicroscopy and chromoendoscopy with topical cresyl violet

Background Confocal laser endomicroscopy (CLE) has been shown to reliably predict histology during ongoing endoscopy. To unmask lesions for CLE, chromoendoscopy has been mandated. Usually fluorescein then serves as a contrast agent for CLE, but it does not allow direct nuclear visualization, must be injected, leads to a transient skin discoloration, and may have allergic side effects. Objective To establish a single topical dye, cresyl violet (CV), for simultaneous chromoendoscopy and in vivo CLE of the lower GI tract. Design Animal preclinical study, prospective clinical trial. Setting Mainz University Clinic (tertiary care center). Patients, Methods, and Interventions To establish the sta…

Examination Technique of Confocal Laser Endomicroscopy

The first publication about a confocal fluorescence microscope integrated into the distal tip of a conventional colonoscope (Pentax EC 3830FK, Tokyo, Japan) appeared in 2004 [1], showing that in vivo microscopy at subcellular resolution (0.7 µm) simultaneously displayed with white-light endoscopy had become possible. Today, endomicroscopy can be performed in the upper and lower GI tract [2]–[10]. This chapter deals with the examination technique of confocal laser endomicroscopy.