The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract

Aliment Pharmacol Ther 31, 548–552 Summary Background  Confocal laser endomicroscopy (CLE) is rapidly emerging as a valuable tool for gastrointestinal endoscopic imaging. Fluorescent contrast agents are used to optimize imaging with CLE, and intravenous fluorescein is the most widely used contrast agent. Fluorescein is FDA-cleared for diagnostic angiography of the retina. For these indications, the safety profile of fluorescein has been well-documented; however, to date, fluorescein is not cleared for use with CLE. Aims  To estimate the rate of serious and total adverse events attributable to intravenous fluorescein when used for gastrointestinal CLE. Methods  We performed a cross sectional…

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

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.