Endoscopic confocal microscopy.
OBJECTIVE
Endoscopic confocal microscopy is a new endoscopic imaging technology that produces high-magnification cross-sectional images of the gastrointestinal epithelium during endoscopy. These high-magnification images might allow the endoscopist to make a tissue diagnosis during endoscopy without biopsy and histopathology. The purpose of this article is to review the salient features of endoscopic confocal microscopy, describe current clinical research areas using the technology, and depict its potential role in the management of gastrointestinal diseases. This review includes an overview of the technology, a review of recent publications describing its function, and a discussion of potential applications.


RESULTS
Endoscopic confocal microscopy has been technologically feasible only for a short time; therefore, the published experience is limited. Studies describing the use of endoscopic confocal microscopy for the detection of dysplastic tissue have been limited to a single paper in which endoscopic confocal microscopy was reported to be highly sensitive and specific for the detection of colonic dysplasia in a general screening population. Active areas of investigation include detecting dysplasia in ulcerative colitis and Barrett's esophagus. A recent case report detailed the ability of endoscopic confocal microscopy to detect gastric Helicobacter pylori in vivo.


CONCLUSIONS
Endoscopic confocal microscopy is a new imaging technology that produces high-magnification cross-sectional images of the gastrointestinal tract. Its role in detecting and managing diseases of the gastrointestinal tract has been studied in colon cancer screening and is currently being evaluated in a variety of premalignant conditions.
Evans
John A
JA
Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Nishioka
Norman S
NS
D020776:Endoscopes, Gastrointestinal; D004867:Equipment Design; D006801:Humans; D018613:Microscopy, Confocal / Q000295:instrumentation*