In vivo characterisation of superficial colorectal neoplastic lesions with high-resolution probe-based confocal laser endomicroscopy in combination with video-mosaicing: a feasibility study to enhance routine endoscopy.
BACKGROUND
Recent technological advances in miniaturisation have allowed for a confocal scanning microscope to be integrated into trans-endoscopic probes enabling endoscopists to collect in vivo virtual biopsies of the gastrointestinal mucosa during endoscopy.


OBJECTIVE
The aim of the present study was to assess prospectively the clinical applicability and predictive power of a probe-based confocal laser endomicroscopy for the in vivo diagnosis of colorectal neoplasia.


METHODS
Patients with evidence of colorectal superficial neoplasia at routine endoscopy, were included prospectively in this study. Lesions were identified using white-light endoscopy followed by pCLE imaging recorded by a Coloflex UHD-type probe. The images were interpreted as either neoplastic or not according to vascular and cellular changes. pCLE readings were then compared with histopathological results from endoscopically resected lesions and/or targeted biopsy specimens.


RESULTS
A total of 32 lesions were identified in 20 consecutive patients. Histopathology diagnosis was of adenomas in 19 cases, hyperplastic polyps in 11 cases and adenocarcinoma in 2 cases. For the detection of neoplastic tissue pCLE had a sensitivity of 100%, a specificity of 84.6%, an accuracy of 92.3, a PPV of 90.5% and a NPV of 100%.


CONCLUSIONS
pCLE permits high-quality imaging, enabling prediction of intraepithelial neoplasia with a high level of accuracy.
De Palma
Giovanni D
GD
Department of Surgery and Advanced Technologies, Center of Excellence for Technical Innovation in Surgery (ITC), University of Naples Federico II, School of Medicine, Via Pansini, 5, 80131, Naples, Italy. giovanni.depalma@unina.it
Staibano
Stefania
S
Siciliano
Saverio
S
Persico
Marcello
M
Masone
Stefania
S
Maione
Francesco
F
Siano
Maria
M
Mascolo
Massimo
M
Esposito
Dario
D
Salvatori
Francesca
F
Persico
Giovanni
G
D001706:Biopsy; D003113:Colonoscopy / Q000295:instrumentation*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D017076:Computer-Aided Design / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D011237:Predictive Value of Tests; D013223:Statistics as Topic; D014741:Video Recording / Q000295:instrumentation*