Needle-based confocal endomicroscopy for in vivo histology of intra-abdominal organs: first results in a porcine model (with videos).
BACKGROUND
Probe-based confocal laser scanning endomicroscopy enables in vivo real time histopathology of the mucosa layer. Recently, a prototype of a new confocal miniprobe has been developed that is small enough to be introduced through a 22-gauge puncture needle.


OBJECTIVE
The aim of this study was to evaluate the feasibility of such needle-based confocal laser scanning endomicroscopy (nCLE) for in vivo histology of various organs in a porcine model.


METHODS
Feasibility study.


METHODS
Nonsurvival animal experiments with the animals under general anesthesia at three academic centers.


METHODS
Ten pigs were examined while they were under general anesthesia. Either EUS-guided organ puncture or natural-orifice transluminal endoscopic surgery (NOTES) procedure was used. The confocal miniprobe was inserted through the 22-gauge needle, and puncture of various intra-abdominal structures and organs was performed (lymph nodes, diaphragm, ovaries, liver, spleen, and pancreas) after intravenous injection of fluorescein (5-10 mL 1% or 2 mL 10% solution). Real-time sequences were recorded. Biopsy specimens were taken for standard histopathology.


RESULTS
It was technically feasible to introduce the needle-based confocal miniprobe into various organs at the time of EUS or NOTES procedures. The device enabled real-time in vivo collection of images at histologic resolutions and of acceptable image quality from several intra-abdominal organs interrogated.


CONCLUSIONS
Data were assessed in an experimental animal setting and on healthy organs only.


CONCLUSIONS
Needle-based confocal laser endomicroscopy (CLE) of intra-abdominal organs is feasible in a porcine model. This innovative, minimally invasive technique has the potential to facilitate in vivo histology during EUS punctures or NOTES peritoneoscopy.
Becker
Valentin
V
II Medical Department, Klinikum Rechts der Isar, Technical University of Munich, D-81675 Munich, Germany.
Wallace
Michael B
MB
Fockens
Paul
P
von Delius
Stefan
S
Woodward
Timothy A
TA
Raimondo
Massimo
M
Voermans
Rogier P
RP
Meining
Alexander
A
D000818:Animals; D001706:Biopsy; D003964:Diaphragm / Q000166:cytology / Q000000981:diagnostic imaging; D004064:Digestive System / Q000166:cytology* / Q000000981:diagnostic imaging; D016145:Endoscopy, Digestive System / Q000379:methods*; D019160:Endosonography; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D019793:Fluorescein / Q000008:administration & dosage; D005456:Fluorescent Dyes / Q000008:administration & dosage; D008099:Liver / Q000166:cytology / Q000000981:diagnostic imaging; D018613:Microscopy, Confocal / Q000295:instrumentation*; D009339:Needles; D010053:Ovary / Q000166:cytology* / Q000000981:diagnostic imaging; D010179:Pancreas / Q000166:cytology / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D013154:Spleen / Q000166:cytology* / Q000000981:diagnostic imaging; D013552:Swine; D014741:Video Recording
D005456:Fluorescent Dyes; D019793:Fluorescein