title: Confocal laser endomicroscopy in gastrointestinal and pancreatobiliary diseases.
abstract: Confocal laser endomicroscopy (CLE) is an emerging diagnostic procedure that enables in vivo pathological evaluation during ongoing endoscopy. There are two types of CLE: endoscope-based CLE (eCLE), which is integrated in the tip of the endoscope, and probe-based CLE (pCLE), which goes through the accessory channel of the endoscope. Clinical data of CLE have been reported mainly in gastrointestinal (GI) diseases including Barrett's esophagus, gastric neoplasms, and colon polyps, but, recently, a smaller pCLE, which goes through a catheter or a fine-needle aspiration needle, was developed and clinical data in the diagnosis of biliary stricture or pancreatic cysts have been increasingly reported. The future application of this novel technique expands beyond the pathological diagnosis to functional or molecular imaging. Despite these promising data, the generalizability of the procedure should be confirmed especially in Japan and other Asian countries, where the current diagnostic yield for GI luminal diseases is high. Given the high cost of CLE devices, cost-benefit analysis should also be considered.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Susumu
authors.initials: S
authors.lastname: Shinoura
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwashita
authors.forename: Jason B
authors.initials: JB
authors.lastname: Samarasena
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Chang
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D001660:Biliary Tract Diseases / Q000175:diagnosis*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D018613:Microscopy, Confocal / Q000295:instrumentation; D010182:Pancreatic Diseases / Q000175:diagnosis*
keywords: confocal laser microscopy; endoscopy; pathology