Confocal endomicroscopy: in vivo diagnosis of neoplastic lesions of the gastrointestinal tract

Abstract

Confocal endomicroscopy is a novel technology which allows subsurface histological diagnosis at a cellular and subcellular level in vivo. It thereby provides instantaneous histopathology during ongoing upper and lower endoscopy. This allows immediate diagnosis of neoplastic and inflammatory lesions of the intestinal mucosa. Studies have demonstrated the power of confocal endomicroscopy in screening and surveillance colonoscopy, ulcerative colitis, Barrett's esophagus, and gastric cancer. In animal models of human diseases, the same technology has provided molecular imaging of cancer, functional imaging of altered perfusion in malignant and inflammatory disease and high resolution in vivo morphological diagnosis. Fields of ongoing research are the development of molecular markers for in vivo immunohistochemistry and the application of confocal microscopy to intraabdominal organs in humans. Confocal endomicroscopy is evolving as a novel technique for rapid intravital diagnosis of gastrointestinal neoplastic diseases at the microscopic level and bears the potential for molecular imaging in humans in the future.