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- W2024193436 abstract "Introduction: Differentiation between neoplastic changes, hyperplasia and focal inflammation during colonoscopy remains a challenging task even for experienced endoscopists in patients with ulcerative colitis (UC). In the present study, we have analyzed the potential of a novel technique; denoted in vivo fluorescence confocal endomicroscopy, to characterize the microscopic structure of colonic cells and predict histology in UC during colonoscopy. Methods: Patients with long-standing UC in clinical remission were enrolled into the study and underwent total colonoscopy with the newly developed confocal laser endoscope (Optiscan, Australia; Pentax, Japan; excitation of 488 nm argon ion laser; detection >515 nm; optical slice thickness 7mm; lateral resolution 0.7mm; frame rate 0.8 or 1.6 frames/sec with 1024 × 1024 or 1024 × 512 pixels). After reaching the cecum, a fluorescent contrast agent (fluorescein) was administered intravenously. During withdrawal of the endoscope, methylene blue-aided pan-chromoendoscopy was performed to unmask circumscript lesions. Standardized locations (every 10 cm) and every circumscript lesion were examined using the confocal microscope, and afterwards biopsies were taken. Confocal images were graded according to cellular and vascular changes and were correlated with conventional histology in a prospective and blinded fashion. Results: 41 UC patients were included in the prospective study. 14596 confocal images from 464 different locations (369 inconspicuous, 95 circumscript lesions) were compared with histologic results from 1392 biopsies. 67 of 95 circumscript lesions could only be seen after chromoendoscopy. Different cellular structures (epithelial and blood cells), capillaries and connective tissue limited to the mucosal layer could be identified by confocal microscopy. The presence of neoplastic changes (Sensitivity: 94.4%; Specificity 95,6%; Accuracy 99,3%) and inflammation could be predicted with high accuracy. Conclusions: The combination of chromoendoscopy and confocal laser endoscopy facilitates surveillance in UC. Chromoendoscopy unmasks circumscript lesions and confocal laser microscopy can be used to predict neoplastic changes with high accuracy. Thus, targeted biopsies of relevant lesions can be performed and rapid prediction of neoplastic changes may lead to significant improvements in the clinical management of UC patients." @default.
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- W2024193436 date "2004-04-01" @default.
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- W2024193436 title "In vivo Fluorescence Confocal Laser Colonoscopy for Prediction of Neoplasia in Patients with Ulcerative Colitis" @default.
- W2024193436 doi "https://doi.org/10.1016/s0016-5107(04)00491-2" @default.
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