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- W2978346723 abstract "Purpose: Endoscopic methods to diagnose cholangiocarinoma include ERCP with tissue sampling, fluorescence in-situ hypridization, and digital image analysis. All of these methods are of low sensitivity. Confocal endomicroscopy is a new imaging system which may provide in vivo diagnosis of indeterminate biliary strictures. The purpose of this study was to evaluate indeterminate biliary strictures using confocal endomicroscopy. Methods: Fourteen patients with indeterminate biliary strictures underwent ERCP. Patients received up to 10 ml of 0.5-10% intravenous fluorescein, prior to imaging the biliary strictures and bile ducts with a confocal cholangioprobe and in 1 patient a confocal high definition probe. Standard brushings and biopsies were performed when clinically indicated. In separate studies, rat bile ducts were imaged using a table top-multiphoton microscope. Results: Previously published criteria were used to evaluate for malignancy in the confocal images obtained in the 14 patients (Table 1). Using the high definition probe, reticular structures could be distinguished from blood vessels. These findings suggest that, if a reticular pattern was seen without other markers of potential malignancy then it was less likely to represent a malignancy. To correlate these findings with histological structures, 3D reconstructions of intact rat bile ducts were obtained by multiphoton microscopy (Figure 1). This revealed epithelial glands extending from the lumen to a depth of ˜50 microns, where connective tissue, blood vessels, and a separate reticular network were visualized. This shows the histological correlates of what was detected by confocal imaging in patients.TableFigureConclusion: A negative confocal imaging study of the biliary tree can be used to rule out carcinoma, but there are frequent false positives. Better correlation with known histological structures may lead to improved accuracy of diagnoses." @default.
- W2978346723 created "2019-10-10" @default.
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- W2978346723 date "2009-10-01" @default.
- W2978346723 modified "2023-10-18" @default.
- W2978346723 title "Probe-based Laser Confocal Endomicroscopy for the Diagnosis of Biliary Malignancies" @default.
- W2978346723 doi "https://doi.org/10.14309/00000434-200910003-00193" @default.
- W2978346723 hasPublicationYear "2009" @default.
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