Review article: in vivo imaging by endocytoscopy
Résumé
Introduction: Endocytoscopy (EC) enables in vivo microscopic imaging at 1400-fold magnification, thereby allowing the analysis of mucosal structures at the cellular level. In contrast to fluorescence imaging with confocal laser endomicroscopy which allows analysis of mucosal structures up to 250 µm in depth, EC is based on the principle of contact light microscopy and only allows visualization of the very superficial mucosal layer. Aim: To systematically review the feasibility and diagnostic yield of EC for in vivo diagnosis of diseases. Material and Methods: A systematic search of the literature on diagnostic interventions in the gastrointestinal tract using EC was performed by searches in MEDLINE, Current Contents, PubMed, cross references and references from relevant articles using the search terms "endocytoscopy", "endocytoscope", "magnification endoscopy", "endocytoscopic imaging", "virtual histology", and "optical biopsy". Only full manuscripts and case reports published in English were included. Results: Overall twenty-nine relevant reports were identified. EC was feasible to detect esophageal squamous cell cancer with sensitivity, specificity and accuracy of 95%, 84% and 82%, respectively. Moreover, EC reached excellent sensitivity and specifity for in vivo diagnosis of colon polyps (91% and 100%, respectively). Other diagnostic applications of EC included diagnosis of Barrett's oesophagus, Helicobacter pylori, celiac disease, and small cell lung cancer. No serious complications of EC have yet been reported. Conclusions: EC is a safe and effective new endoscopic imaging technique to obtain in vivo histology and guided biopsies with high diagnostic accuracy. Therefore, EC has the potential to facilitate both diagnosis and patient management.
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PEER_stage2_10.1111%2Fj.1365-2036.2011.04647.x.pdf (435.42 Ko)
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