Confocal Laser Endomicroscopy Developed to Improve GI, Biliary Disease Detection

physicians are using the world's smallest microscope to improve gastroendoscopy (GI) and biliary disease detection and to speed treatment.

A new, real-time optical biopsy can be performed with a probe-based confocal laser endomicroscopy (pCLE) system, known as Cellvizio, the world's smallest flexible microscope. Cellvizio is helping physicians detect tissue in the GI tract that could lead to various types of cancers such as colon, esophageal, pancreatic, cholangiocarcinoma (cancer of the bile ducts), and gallbladder cancer.

These cancers combined are responsible for thousands of deaths each year in the United States. For pancreatic cancer alone, over 37,000 individuals are diagnosed and over 34,000 die each year from it. In addition, The American Cancer society notes that esophageal cancer rates have continued to increase in the last 20 years.

Now, clinicians from the University of Washington (UW; Seattle, WA, USA) are leading cancer detection to diagnose gastrointestinal and biliary diseases on the spot and treat patients immediately. This new tool allows them to view tissue inside a patient's body in real time at the cellular level so they can precisely pinpoint tissue that should be removed or treated.

Cellvizio can more accurately differentiate cancerous and precancerous tissue during colonoscopies, endoscopies, and endoscopic retrograde cholangiopancreatographies (ERCPs), the standard pancreatic and bile duct cancer detection procedure. "Until now, if we found suspicious tissue during one of these diagnostic procedures, we often had to randomly cut out tissue and send it to a laboratory for analysis, which can take up to a week," explained Michael Saunders, M.D., UW clinical associate professor of medicine and director of the Digestive Diseases Center at UW Medical Center. "This not only meant that sick patients would have to come back for treatment later, but that dangerous tissue could be missed due to random sampling techniques. With Cellvizio, we can pinpoint the dangerous tissue during the initial diagnostic exam, remove it the same day and then go back to ensure that we got it all."

"This new imaging tool gives us the opportunity to immediately see changes in the cells and potentially gain insights of what may be wrong and thus optimize patient treatment," noted Joo Ha Hwang, M.D., Ph.D., UW assistant professor of medicine, Digestive Diseases Center. "Importantly, Cellvizio is effective at ruling out disease, which helps us avoid unnecessary procedures and the costs, time and potential complications associated with them."

Cellvizio was cleared by the U.S. Food & Drug Administration for use in the gastrointestinal tract and lungs, and over 3,000 Cellvizio procedures have been completed worldwide to date. The technology was developed by Mauna Kea Technologies (Paris, France).

Related Links:
University of Washington
Mauna Kea Technologies