Original article
Vol. 143 No. 1314 (2013)
Perspectives using probe-based confocal laser endomicroscopy of the respiratory tract
- Jonas Yserbyt
- Christophe Dooms
- Vincent Ninane
- Marc Decramer
- Geert Verleden
Summary
QUESTIONS UNDER STUDY/PRINCIPLES: Although probe-based confocal laser endomicroscopy (pCLE) is on the edge of entering daily practice in gastroenterological endoscopy, findings in the field of respiratory medicine are only rarely reported, keeping pCLE during flexible bronchoscopy as a mere preclinical research tool. Since the endomicroscopic aspects of normal bronchial and alveolar tissue have recently been described, we want to take part in the development of a pCLE glossary, describing the pCLE features of pulmonary pathologies.
METHODS: We recruited among patients referred for diagnostic bronchoscopy for pCLE imaging. Images from the central airways were obtained in every patient and alveoloscopy was performed in at least five sub-segments per patient.
RESULTS: Using pCLE imaging, we were able to discriminate normal from abnormal endomicroscopical patterns in four respiratory conditions. These findings were matched with classical histopathology.
CONCLUSION: Reflecting on our own experience using pCLE imaging, we summarise the present state of knowledge, discuss five clinical cases and discuss current limitations and the future promise of this novel imaging tool.
The study has been registered with www.clinicaltrials.gov (number http://www.clinicaltrials.gov/ct2/show/NCT01204970?term=NCT01204970&rank=1 )
References
- Goetz M, Watson A, Kiesslich R. Confocal laser endomicroscopy in gastrointestinal diseases. Biophotonics. 2011;4:498–508.
- Thiberville L, Moreno-Swirc S, Vercauteren T, Peltier E, Cave C, Bourg Heckly G. In Vivo Imaging of the Bronchial Wall Microstructure Using Fibered Confocal Fluorescence Microscopy. Am J Respir Crit Care Med. 2007;175:22–31.
- Thiberville L, Salaün M, Lachkar S, Dominique S, Moreno-Swirc S, Vever-Bizet C, et al. Human in vivo fluorescence microimaging of the alveolar ducts and sacs during bronchoscopy. Eur Respir J. 2009;33:974–85.
- Filner J. Bronchoscopic Fibered Confocal Fluorescence Microscopy Image Characteristics and Pathologic Correlations. J Bronchol Intervent Pulm. 2011;18:23–30.
- Yick C, von der Thüsen J, Bel E, Sterk P, Kunst P. In vivo imaging of the airway wall in asthma: fibered confocal fluorescence microscopy in relation to histology and lung function. Respiratory Research. 2011;12:85–93.
- Newton R, Shah P. Imaging parenchymal lung diseases with confocal Endomicroscopy. Respiratory Medicine. 2011;106:127–37.
- Salaün M, Roussel F, Hauss P, Lachkar S, Thiberville L. In vivo imaging of pulmonary alveolar proteinosis using confocal endomicroscopy. Eur Respir J. 2010;36:451–3.
