Confocal Endomicroscopy

Confocal laser endomicroscopy is a new endoscopic imaging technique, which constitutes a true technological advance over all previous techniques. Indeed, it adapts optical microscopy to 'Live' digestive endoscopy, thanks to miniaturized microscopes that allow the study of the digestive mucosa at a subcellular level during an ongoing endoscopy. From a technical point of view, the digestive mucosa is marked by a fluorescent molecule (for instance, fluorescein) and illuminated by a low-power laser beam. The scanning of a microscopic field of mucosa by the laser, combined with the selection of photons originating in the same focal plane ('confocal' plane) results in the imaging of an optical section of this zone of interest. Endomicroscopy allows an evaluation of the epitheLial architecture and microvessels of the digestive mucosa with a magnification of about 1000-fold. The result is an 'optical biopsy' that allows the in vivo histological diagnosis of a lesion in real time. The aim is to characterize lesions during the examination, in real time and in situ, in order to target 'smart' biopsies, avoiding unnecessary tissue sampLing or guide therapy. In the near future, the development of specific dyes might lead to the development of truly modern 'molecular endoscopy.'.