Review article: in vivo imaging by endocytoscopy
Article first published online: 3 APR 2011
© 2011 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 33, Issue 11, pages 1183–1193, June 2011
How to Cite
Neumann, H., Fuchs, F. S., Vieth, M., Atreya, R., Siebler, J., Kiesslich, R. and Neurath, M. F. (2011), Review article: in vivo imaging by endocytoscopy. Alimentary Pharmacology & Therapeutics, 33: 1183–1193. doi: 10.1111/j.1365-2036.2011.04647.x
- Issue published online: 2 MAY 2011
- Article first published online: 3 APR 2011
- Publication data Submitted 3 January 2011 First decision 18 January 2011 Resubmitted 9 March 2011 Accepted 13 March 2011 This uncommissioned review article was subject to full peer-review.
Aliment Pharmacol Ther 2011; 33: 1183–1193
Background 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 visualisation of the very superficial mucosal layer.
Aim To systematically review the feasibility and diagnostic yield of EC for in vivo diagnosis of diseases.
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 oesophageal squamous cell cancer with sensitivity, specificity and accuracy of 95%, 84% and 82%, respectively. Moreover, EC reached excellent sensitivity and specificity for in vivo diagnosis of colon polyps (91% and 100%, respectively). Other diagnostic applications of EC included diagnosis of Barrett’s oesophagus, Helicobacter pylori, coeliac disease and small cell lung cancer. No serious complications of EC have yet been reported.
Conclusions Endocytoscopy is a safe and effective new endoscopic imaging technique to obtain in vivo histology and guided biopsies with high diagnostic accuracy. Therefore, endocytoscopy has the potential to facilitate both diagnosis and patient management.