CONFOCAL ENDOMICROSCOPY - GastroFlexTM for Eso-Gastro-Duodenoscopy (EGD)
A major innovation for the management of Barrett's Esophagus (BE)
Cellvizio provides a direct method to visualize the microstructure of the esophagus and differentiate normal versus abnormal BE tissue in real-time which may improve targeted sampling, provide earlier disease detection and help patient management [1].
Watch the short movie below to see Cellvizio in action during EGD.
Physicians have also used Cellvizio imaging in conjunction with other clinically revelant parameters during BE treatment procedures to guide resection or ablation, to evaluate margins for residual malignancy and to visually monitor the patient’s condition during follow-up endoscopy procedures [2]. In many cases, unnecessary procedures may be avoided which may impact on overall costs, such as endoscopy suite time and pathology testing.
The DONT BIOPCE study
Prof. Prateek Sharma (V.A. Kansas City) presented the full results of this international, multi-centric randomized control trial during an oral presentation DDW 2010. The key results of the study that involved 101 patients, as presented by Prof. Sharma are:
pCLE can detect 100% more pre-cancerous lesions than white-light endoscopy and 70% more pre-cancerous lesions than NBI, when probing non-suspicious locations : a much better real-time assessment of the extent of dysplasia is possible with pCLE.
About 40% of patients had negative examinations on white light, NBI and pCLE and negative corresponding biopsies: thanks to a very high Negative Predictive Value for pCLE, there could be a significant reduction of negative biopsies taken.
Endomicroscopic images of the esophagus showing different types of patterns: normal squamous epithelium (left); high grade dysplasia (center) and inflammation following therapy (right) as published by several teams
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