New Technology to Improve IBD Diagnoses

A team of 26 experts from the US, Europe, and Scandinavia has recommended routine implementation of a new probe-based Confocal Laser Endomicroscopy (pCLE) system,Cellvizio, to improve diagnostic evaluation and management of several gastric, intestinal, and biliary diseases.

According to results from multi-center trials published in the United European Gastroenterology Journal, the Cellvizio technology provided physicians with accurate real-time ability to confirm absence of disease and in assist in making immediate treatment decisions through high-resolution cellular imaging of internal tissues.

In addition, Cellvizio can provide benefits at each step of patient management and in multiple indications, including Barrett’s Esophagus, gastric diseases, bilio-pancreatic strictures, pancreatic cysts, colorectal lesions, lung nodules, urinary tract lesions, and inflammatory bowel diseases.

Currently comprised of miniaturized optics, optical fiber bundles, high-speed scanning, and advanced imaging processing components, the Cellvizio system quickly produces images allowing surgeons to detect cellular-level features that can discern between cancerous and benign colorectal polyps during the colonoscopy.

The coauthors noted this technology used a separate unit outside the endoscope, which emitted the laser illumination required for imaging and is directed to the mucosa through a bundle of optical fibers in a small probe called a Confocal Miniprobe.

The researchers’ primary objective was to provide guidance on the standardization of practice and training in Barrett’s esophagus, biliary strictures, colorectal lesions, and inflammatory bowel diseases (IBD).

The authors noted, “pCLE should be added as enhancement of the diagnostic arsenal in the evaluation of the referenced indications based on its providing microscopic information that improves the diagnostic performance of the physician.” They recommended establishing institutional training programs in order to actually ensure good practice and implement this technology in the clinical routine.

Jean-Paul Galmiche, MD, Gastroenterology and Hepatology, University Hospital Nantes, France, concluded, “Cellvizio has taken a very important role in the evaluation of a growing number of gastrointestinal pathologies. In order to standardize its use around the world, it was necessary to start developing a first set of recommendations for some key indications of the technology.”