A breakthrough for endoscopic diagnostics - Confocal endoscopy
Once again, New Orleans, Lousiana was host to the Digestive Disease Week from May 15 to 20, 2004.
Dr. med. R. Kiesslich (Mainz) presented the results of two clinical studies which employed the confocal system. In the first study, 42 patients who had undergone a polypectomy/surgery were screened for colorectal carcinoma. Comparing the confocal images with the histologically prepared biopsies, the confocal endoscopy showed a sensitivity of 97.4%, a specificity of 99.4% and anaccuracy of 99.2% for the prediction of neoplasia.
The second study involved 41 patients and investigated the significance of confocal endoscopy for patients with colitis ulcerosa, in conjunction with (chromoendoscopy). Chromoendoscopy proved to be a highly effective supplementary method, with the help of which it was possible to unmask localised areas and detect neoplastic changes, which were then targeted by using confocal microscopy. Also in this study the histology was predicted with a sensitivity of 94.4%, a specificity of 95.6% and an accuracy of 99.3%.
The follow-up discussion proceeded to describe confocal endoscopy as summarised below:
- A breakthrough for endoscopic diagnostics
- Revolutionary portrayal of microscopic structures during the endoscopic examination
- Widespread use for Screening (colorectal carcinoma) and Monitoring (colitis ulcerosa)
- Interpretation skills can be acquired and produce efficient diagnoses
- Option of optical biopsy comparable with conventional histology
- Safe method
In the medium term, there will therefore be no alternative to confocal endoscopy for gastroenterological centres.