BACKGROUND: Confocal laser scanning microscopy (CLSM) is reported to be a promising tool for in vivo histopathology during an endoscopy. The most commonly used fluorophore is fluorescein sodium given intravenously. However, so far, there are no objective data on contrast dynamics and image quality over time after injection of the substance. OBJECTIVE: We aimed to investigate the ideal time period for the best CLSM imaging when using fluorescein sodium. DESIGN: The proximal stomachs of 4 anesthetized pigs were examined via standard endoscopes with a portable confocal miniprobe. After injection of 1% fluorescein intravenously (0.1 mL/kg body weight), consecutive sequences were recorded after 1, 2, 3, 5, 8, 20, 30, 40, 50, and 60 minutes. After the procedure, histograms, which represented signal intensity of 20 images (at respective time points), were analyzed from representative regions of interest (ROI). The mean (standard deviation [SD]) pixel value of the pixel values in the ROI were noted. A signal-to-noise ratio (SNR), defined as the ratio between the mean and the SD, was calculated. In addition, 5 images per time period were put into a random order and then blindly evaluated by 2 endoscopists. RESULTS: A total of 560 histograms from selected ROIs were analyzed. The SNR decreased significantly after 8 minutes, with the lowest values being reached after 30 minutes. Subjective evaluation of still images also demonstrated a continuous decrease, with the lowest image quality after 30 minutes. A slight increase of image quality after 40 minutes occurred because of extramucosal leakage of fluorescein, with fluorophore deposits in the crypt orifices. CONCLUSIONS: In the pig model, fluorescein-based CLSM of the GI tract delivered the best contrast and image quality within the first 8 minutes after injection of the fluorophore. These data might facilitate standardization of the procedure for research purposes but may also help when applying this new technology in a daily routine manner.
BACKGROUND: Confocal laser scanning microscopy (CLSM) is reported to be a promising tool for in vivo histopathology during an endoscopy. The most commonly used fluorophore is fluorescein sodium given intravenously. However, so far, there are no objective data on contrast dynamics and image quality over time after injection of the substance. OBJECTIVE: We aimed to investigate the ideal time period for the best CLSM imaging when using fluorescein sodium. DESIGN: The proximal stomachs of 4 anesthetized pigs were examined via standard endoscopes with a portable confocal miniprobe. After injection of 1% fluorescein intravenously (0.1 mL/kg body weight), consecutive sequences were recorded after 1, 2, 3, 5, 8, 20, 30, 40, 50, and 60 minutes. After the procedure, histograms, which represented signal intensity of 20 images (at respective time points), were analyzed from representative regions of interest (ROI). The mean (standard deviation [SD]) pixel value of the pixel values in the ROI were noted. A signal-to-noise ratio (SNR), defined as the ratio between the mean and the SD, was calculated. In addition, 5 images per time period were put into a random order and then blindly evaluated by 2 endoscopists. RESULTS: A total of 560 histograms from selected ROIs were analyzed. The SNR decreased significantly after 8 minutes, with the lowest values being reached after 30 minutes. Subjective evaluation of still images also demonstrated a continuous decrease, with the lowest image quality after 30 minutes. A slight increase of image quality after 40 minutes occurred because of extramucosal leakage of fluorescein, with fluorophore deposits in the crypt orifices. CONCLUSIONS: In the pig model, fluorescein-based CLSM of the GI tract delivered the best contrast and image quality within the first 8 minutes after injection of the fluorophore. These data might facilitate standardization of the procedure for research purposes but may also help when applying this new technology in a daily routine manner.
Authors: Richard C Newton; David P Noonan; Valentina Vitiello; James Clark; Christopher J Payne; Jianzhong Shang; Mikael Sodergren; Ara Darzi; Guang-Zhong Yang Journal: Surg Endosc Date: 2012-04-26 Impact factor: 4.584
Authors: Michael B Wallace; Prateek Sharma; Charles Lightdale; Herbert Wolfsen; Emmanuel Coron; Anna Buchner; Monther Bajbouj; Ajay Bansal; Amit Rastogi; Julian Abrams; Julia E Crook; Alexander Meining Journal: Gastrointest Endosc Date: 2010-04-08 Impact factor: 9.427
Authors: Muhammad W Shahid; Julia E Crook; Alexander Meining; Aymeric Perchant; Anna Buchner; Victoria Gomez; Michael B Wallace Journal: J Interv Gastroenterol Date: 2011-10-01
Authors: Geoffrey A Sonn; Kathleen E Mach; Kristin Jensen; Pei-Lin Hsiung; Sha-Nita Jones; Christopher H Contag; Thomas D Wang; Joseph C Liao Journal: J Endourol Date: 2009-02 Impact factor: 2.942
Authors: Waseem K Jerjes; Tahwinder Upile; Brian J Wong; Christian S Betz; Henricus J Sterenborg; Max J Witjes; Kristian Berg; Robert van Veen; Merrill A Biel; Adel K El-Naggar; Charles A Mosse; Malini Olivo; Rebecca Richards-Kortum; Dominic J Robinson; Jennifer Rosen; Arjun G Yodh; Catherine Kendall; Justus F Ilgner; Arjen Amelink; Vanderlei Bagnato; Hugh Barr; Lina Bolotine; Irving Bigio; Zhongping Chen; Lin-Ping Choo-Smith; Anil K D'Cruz; Ann Gillenwater; Andreas Leunig; Alexander J MacRobert; Gordon McKenzie; Ann Sandison; Khee C Soo; Herbert Stepp; Nicholas Stone; Katarina Svanberg; I Bing Tan; Brian C Wilson; Herbert Wolfsen; Colin Hopper Journal: Head Neck Oncol Date: 2011-08-23