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Objectives Confocal laser endomicroscopy ( CLE) consists of endoscope-based CLE ( eCLE) and probe-based CLE ( pCLE). This study aimed to compare e CLE and pCLE in their diagnostic yield in different parts of the gastrointestinal ( GI) tract. Methods Consecutive patients were scheduled for CLE examination due to GI symptoms. All patients were randomly assigned to eCLE or pCLE group and underwent a programmed procedure using one type of CLE. Differences in procedure time, complication rate, CLE image quality and image acquisition feasibility between these two types of CLE for esophagogastroduodenoscopy (EGD) and colonoscopy were calculated. Results Altogether 513 CLE procedures were performed, including 324 EGD and 189 colonoscopy. The procedure time of pCLE was significantly shorter than that of eCLE both in EGD and colonoscopy (16.78 min vs 18.13 min for EGD, P = 0.027; 32.48 min vs 39.89 min for colonoscopy, P < 0.001). No significant difference was found between these two types of CLE in diagnostic utility, including the detection and prediction of histopathological results of the lesions. The CLE image quality of both e CLE and p CLE were comparable in the stomach and colon, but eCLE seemed to be superior to pCLE in examining the esophagus. Colonoscopy using pCLE had a higher complete rate than that of eCLE, although the difference was not statistically significant ( P = 0.065). Conclusions pCLE is more flexible in diagnosing GI diseases with a shorter procedure time than eCLE regardless of comparable diagnostic yields, except the diagnosis of esophageal diseases in which eCLE provides better image quality. [ABSTRACT FROM AUTHOR]

Objective This study aimed to compare the diagnostic value and image quality of high-definition magnifying white light endoscopy ( M- WLE) and high-definition magnifying endoscopy with i-scan ( M-i-scan) for Helicobacter pylori ( H. pylori) infection. Methods Patients complaining of dyspepsia who underwent esophagogastroduodenoscopy at the Endoscopy Unit of Qilu Hospital ( Jinan, Shandong Province, China) from January to March, 2011 were prospectively recruited. The greater curvature of the stomach was carefully observed using both M- WLE and M-i-scan. The gastric mucosal classification and image quality scores were recorded. The relationship between gastric mucosal classification and final diagnosis of H. pylori infection was determined. Results A total of 84 patients were recruited in this study. The accuracy and specificity of the combination of types 2-3 patterns predicting H. pylori infection were significantly higher for M-i-scan than those for M- WLE (accuracy: 94.0% vs 84.5%, P = 0.046; and specificity: 93.5% vs 80.6%, P = 0.032), while the sensitivity of the two modes was the same. The M-i-scan provided a better image quality for H. pylori infection than M- WLE ( P < 0.001). Conclusion The M-i-scan may be superior to M- WLE for the prediction of H. pylori infection, but its diagnostic sensitivity needs to be improved. [ABSTRACT FROM AUTHOR]

Objective To evaluate the feasibility and accuracy of confocal laser endomicroscopy ( CLE) for the in vivo diagnosis of colorectal cancer ( CRC) compared with conventional histology. Methods Consecutive patients who had undergone CLE examination for screening or surveillance colonoscopy were recruited. Suspected malignant lesions and adjacent mucosal sites were first examined by confocal imaging and then biopsied specimens of these sites were obtained. The confocal images were independently interpreted by two endoscopists. The diagnosis made with CLE was compared with the conventional histological diagnosis in a prospective and blinded fashion. Results In total, 71 patients with suspected malignant lesions were included in the study. A total of 74 lesions and 92 adjacent mucosal sites were observed. The sensitivity, specificity and accuracy of CLE in diagnosing CRC were 97.1%, 99.0% and 98.2% for endoscopist A, and 98.6%, 96.9% and 97.6% for endoscopist B, respectively. The interobserver agreement between the two endoscopists was excellent (κ = 0.950). The accuracy of diagnosing poorly differentiated CRC using CLE was 97.0% for endoscopist A and 95.6% for endoscopist B. Conclusion CLE has the potential to enable an immediate diagnosis of CRC and the degree of differentiation of CRC during ongoing endoscopy in vivo. [ABSTRACT FROM AUTHOR]