Is There a Role for Confocal Laser Endomicroscopy in Renal Mass Biopsy?

The incidental detection of small renal masses (SRMs) is on the rise. However, not all require aggressive treatments as up to 20% are identified as benign, and the majority of malignant tumors harbor indolent features. Improved preoperative diagnostics are needed to differentiate tumors requiring aggressive treatment from those more suitable for surveillance. This chapter introduces the novel concept of confocal laser endomicroscopy (CLE) as a real-time, diagnostic optical biopsy tool for SRMs. Pertinent CLE studies in urology as well as other medical specialties are discussed, including a detailed review of a recent study specifically addressing CLE in ex vivo human SRMs. Future directions in CLE applications and research are explored for a comprehensive look at one of the leading optical imaging technologies currently under development.