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©2012 Baishideng Publishing Group Co.
World J Gastrointest Endosc. Oct 16, 2012; 4(10): 462-471
Published online Oct 16, 2012. doi: 10.4253/wjge.v4.i10.462
Published online Oct 16, 2012. doi: 10.4253/wjge.v4.i10.462
ECS | CEM | |
Available systems | ||
Probe based | Olympus (Japan) | Optiscan (Australia) endomicroscope integrated into Pentax (Japan) endoscope |
Integrated | Olympus (Japan) | Cellvizio, Mauna Kea Technologies (France) |
Max resolution | NA | 1024 × 1024 pixels with integrated system (lower with probe based system) |
Max magnification | 1400 × (probe) 580 × (integrated) | 1000 × |
Field of view | 300 μm × 300 μm (450 x magnification) | 475 μm × 475 μm |
120 μm × 120 μm (1125 x magnification) | ||
Depth of imaging | Superficial mucosal layer only | Probe based: Different probes allow for different imaging depths |
Integrated system: Variable, up to 250 μm below surface (lamina propria) | ||
Contrast agents | 0.5%-1% methylene blue | Fluorescein sodium |
0.25% toluidine blue | Acriflavine | |
Commercially available? | No | Yes |
Advantages | Higher magnification than CEM | Can visualize subsurface structures up to 250 μm |
Commercially available | ||
Disadvantages | Cannot visualize subsurface structures | Lower magnification than ECS |
Requires mucolytic preparation of tissue | Two contrast agents required for optimal imaging | |
Not commercially available |
Modality | Findings | Test characteristics |
Endocytoscopy | Nuclear atypia | Sensitivity 81%-95%1 |
Increased nucleus: Cytoplasm ratio | Specificity 84%-100%1 | |
Increase in cell density | Accuracy 82%-90%1 | |
Irregular cellular distribution | ||
Confocal endomicroscopy | Dilated intraepithelial papillary capillary loops | Accuracy 85%-96% |
Abnormal cellular structures |
Feature | Normal | Malignant |
Vessel Architecture | Hexagonal, honeycomb appearance of capillaries | Distorted, dilated capillaries with increased leakage |
Capillaries surround the stroma, which encircle the crypt openings | Irregular arrangement with no specific relationship to adjacent tissue | |
Crypts | Regular luminal openings and distribution | Heterogeneous distribution with irregular layer epithelial cells |
Crypts covered by uniform layer of epithelial cells (including Goblet cells) | Loss of crypts and goblet cells | |
Sensitivity | ECS: 79%-91%[6,35] | |
CEM: 91%[37] | ||
Specificity | ECS: 90%-100%[6,35] | |
CEM: 76%[37] |
- Citation: Arya AV, Yan BM. Ultra high magnification endoscopy: Is seeing really believing? World J Gastrointest Endosc 2012; 4(10): 462-471
- URL: https://www.wjgnet.com/1948-5190/full/v4/i10/462.htm
- DOI: https://dx.doi.org/10.4253/wjge.v4.i10.462