Endosc Int Open 2015; 03(05): E516-E522
DOI: 10.1055/s-0034-1392233
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Use of endoscopic distal attachment cap to enhance image stabilization in probe-based confocal laser endomicroscopy in colorectal lesions[*]

Vivian Ussui**
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
Can Xu**
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
2   Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China
Julia E. Crook
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
Nancy N. Diehl
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
Joy Hardee
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
Estela G. Staggs
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
Muhammad W. Shahid
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
3   Owatonna Clinic, Mayo Clinic Health System, Owatonna, Minnesota, United States
Michael B. Wallace
1   Mayo Clinic in Florida, Jacksonville, Florida, United States
› Author Affiliations
Further Information

Publication History

submitted 22 December 2014

accepted after revision 13 April 2015

Publication Date:
21 July 2015 (online)

Background and study aims: Colorectal cancer can be prevented through the use of colonoscopy with polypectomy. Most colon polyps are benign or low grade adenomas. However, currently all lesions need histopathologic analysis, which increases diagnostic costs and delays the final diagnosis. Confocal laser endomicroscopy (CLE) is a new technology that enables real-time endomicroscopy. However, there are challenges to maintaining a stable image with currently available systems. We conducted a small study to obtain a preliminary assessment of whether the use of an endoscopic distal attachment cap may enhance image quality of CLE in comparison with images obtained with free-hand acquisition.

Patients and methods: Forty outpatients underwent colonoscopy for evaluation of colon polyps in a single academic medical center. Patients were assigned randomly to 1 of 2 study arms on the basis of whether an endoscopic distal attachment cap was used (n = 21, Cap Used) or not used (n = 19, No Cap) in the procedure. The quality of confocal images and probe stabilization was summarized.

Results: A total of 81 polyps were identified. The proportion of polyps with images of high quality was 74 % (28/38) in the Cap Used group and 79 % (30/38) in the No Cap arm. Image stability was also similar with and without a cap. Diagnostic accuracy was estimated to be slightly higher in the Cap Used group for probe-based confocal laser endomicroscopy (pCLE; 78 % vs 70 %). This was also true for white-light and narrow-band imaging.

Conclusions: This preliminary study did not yield any evidence to support that the use of an endoscopic distal attachment cap improves the quality of images obtained during CLE.

* This sudy was presented as a poster abstract at DDW 2013

** Drs. Ussui and Xu: These authors contributed equally.

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