Confocal endomicroscopy

Purpose of review. Confocal laser endomicroscopy is an emerging field of endoscopic imaging allowing gastroenterologists to obtain in-vivo histology of the gastrointestinal mucosa. The present review will address the more recent advances in confocal laser endomicroscopy and discuss its future. Recent findings. Interest in confocal laser endomicroscopy and in-vivo diagnosis of gastrointestinal disorders has increased in the last few years. Confocal laser endomicroscopy can localize intraepithelial neoplasia in chronic ulcerative colitis and enable 'smarter' mucosal biopsy when combined with chromoendoscopy. Confocal laser endomicroscopy may accurately diagnose neoplasia in the esophagus, stomach, colon, and bile duct. Moreover, in-vivo visualization of morphologic epithelial abnormalities, such as intraepithelial bacteria and 'gaps in the gut', may increase our understanding of the possible pathogenic mechanisms of disease. Fluorescent peptide markers that target neoplasia are also being developed as a complementary approach to visualization of in-vivo histopathology. Summary. Confocal endomicroscopy is a developing area of gastrointestinal endoscopy with expanding clinical and research applications. The present review focuses on recent advances in confocal endomicroscopy.