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Confocal Laser Endomicroscopy

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Urologic Surgery in the Digital Era

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Abstract

Confocal laser endomicroscopy (CLE) is a promising fluorescence-based fiber-optic imaging technique able to provide a microscopical assessment of tissues.

It was developed in 2007 and was first used to study histopathologic changes in bronchial and enteric tissue (Thiberville et al., Am J Respir Crit Care Med 175(1):22–31, 2007; Wang et al., Clin Gastroenterolo Hepatol 5:1300–5, 2007). In 2009 it was proposed that CLE could be used for real-time visualization of tissue microarchitecture and cellular morphology of the lower urinary tract, with improved diagnosis of urothelial carcinoma (Sonn et al., J Urol 182:1299–305, 2009) (i.e., tumor grading) and, more recently, CLE has been used in the upper urinary tract with similar purposes (Villa et al., J Endourol 30(2):237–42, 2016; Breda et al., Eur Urol Focus 4(6):954–959, 2018). Similarly, reflectance confocal microscopy has been introduced in 2007 in the field of dermatology to improve the diagnostic specificity when integrated with dermoscopy (Pellacani et al., J Invest Dermatol 127(12):2759–5, 2007; Guitera et al., J Invest Dermatol 132(10):2386–2394, 2012).

As far as prostate cancer is concerned, it has been used more recently to microscopically depict prostate tissue, distinguishing between cancerous and non-cancerous one; the real-time fashion of CLE makes it suitable for the intra-operative setting, to assess surgical margin status thus tailoring the correct plane of dissection (Puliatti et al., BJU Int 124(3):469–476, 2019; Lopez et al., J Urol 195(4 Pt 1):1110–1117, 2016).

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Abbreviations

CIS:

carcinoma in situ

CLE:

confocal laser endomicroscopy

CTU:

computed tomography urography

EAU:

European Association of Urology

FCM:

fluorescence confocal microscopy

NVB:

neurovascular bundles

OCT:

optical coherence tomography

PDD:

photodynamic diagnosis

RNU:

radical nephroureterectomy

UTUC:

upper tract urinary carcinoma

WLC:

white light cystoscopy

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Author information

Authors and Affiliations

  1. Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain

    Alberto Breda, Angelo Territo, Giulio Bevilacqua & Iacopo Meneghetti

  2. Department of Urology, University of Modena & Reggio Emilia, Modena, Italy

    Salvatore Micali, Mino Rizzo, Maria Chiara Sighinolfi, Bernardo Rocco & Giampaolo Bianchi

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  1. Grande Ospedale Metropolitano, Reggio Calabria, Italy

    Domenico Veneziano

  2. Department of Urology, Hacettepe University, Ankara, Turkey

    Emre Huri

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Breda, A. et al. (2021). Confocal Laser Endomicroscopy. In: Veneziano, D., Huri, E. (eds) Urologic Surgery in the Digital Era. Springer, Cham. https://doi.org/10.1007/978-3-030-63948-8_11

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  • DOI: https://doi.org/10.1007/978-3-030-63948-8_11

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