Abstract
Background: Confocal laser endomicroscopy (CLE) is a novel technique enabling in vivo microscopy of the human gastrointestinal mucosa. Cellular details even below the tissue surface can be visualized at high resolution during ongoing endoscopy. Objective: This review summarizes the current clinical data on the use of CLE in different disease states and discusses a perspective for future clinical and scientific application of CLE. Methods: Review on published literature and meeting abstracts. Results/conclusion: Confocal laser endomicroscopy covers a growing field of indications in both upper and lower gastrointestinal endoscopy and beyond. It has been shown to reliably predict the presence of neoplastic lesions and inflammatory changes of the gastrointestinal mucosa during endoscopy. With CLE, ‘smart’ biopsies can be targeted to regions with microscopic alterations rather than having to rely on blind, untargeted sampling. This results in a reduction in the number of biopsies and in an increase in their diagnostic yield at the same time. Dynamic imaging of microscopic events in their natural environment and molecular imaging by CLE will open a door for an advanced understanding of tissue function and microarchitecture in vivo.