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Wang KK, Carr-Locke DL, Singh SK, Neumann H, Bertani H, Galmiche JP, Arsenescu RI, Caillol F, Chang KJ, Chaussade S, Coron E, Costamagna G, Dlugosz A, Ian Gan S, Giovannini M, Gress FG, Haluszka O, Ho KY, Kahaleh M, Konda VJ, Prat F, Shah RJ, Sharma P, Slivka A, Wolfsen HC, Zfass A. Use of probe-based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence. United European Gastroenterol J 2015; 3:230-54. [PMID: 26137298 DOI: 10.1177/2050640614566066] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/17/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Probe-based confocal laser endomicroscopy (pCLE) provides microscopic imaging during an endoscopic procedure. Its introduction as a standard modality in gastroenterology has brought significant progress in management strategies, affecting many aspects of clinical care and requiring standardisation of practice and training. OBJECTIVE This study aimed to provide guidance on the standardisation of its practice and training in Barrett's oesophagus, biliary strictures, colorectal lesions and inflammatory bowel diseases. METHODS Initial statements were developed by five group leaders, based on the available clinical evidence. These statements were then voted and edited by the 26 participants, using a modified Delphi approach. After two rounds of votes, statements were validated if the threshold of agreement was higher than 75%. RESULTS Twenty-six experts participated and, among a total of 77 statements, 61 were adopted (79%) and 16 were rejected (21%). The adoption of each statement was justified by the grade of evidence. CONCLUSION pCLE should be used to enhance the diagnostic arsenal in the evaluation of these indications, by providing microscopic information which improves the diagnostic performance of the physician. In order actually to implement this technology in the clinical routine, and to ensure good practice, standardised initial and continuing institutional training programmes should be established.
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Affiliation(s)
- Kenneth K Wang
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - David L Carr-Locke
- Division of Digestive Diseases, Beth Israel Medical Center, New York City, NY, USA
| | - Satish K Singh
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Helmut Neumann
- The Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
| | - Helga Bertani
- Endoscopy Unit, Nuovo Ospedale Civile S. Agostino Estense, Modena, Italy
| | | | | | - Fabrice Caillol
- Endoscopy Unit, Paoli-Calmettes Institute, Marseille, France
| | - Kenneth J Chang
- H.H. Chao Comprehensive Digestive Disease Center, University of California, Irvine, CA, USA
| | - Stanislas Chaussade
- Division of Gastroenterology, Hopital Cochin and Paris-Descartes University, Paris, France
| | - Emmanuel Coron
- Division of Gastroenterology and Hepatology, Nantes CHU, Rouen, France
| | | | - Aldona Dlugosz
- Karolinska Institutet, Department of Medicine, Division of Gastroenterology and Hepatology, Karolinska University Hospital, Stockholm, Sweden
| | - S Ian Gan
- Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA
| | - Marc Giovannini
- Endoscopy Unit, Paoli-Calmettes Institute, Marseille, France
| | - Frank G Gress
- Division of Digestive and Liver disease, Columbia University Medical Center, New York City, NY, USA
| | - Oleh Haluszka
- Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA
| | - Khek Y Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michel Kahaleh
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York City, NY, USA
| | - Vani J Konda
- Center for Endoscopic Research and Therapeutics, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Frederic Prat
- Division of Gastroenterology, Hopital Cochin and Paris-Descartes University, Paris, France
| | - Raj J Shah
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Prateek Sharma
- Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, MI, USA ; Department of Gastroenterology and Hepatology, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Adam Slivka
- Division of Gastroenterology & Hepatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Alvin Zfass
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, VA, USA
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