High-resolution miniprobe-based confocal microscopy in combination with video mosaicing (with video)

Background: A new portable confocal laser microscopy system has recently been developed Objective: Our purpose was to evaluate the feasibility of performing real-time microscopic imaging with a prototype of a new high-resolution miniprobe in conjunction with a video mosaicing algorithm. Design: Feasibility study Setting: Tertiary referral center at a large university hospital. Patients: Seven patients referred for endoscopy for various indications. Main Outcome Measurements: High-resolution laser microscopy of the upper and lower GI tract was performed with standard endoscopes. Seven to 10 mL of 1% fluorescein was injected intravenously a few seconds before the procedure. No additional preparation was required. The prototype used has a lateral resolution of 1.2 mu m and an axial resolution of 3 mu m with a total field of 240 x 200 mu m. From all stored video sequences a video mosaicing algorithm was used to combine the successive individual images, cancel motion artifacts, and reconstitute panoramas of the tissues. Results: Cell-to-cell borders, single cell structures, and mucosal inflammation was readily detectable. By the use of the mosaicing algorithm, the image area could be increased 2- to 4-fold, and image definition could be further enhanced to allow finer detail visualization. Limitations: Low number of patients, early feasibility study. Conclusions: Our preliminary data show that high-resolution miniprobe-based confocal fluorescence microscopy in conjunction with video mosaicing has the potential to provide images similar to standard histopathologic studies. Dynamic images with a smaller field of view can be combined to reconstruct still images of high resolution covering a fairly large area.