Proceedings of the American Thoracic Society
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The Proceedings of the American Thoracic Society 6:444-449 (2009)
© 2009 The American Thoracic Society
doi: 10.1513/pats.200902-009AW
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Confocal Fluorescence Endomicroscopy of the Human Airways

Luc Thiberville1,2, Mathieu Salaün1,2, Samy Lachkar1, Stephane Dominique1, Sophie Moreno-Swirc1, Christine Vever-Bizet3,4 and Genevieve Bourg-Heckly3,4

1 Rouen University Hospital, Rouen, France; 2 Faculté de Médecine-Pharmacie, Rouen, France; LITIS EA 4108 (groupe Quant-IF), Rouen, France; 3 Université Pierre et Marie Curie, Paris, France; and 4 UMR CNRS 7033, BioMoCeTi, Paris, France

Correspondence and requests for reprints should be addressed to Luc Thiberville, M.D., Clinique Pneumologique, Hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen Cedex, France. E-mail: Luc.Thiberville{at}univ-rouen.fr

ABSTRACT

Confocal endomicroscopes aim at providing to the clinician microscopic imaging of a living tissue. The currently available microendoscopic devices use the principle of confocal fluorescent microscopy, in which the objective is replaced by an optical fiber and a miniaturized scanhead at the distal end of the endoscope or by a retractable bundle of optical fibers. Such systems have recently been applied to the explorations of several organs, including the gastrointestinal tract, and more recently to the proximal and distal airways in vivo. Respiratory fluorescence microendoscopes use 488 nm or 660 nm excitation laser light and thin flexible miniprobes that are introduced into the working channel of the bronchoscope. The devices have a lateral resolution of 3 µm, a field of view of 600 µm, and produce real-time imaging at 9 frames per second. For in vivo imaging, the miniprobe is applied onto the bronchial wall surface or advanced into a distal bronchiole down to the acinus. In nonsmokers, the 488-nm excitation device images the autofluorescence of the elastin that is contained in the basement membrane of the proximal airways and that participates to the axial backbone of the peripheral interstitial respiratory system. In smokers, a specific tobacco tar–induced fluorescence allows in vivo macrophage and alveolar wall imaging. Using 660 nm excitation and topical methylene blue, the technique enables cellular imaging of both bronchial epithelial layer and peripheral lung nodules. This article reviews the capabilities and possible limitations of confocal microendoscopy for in vivo proximal and distal lung explorations.

Key Words: bronchoscopy • diagnostic imaging • laser scanning • confocal microscopy • pulmonary alveoli


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Chair's Summary
Vladimir R. Muzykantov
Proceedings of the American Thoracic Society 2009 6: 398-402. [Full Text]  





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