Reduced Intravenous Fluorescein Dose for Upper and Lower Gastrointestinal Tract Probe-Based Confocal Laser Endomicroscopy
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE. Methods: Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in thestudy. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination ofthe optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by threeendoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were notdeemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated. Results: A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLEwith IV fluorescein at 0.5 mg/kg. Conclusions: In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both theupper and lower GI tract.
Abstract
Background/Aims: Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE. Methods: Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in thestudy. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination ofthe optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by threeendoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were notdeemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated. Results: A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLEwith IV fluorescein at 0.5 mg/kg. Conclusions: In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both theupper and lower GI tract.
참고문헌 (32)
- Wallace MB, "Probe-based confocal laser endomicroscopy", Gastroenterology, 136, pp.1509~1513 (2009)
- Sharma P, "Real-time increased detection of neoplastic tissue in Barrett’s esophagus with probe-based confocal laser endomicroscopy : final results of an international multicenter, prospective, randomized, controlled trial", Gastrointest Endosc, 74, pp.465~472 (2011)
- Park JC, "Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection", J Gastroenterol Hepatol, 32, pp.1046~1054 (2017)
- Kim B, "Probe-based confocal laser endomicroscopy for evaluating the submucosal invasion of colorectal neoplasms", Surg Endosc, 31, pp.594~601 (2017)
- Abe S, "Pilot study on probe-based confocal laser endomicroscopy for colorectal neoplasms : an initial experience in Japan", Int J Colorectal Dis, 33, pp.1071~1078 (2018)
- Buchner AM, "The learning curve of in vivo probe-based confocal laser endomicroscopy for prediction of colorectal neoplasia", Gastrointest Endosc, 73, pp.556~560 (2011)
- Pittayanon R, "The learning curve of gastric intestinal metaplasia interpretation on the images obtained by probe-based confocal laser endomicroscopy", Diagn Ther Endosc, 2012, pp.278045~ (2012)
- Wallace MB, "The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract", Aliment Pharmacol Ther, 31, pp.548~552 (2010)
- Ha SO, "Anaphylaxis caused by intravenous fluorescein : clinical characteristics and review of literature", Intern Emerg Med, 9, pp.325~330 (2014)
- Xu K, "Intravenous fluorescein angiography-associated adverse reactions", Can J Ophthalmol, 51, pp.321~325 (2016)
- Marcus DF, "Adverse reactions during intravenous fluorescein angiography", Arch Ophthalmol, 102, pp.825~ (1984)
- Yannuzzi LA, "Fluorescein angiography complication survey", Ophthalmology, 93, pp.611~617 (1986)
- Lira RP, "Adverse reactions of fluorescein angiography : a prospective study", Arq Bras Oftalmol, 70, pp.615~618 (2007)
- McLauchlan R, "Ethnic variation in fluorescein angiography induced nausea and vomiting", Eye(Lond), 15(Pt 2), pp.159~162 (2001)
- Keerl R, "Use of sodium fluorescein solution for detection of cerebrospinal fluid fistulas : an analysis of 420 administrations and reported complications in Europe and the United States", Laryngoscope, 114, pp.266~272 (2004)
- Dowlati A, "Novel phase I dose de-escalation design trial to determine the biological modulatory dose of the antiangiogenic agent SU5416", Clin Cancer Res, 11, pp.7938~7944 (2005)
- Sano Y, "Narrow-band imaging(NBI)magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI expert team", Dig Endosc, 28, pp.526~533 (2016)
- Wallace M, "Miami classification for probebased confocal laser endomicroscopy", Endoscopy, 43, pp.882~891 (2011)
- Zhang YL, "A lower dose of fluorescein sodium is more suitable for confocal laser endomicroscopy : a feasibility study", Gastrointest Endosc, 84, pp.917~923 (2016)
- Caillol F, "Endomicroscopy in bile duct : inflammation interferes with pCLE applied in the bile duct : a prospective study of 54 patients", United European Gastroenterol J, 1, pp.120~127 (2013)
- Shahid MW, "Exploring the optimal fluorescein dose in probe-based confocal laser endomicroscopy for colonic imaging", J Interv Gastroenterol, 1, pp.166~171 (2011)
- Nonaka K, "Probe-based confocal laser endomicroscopy of the duodenal mucosa with fluorescein dispersion", Dig Endosc, 26, pp.604~ (2014)
- Nonaka K, "Histopathological confirmation of similar intramucosal distribution of fluorescein in both intravenous administration and local mucosal application for probe-based confocal laser endomicroscopy of the normal stomach", World J Clin Cases, 3, pp.993~999 (2015)
- Tashima T, "Successful ex-vivo probe-based confocal laser endomicroscopy of a superficial nonampullary duodenal epithelial tumor with dripping of food additives : a case of tubular adenocarcinoma", VideoGIE, 4, pp.128~130 (2019)
- Meining A, "Classification of probe-based confocal laser endomicroscopy findings in pancreaticobiliary strictures", Endoscopy, 44, pp.251~257 (2012)
- Spessotto P, "Probe-based confocal laser endomicroscopy for in vivo evaluation of the tumor vasculature in gastric and rectal carcinomas", Sci Rep, 7, pp.9819~ (2017)
- Tian Y, "Papaverine adjuvant therapy for microcirculatory disturbance in severe ulcerative colitis complicated with CMV infection : a case report", Clin J Gastroenterol, 12, pp.407~413 (2019)
- Shah T, "Accuracy of probe-based confocal laser endomicroscopy(pCLE)compared to random biopsies during endoscopic surveillance of Barrett’s esophagus", Endosc Int Open, 6, pp.E414~E420 (2018)
- Wellikoff AS, "Comparison of in vivo probe-based confocal laser endomicroscopy with histopathology in lung cancer : a move toward optical biopsy", Respirology, 20, pp.967~974 (2015)
- Caillol F, "Evaluation of pCLE in the bile duct : final results of EMID study : pCLE : impact in the management of bile duct strictures", Surg Endosc, 29, pp.2661~2668 (2015)
- Löhr JM, "Outcome of probe-based confocal laser endomicroscopy(pCLE)during endoscopic retrograde cholangiopancreatography : a single-center prospective study in 45 patients", United European Gastroenterol J, 3, pp.551~560 (2015)
- Wu K, "Dynamic real-time microscopy of the urinary tract using confocal laser endomicroscopy", Urology, 78, pp.225~231 (2011)