Probe-based confocal laser endomicroscopy for pleural malignancies diagnosis.

[en] BACKGROUND AND OBJECTIVE: Probe based confocal laser endomicroscopy (pCLE) is an optical imaging technique allowing live tissue imaging at a cellular level. Currently, this tool remains experimental. Two studies regarding pleural disease have been published and suggest that pCLE could be valuable for pleural disease investigations. However, normal and malignant pleural pCLE features remain unknown. Therefore, we conducted a prospective trial of pCLE during medical thoracoscopy to study and describe the malignant and benign pleural pCLE features. METHODS: Every patient >18 years referred to our department for medical thoracoscopy was eligible. Medical thoracoscopy was performed under sedation, allowing spontaneous breathing. Five millilitres of fluorescein (10%) was intravenously administrated 5 min before image acquisition. The pCLE was introduced through the working channel of the thoracoscope and gently placed on the parietal pleura to record videos. Afterwards, biopsies were performed on the corresponding sites. Malignant and benign pleural pCLE features were precisely described and compared using 11 preselected criteria. RESULTS: A total of 62 patients were included in the analysis including 36 benign and 26 malignant pleura. Among our preselected criteria, 'abnormal tissue architecture' and 'dysplastic vessels' were strongly associated with malignancies (100% and 85% ss, 721% and 74% sp, respectively) whereas, the 'full chia seeds sign' and 'cell shape homogeneity' were associated with benignity (36% and 56% ss, 100% and 70% sp, respectively). No study-related adverse events occurred. CONCLUSION: Benign and malignant pleural involvement have clearly distinct pCLE features.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

BONHOMME, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie

HEINEN, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de pneumologie - allergologie

Detrembleur, Nancy

Corhay, Jean-Louis ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques

Louis, Renaud ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie

DUYSINX, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Oncologie thoracique

Language :

English

Title :

Probe-based confocal laser endomicroscopy for pleural malignancies diagnosis.

Publication date :

2021

Journal title :

Respirology (Carlton, Vic.)

ISSN :

1323-7799

eISSN :

1440-1843

Volume :

Issue :

Pages :

188-195

Peer reviewed :

Peer reviewed

Additional URL :

https://onlinelibrary.wiley.com/doi/10.1111/resp.13945

Commentary :

Available on ORBi :

since 22 March 2021

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Bibliography

Wijmans L, D'Hooghe JNS, Bonta PI, Annema JT. Optical coherence tomography and confocal laser endomicroscopy in pulmonary diseases. Curr. Opin. Pulm. Med. 2017; 23: 275–83.
Hassan T, Piton N, Lachkar S, Salaün M, Thiberville L. A novel method for in vivo imaging of solitary lung nodules using navigational bronchoscopy and confocal laser microendoscopy. Lung 2015; 193: 773–8.
Hassan T, Thiberville L, Hermant C, Lachkar S, Piton N, Guisier F, Salaun M. Assessing the feasibility of confocal laser endomicroscopy in solitary pulmonary nodules for different part of the lungs, using either 0.6 or 1.4 mm probes. PLoS One 2017; 12: e0189846.
Wijmans L, de Bruin DM, Meijer SL, Annema JT. Needle based confocal laser endomicroscopy for mediastinal lesions, an in vivo pilot-study. Eur. Respir. J. 2016; 48: OA3015.
Wijmans L, Yared J, de Bruin DM, Meijer SL, Baas P, Bonta PI, Annema JT. Needle-based confocal laser endomicroscopy (nCLE) for real-time diagnosing and staging of lung cancer. Eur. Respir. J. 2019; 53: 1801520.
Benias PC, D'Souza LS, Papafragkakis H, Kim J, Harshan M, Theise ND, Carr-Locke DL. Needle-based confocal endomicroscopy for evaluation of malignant lymph nodes – a feasibility study. Endoscopy 2016; 48: 923–8.
Fuchs FS, Zirlik S, Hildner K, Schubert J, Vieth M, Neurath MF. Confocal laser endomicroscopy for diagnosing lung cancer in vivo. Eur. Respir. J. 2013; 41: 1401–8.
Wijmans L, Baas P, Sieburgh TE, de Bruin DM, Ghuijs PM, van de Vijver MJ, Bonta PI, Annema JT. Confocal laser endomicroscopy as a guidance tool for pleural biopsies in malignant pleural mesothelioma. Chest 2019; 156: 754–63.
Zirlik S, Hildner K, Rieker RJ, Vieth M, Neurath MF, Fuchs FS. Confocal laser endomicroscopy for diagnosing malignant pleural effusions. Med. Sci. Monit. 2018; 24: 5437–47.
Galbis JM, Mata M, Guijarro R, Esturi R, Figueroa S, Arnau A. Clinical-therapeutic management of thoracoscopy in pleural effusion: a groundbreaking technique in the twenty-first century. Clin. Transl. Oncol. 2011; 13: 57–60.
Grossebner MW, Arifi AA, Goddard M, Ritchie AJ. Mesothelioma – VATS biopsy and lung mobilization improves diagnosis and palliation. Eur. J. Cardiothorac. Surg. 1999; 16: 619–23.
Kindler HL, Ismaila N, Armato SG, Bueno R, Hesdorffer M, Jahan T, Jones CM, Miettinen M, Pass H, Rimner A et al. Treatment of malignant pleural mesothelioma: American Society of Clinical Oncology clinical practice guideline. J. Clin. Oncol. 2018; 36: 1343–73.
Bonhomme O, Duysinx B, Heinen V, Detrembleur N, Corhay J-L, Louis R. First report of probe based confocal laser endomicroscopy during medical thoracoscopy. Respir. Med. 2019; 147: 72–5.
Prakash UBS, Reiman HM. Comparison of needle biopsy with cytologic analysis for the evaluation of pleural effusion: analysis of 414 cases. Mayo Clin. Proc. 1985; 60: 158–64.
Loddenkemper R. Thoracoscopy – state of the art. Eur. Respir. J. 1998; 11: 213–21.
Skalski J, Astoul P, Maldonado F. Medical thoracoscopy. Semin. Respir. Crit. Care Med. 2014; 35: 732–43.
Xia H, Wang X-J, Zhou Q, Shi H-Z, Tong Z-H. Efficacy and safety of talc pleurodesis for malignant pleural effusion: a meta-analysis. PLoS One 2014; 9: e87060.
Fockens P, Chen Y, Dekker E, Sharma P, Lauwers G, Meining A, Wallace M. Miami classification for probe-based confocal laser endomicroscopy. Endoscopy 2011; 43: 882–91.
English JC, Leslie KO. Pathology of the pleura. Clin. Chest Med. 2006; 27: 157–80.
Cannizzaro R, Mongiat M, Canzonieri V, Fornasarig M, Maiero S, De Re V, Todaro F, De Paoli P, Spessotto P. Endomicroscopy and cancer: a new approach to the visualization of neoangiogenesis. Gastroenterol. Res. Pract. 2012; 2012: 1–5.
Wong TY, Sun J, Kawasaki R, Ruamviboonsuk P, Gupta N, Lansingh VC, Maia M, Mathenge W, Moreker S, Muqit MMK et al. Guidelines on diabetic eye care: the International Council of Ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings. Ophthalmology 2018; 125: 1608–22.
Dvorak HF. Vascular permeability factor/vascular endothelial growth factor: a critical cytokine in tumor angiogenesis and a potential target for diagnosis and therapy. J. Clin. Oncol. 2002; 20: 4368–80.
Ramjiawan RR, Griffioen AW, Duda DG. Anti-angiogenesis for cancer revisited: is there a role for combinations with immunotherapy? Angiogenesis 2017; 20: 185–204.
Napoleon B, Palazzo M, Lemaistre A, Caillol F, Palazzo L, Aubert A, Buscail L, Maire F, Morellon BM, Pujol B et al. Needle-based confocal laser endomicroscopy of pancreatic cystic lesions: a prospective multicenter validation study in patients with definite diagnosis. Endoscopy 2019; 51: 825–35.
Fumex F, Napoleon B, Lucidarme D, Filoche B, Palazzo L, Monges G, Giovannini M, Lepilliez V, Pujol B, Caillol F et al. A novel approach to the diagnosis of pancreatic serous cystadenoma: needle-based confocal laser endomicroscopy. Endoscopy 2015; 47: 26–32.
Konda VJ, Meining A, Jamil LH, Giovannini M, Hwang JH, Wallace MB, Chang KJ, Siddiqui UD, Hart J, Lo SK et al. A pilot study of in vivo identification of pancreatic cystic neoplasms with needle-based confocal laser endomicroscopy under endosonographic guidance. Endoscopy 2013; 45: 1006–13.
Krishna SG, Hart PA, Malli A, Kruger A, McCarthy ST, El-Dika S, Walker JP, Dillhoff ME, Manilchuk A, Schmidt CR et al. Endoscopic ultrasound-guided confocal laser endomicroscopy increases accuracy of differentiation of pancreatic cystic lesions. Clin. Gastroenterol. Hepatol. 2020; 18: 432–40.e6.
Liu J, Li M, Li Z, Zuo X-L, Li C-Q, Dong Y-Y, Zhou C-J, Li Y-Q. Learning curve and interobserver agreement of confocal laser endomicroscopy for detecting precancerous or early-stage esophageal squamous cancer. PLoS One 2014; 9: e99089.
Buchner AM, Gomez V, Heckman MG, Shahid MW, Achem S, Gill KR, Laith J, Kahaleh M, Lo SK, Picco M et al. The learning curve of in vivo probe-based confocal laser endomicroscopy for prediction of colorectal neoplasia. Gastrointest. Endosc. 2011; 73: 556–60.