further applications

Endomicroscopy can not only be used to receive histology. The great potential of endomicroscopy is to display and observe physiologic and pathophysiologic changes during ongoing endoscopy. Furthermore molecular imaging becomes possible.

Cell shedding is a physiologic process. After cell shedding an epithelial gap occurs, this is sealed within seconds. Patients with inflammatory bowel disease show malfunction of gap closure which can lead to invasion of bacteria into the lamina propria. These changes can be observed with endomicroscopy and might define new options for treatment of inflammatory bowel diseases [Kiesslich et al. 2007]. Endomicroscopy displays not only tissue also bacterial interaction with the mucosal layer can be seen [Günther et al. 2008].

Molecular imaging has already achieved [Hsiung et al. 2008]. Dysplastic colonic crypts could be selectively stained with heptapeptides which were linked with fluorescein. This approach will open the door for new clinical algorithms, which will be dependent on the endomicroscopic findings (e.g. predictiction of the efficiency of chemotherapy with biological).

The diagnostic spectrum of endomicroscopy is constantly increasing and the borders of the GI-tract are already passed. Endomicroscopy can be used to investigate the bile duct, the liver and the cervix [Meining et al. 2008, Goetz et al. 2008, Tan et al 2007].