Endoscopic Ultrasound-guided Needle-based Confocal Laser Endomicroscopy for Evaluation of Malignant Lymph Nodes - a Pilot Study

Current modalities for lymph node staging in cancer can be limited. Needle-based confocal laser endomicroscopy (nCLE) is a novel endoscopic technique, which is compatible with the 19-gauge FNA needle. Under endoscopic ultrasonography (EUS) guidance, nCLE enables real-time in vivo imaging of lesion tissues at cellular and subcellular levels.This study aimed to evaluate the feasibility of needle-based confocal laser endomicroscopy (nCLE) at the time of endoscopic ultrasound (EUS) and to describe the nCLE features that distinguish between benign and malignant lymph nodes.

Inclusion Criteria:

• patients undergoing EUS for staging of malignancy or assessment of enlarged lymph nodes

Exclusion Criteria:

• Patients aged <18 years or >80 years
• Known allergy to fluorescein dye
• Previous EUS-FNA performed within the past 3 months, and usualcontraindications to EUS-FNA
• Pregnancy or breastfeeding
• Inability to provide informed consent