Identification of liver metastases with confocal laser endomicroscopy at two excitation wavelengths

Metastasis of colorectal cancer to the liver is the most common indication for hepatic resection in a western population. Incomplete excision of malignancy due to residual microscopic disease normally results in worse patient outcome. Therefore, a method aiding in the real time discrimination of normal and malignant tissue on a microscopic level would be of benefit.
The ability of fluorescent probe-based confocal laser endomicroscopy to identify normal and malignant liver tissue was evaluated in an orthotopic murine model of colorectal cancer liver metastasis. To maximise information yield, two clinical fluorophores, fluorescein and indocyanine green were injected and imaged in a dual wavelength approach (488 and 660 nm, respectively). Visual tissue characteristics on probe-based confocal laser endomicroscopy examination were compared with histological features. Fluorescence intensity in both tissues was statistically analysed to elucidate if this can be used to differentiate between normal and malignant tissue.

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