Confocal laser endomicroscopy for diagnosing respiratory diseases

Standard imaging techniques regularly are non-diagnostic due to a lack of resolution. Tissue biopsies sometimes also fail to make a diagnosis because of a sampling error caused by a near miss of the lesion. This thesis examines the value of confocal laser endomicroscopy (CLE), which is a real-time imaging technique with near-microscopic resolutions that can be combined with standard diagnostic techniques in pulmonology. In lung cancer CLE is capable of detection of malignancy in tumors and metastatic lymph nodes. Malignant areas were identified in fibrotic pleural lesions in malignant pleural mesothelioma and in interstitial lung diseases important ILD-features such as microscopic honeycombing and different stages of fibrosis were identified. In the future CLE might have a role in the verification that a navigation-guided robot reached a target lesion suspected for lung cancer. In interstitial lung diseases, CLE might reduce the number and the severity of complications and might improve biopsy quality by identification of the ideal biopsy location. The development of classified validation systems is needed to support the use of novel advanced endoscopic imaging techniques.