Endoscopic ultrasound-guided confocal endomicroscopy requires high-quality imaging and interpretation for diagnostic evaluation of pancreatic cystic lesions.

Abstract

The needle-based confocal endomicroscopy (nCLE) probe was first approved by the Food and Drug Administration (FDA) in 2013. In a “white paper” published by the American Gastroenterology Association, competency-based training of novel endoscopic imaging techniques was emphasized compared to the traditional volume-based model of procedures [1]. We define competency as the ability to recognize diagnostic image patterns in nCLE. Only with familiarity of these patterns, can the endoscopist acquire them during the procedure. While competency needs to be achieved before physicians start enrolling patients in a prospective study, image acquisition quality also needs to be continually monitored during the study process to evaluate the learning curve and detect any potential deficiencies.