High-resolution Real-time Imaging Research Articles

Examining the Percent Canopy Cover and Health of Winter Wheat in No-Till and Conventional Tillage Plots Using a Drone

The percent canopy cover and health of winter wheat are important crop performance indicators. Thus, understanding how tillage management practices affect these indicators is beneficial for improving crop performance and consequently yield. The availability of high-resolution drone data with spectral characteristics provides an opportunity to examine the percent canopy cover and health of winter wheat in different tillage systems. This is because the use of drones provides real-time high spatial resolution and temporal images to effectively monitor winter wheat conditions throughout the growing season. Nonetheless, very limited studies have utilized drone data for assessing the percent canopy cover and health conditions of winter wheat for different tillage practices. This study aimed to examine the percent canopy cover and health of winter wheat in no-till and conventional tillage plots using a drone. We used the mean Normalized Difference Vegetation Index (NDVI) ± Standard Deviation (SD) (0.89 ± 0.04) of winter wheat for the growth stages of tillering, jointing, and boot/heading to generate the percent wheat canopy cover. The Normalized Difference Red-Edge (NDRE) produced for winter wheat at the middle and late growth stages was used as a proxy for wheat health condition. We found that the mean percentage canopy cover of winter wheat was about 4% higher in no-till compared to conventional tillage plots in most of the growing season. The mean NDRE ± standard error (SE) of winter wheat was about 0.44 ± 0.01 and 0.43 ± 0.01 for no-till and conventional tillage plots, respectively, during the mid- and late growth stages. There was no significant difference in either the percent canopy cover or health of winter wheat between no-till and conventional tillage plots. The results generated in this study could be used to support farmers’ decision-making process regarding tillage practices and wheat crop performance.

IoT-Enhanced local attention dual networks for pathological image restoration in healthcare

High-resolution pathological images play a pivotal role in accurate disease diagnosis and are important in precision medicine. However, obtaining real-time high-resolution images faces challenges due to hardware limitations and scanning time constraints. Conventional image super-resolution restoration algorithms struggle to provide satisfactory results for pathological images, resulting in blurred and unrealistic restorations. In response to this challenge, this research proposes a pioneering approach by integrating Internet of Things (IoT) technology with Local Attention Dual Network (IOT-LAT) for super-resolution restoration of pathological images. The enhanced IOT-LATincorporates IoT-based data acquisition and processing, IoT-Enhanced non-local attention mechanisms, Gaussian constraint, and parameter-sharing strategies in up-sampling and down-sampling branches. This integration enables real-time super-resolution restoration of pathological images with improved accuracy. The reconstructed images exhibit a structural similarity of 0.914 and a peak signal-to-noise ratio of 30.84 dB. These results validate the effectiveness of the suggested approach in precisely reconstructing high-frequency details and improving modelling efficiency via a lightweight non-local attention mechanism enhanced by the Internet of Things. This work discusses IoT and non-local attention dual networks to improve pathological image super-resolution restoration. This allows for faster and more accurate disease diagnosis and treatment in precision medicine.

Monolithic integration of perovskite heterojunction on TFT backplanes through vapor deposition for sensitive and stable x-ray imaging.

Metal halide perovskites exhibit substantial potential for advancing next-generation x-ray detection. However, fabricating high-performance pixelated imaging arrays remains challenging due to the substantial dark current density and stability issues associated with common organic-inorganic hybrid perovskites. Here, we develop a vapor deposition method to create the first all-inorganic perovskite heterojunction film. The heterojunction introduction effectively reduces the dark current density of detectors to about 0.8 nA·cm-2, satisfying thin-film transistor (TFT) integration standards, while also increases sensitivity to above 2.6 × 104 μC·Gyair-1·cm-2, thus giving rise to a record low detection limit of <1 nGyair·s-1 among all polycrystalline perovskite-based x-ray detectors. The devices also demonstrate remarkable stability across multifarious demanding working conditions. Last, through monolithic integration of the heterojunction film with a 64 × 64 pixelated TFT array, we have achieved high-resolution real-time x-ray imaging, which paves the way for the application of all-inorganic perovskite in low-dose flat-panel x-ray detection.

A comparative study of EM-CCD and CMOS cameras for particle ion trajectory imaging

High-resolution and real-time imaging of particle ion trajectories is essential in nuclear medicine and nuclear engineering. One potential method to achieve high-resolution real-time trajectory imaging of particle ions involves utilizing an imaging system that integrates a scintillator plate with a magnifying unit and a cooled electron multiplying charge-coupled device (EM-CCD) camera. However, acquiring an EM-CCD camera might prove challenging due to the discontinuation of CCD sensor manufacturing by vendors. As an alternative imaging approach, a low-noise, high-sensitivity camera utilizing a cooled complementary metal-oxide-semiconductor (CMOS) sensor offers a promising solution for imaging particle ion trajectories. Yet, it remains uncertain whether CMOS-based cameras can perform as effectively as CCD-based cameras in capturing particle ion trajectories. To address these concerns, we conducted a comparative analysis of the imaging performance between a CMOS-based system and an EM-CCD-based system for capturing alpha particle trajectories. The results revealed that both systems could image the trajectories of alpha particle, but the spatial resolution with the CMOS-based camera exceeded that of the EM-CCD-based camera, primarily due to the smaller pixel size of the sensor. While the signal-to-noise ratio (SNR) of the trajectory image from the CMOS-based camera initially lagged behind that from the EM-CCD-based camera, this disparity was mitigated by implementing binning techniques on the CMOS-based camera images. In conclusion, our findings suggest that a cooled CMOS camera could serve as a viable alternative for imaging particle ion trajectories.

An Embedded-GPU-Based Scheme for Real-Time Imaging Processing of Unmanned Aerial Vehicle Borne Video Synthetic Aperture Radar

The UAV-borne video SAR (ViSAR) imaging system requires miniaturization, low power consumption, high frame rates, and high-resolution real-time imaging. In order to satisfy the requirements of real-time imaging processing for the UAV-borne ViSAR under limited memory and parallel computing resources, this paper proposes a method of embedded GPU-based real-time imaging processing for the UAV-borne ViSAR. Based on a parallel programming model of the compute unified device architecture (CUDA), this paper designed a parallel computing method for range-Doppler (RD) and map drift (MD) algorithms. By utilizing the advantages of the embedded GPU characterized with parallel computing, we improved the processing speed of real-time ViSAR imaging. This paper also adopted a unified memory management method, which greatly reduces data replication and communication latency between the CPU and the GPU. The data processing of 2048 × 2048 points took only 1.215 s on the Jetson AGX Orin platform to form a nine-consecutive-frame image with a resolution of 0.15 m, with each frame taking only 0.135 s, enabling real-time imaging at a high frame rate of 5 Hz. In actual testing, continuous mapping can be achieved without losing the scenes, intuitively obtaining the dynamic observation effects of the area. The processing results of the measured data have verified the reliability and effectiveness of the proposed scheme, satisfying the processing requirements for real-time ViSAR imaging.

Physics constrained unsupervised deep learning for rapid, high resolution scanning coherent diffraction reconstruction

By circumventing the resolution limitations of optics, coherent diffractive imaging (CDI) and ptychography are making their way into scientific fields ranging from X-ray imaging to astronomy. Yet, the need for time consuming iterative phase recovery hampers real-time imaging. While supervised deep learning strategies have increased reconstruction speed, they sacrifice image quality. Furthermore, these methods’ demand for extensive labeled training data is experimentally burdensome. Here, we propose an unsupervised physics-informed neural network reconstruction method, PtychoPINN, that retains the factor of 100-to-1000 speedup of deep learning-based reconstruction while improving reconstruction quality by combining the diffraction forward map with real-space constraints from overlapping measurements. In particular, PtychoPINN gains a factor of 4 in linear resolution and an 8 dB improvement in PSNR while also accruing improvements in generalizability and robustness. This blend of performance and computational efficiency offers exciting prospects for high-resolution real-time imaging in high-throughput environments such as X-ray free electron lasers (XFELs) and diffraction-limited light sources.

Scleral Suture Intraocular Lens Fixation Under Microscope-Intraoperative Optical Coherence Tomography.

The aim of this study was to evaluate the accessibility and potential value of intraoperative optical coherence tomography (iOCT) during scleral suture intraocular lens (IOL) fixation. This was a prospective cohort study in the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, China. Seven eyes with insufficient capsular support and undergoing two-point scleral suture IOL fixation were included. The potential value of iOCT was evaluated, as well as the safety and efficacy of the surgery. Seven eyes were included. With a tailor-made iOCT, the structure of the anterior segment could be clearly visualized during the surgery. Intraoperatively, iOCT helped locate the proper place for fixation and access the position of the IOL. After an average 4.43-month follow-up, the spherical equivalent changed significantly ( P < 0.001), but the intraocular pressure, best-corrected visual acuity, and endothelial cell density remained unchanged ( P > 0.05). The IOL was well-centered with a horizontal and a vertical tilt of 0.74 ± 0.60° and 1.13 ± 0.65°, and decentration of 0.28 ± 0.12 mm and 0.30 ± 0.13 mm. The estimated IOL-induced astigmatism was -0.11 diopters (D) ± 0.46 D. Real-time high-resolution images of the anterior segment acquired by the iOCT helped the surgeon to achieve satisfactory results in scleral suture IOL fixation.

Disordered metasurface enabled single-shot full-Stokes polarization imaging leveraging weak dichroism

Polarization, one of the fundamental properties of light, is critical for certain imaging applications because it captures information from the scene that cannot directly be recorded by traditional intensity cameras. Currently, mainstream approaches for polarization imaging rely on strong dichroism of birefringent crystals or artificially fabricated structures that exhibit a high diattenuation typically exceeding 99%, which corresponds to a polarization extinction ratio (PER) >~100. This not only limits the transmission efficiency of light, but also makes them either offer narrow operational bandwidth or be non-responsive to the circular polarization. Here, we demonstrate a single-shot full-Stokes polarization camera incorporating a disordered metasurface array with weak dichroism. The diattenuation of the metasurface array is ~65%, which corresponds to a PER of ~2. Within the framework of compressed sensing, the proposed disordered metasurface array serves as an efficient sensing matrix. By incorporating a mask-aware reconstruction algorithm, the signal can be accurately recovered with a high probability. In our experiments, the proposed approach exhibits high-accuracy full-Stokes polarimetry and high-resolution real-time polarization imaging. Our demonstration highlights the potential of combining meta-optics with reconstruction algorithms as a promising approach for advanced imaging applications.

The CathCam: A Novel Angioscopic Solution for Endovascular Interventions.

Peripheral arterial diseases are commonly managed with endovascular procedures, which often face limitations in device control and visualization under X-ray fluoroscopy guidance. In response, we developed the CathCam, an angioscope integrated into an expandable cable-driven parallel mechanism to enhance real-time visualization, precise device positioning and catheter support for successful plaque crossing. The primary objective of this study was to assess and compare the performance of the novel CathCam with respect to conventional catheters and the CathPilot (i.e., CathCam without the angioscope), for applications in crossing chronic total occlusions (CTO). We first assessed the system in 3D-printed phantom models, followed by an ex vivo evaluation with CTO samples from a patient's superficial femoral artery. We measured and compared success rates, crossing times, and fluoroscopy times in both experiments. The CathCam demonstrated a 100% success rate in phantom experiments and a 75% success rate in ex vivo experiments with CTO samples, compared to conventional catheters, with 35% and 25% success rates, respectively. The average crossing times for the CathCam and the conventional catheter were 31s and 502s for the phantom experiments and 210s and 511s for the actual CTO lesions. The Cathcam also showed to be a reliable endovascular imaging approach in an in vivo experiment. Compared to conventional catheters, the CathCam significantly increased the success rate and reduced crossing and fluoroscopy times in both phantom and ex vivo setups. CathCam can potentially improve clinical outcomes for minimally invasive endovascular interventions by offering high-resolution real-time imaging alongside accurate device control.

Advanced integration of stereotaxis and real-time MRI for precise and safe medical navigation: a future paradigm for minimally invasive interventions

Minimally invasive techniques have transformed medicine by improving patient outcomes and reducing invasiveness. Existing navigation methods, which use fluoroscopy or pre-operative imaging, lack real-time visualization and precision during complex surgeries. Fluoroscopy may also expose patients and medical staff to ionizing radiation. We propose enhanced stereotaxis and real-time magnetic resonance imaging (MRI) integration to overcome these problems and improve minimally invasive intervention precision and safety. Stereotactic guiding and high-resolution real-time MRI imaging are combined in this research to improve medical navigation. The conceptual framework includes modeling the stereotactic system's magnetic field, real-time tracking of magnetic-sensored medical devices, and dynamic MRI imaging for continuous visibility throughout treatments. Stereotactic and MRI data can be fused for simultaneous vision and navigation, and adaptive path planning algorithms allow real-time targeting and avoidance of key structures. A simulated cardiac electrophysiology catheter ablation treatment shows the combined approach's potential benefits. Real-time adaptive navigation reduces radiation exposure and problems while targeting precisely. This research establishes a new medical navigation paradigm that improves precision, patient safety, and radiation exposure. This integrated method could revolutionize minimally invasive procedures across medical disciplines, despite limitations in patient-specific data integration and real-time algorithm development. This new navigation approach needs further research, validation, and clinical trials to confirm its feasibility and efficacy and improve medical patient care

A high-resolution real-time imaging system for observing the trajectories of neutron induced particles in a scintillator

High-resolution imaging of neutron induced particles is required in such methods as neutron radiography. However, the scintillation spots in a neutron-sensitive scintillator have not yet been imaged nor measured for size. We developed a high-resolution, real-time neutron induced particle imaging system for observing these particles' trajectories in a scintillator. The developed system is based on a magnifying unit and a cooled electron multiplying charge-coupled device (EM-CCD) camera combined with a lithium-containing silver-doped zinc sulfide (Li-ZnS(Ag)) scintillator plate. Neutrons from a californium-252 (252Cf) source were irradiated to the Li-ZnS(Ag) scintillator and imaged with the system. Using our system, we measured the scintillation spots of the neutron induced particles having different shapes in real time. In some of these measured scintillation spots, those with elliptical shapes were observed due to the trajectories of the particles in the scintillator. The spatial resolution calculated from the widths of the scintillation spots was ∼56 μm. Consequently, the developed imaging system is promising for research on neutron imaging that requires high spatial resolution.

Predicting 3D soft tissue dynamics from 2D imaging using physics informed neural networks

Tissue dynamics play critical roles in many physiological functions and provide important metrics for clinical diagnosis. Capturing real-time high-resolution 3D images of tissue dynamics, however, remains a challenge. This study presents a hybrid physics-informed neural network algorithm that infers 3D flow-induced tissue dynamics and other physical quantities from sparse 2D images. The algorithm combines a recurrent neural network model of soft tissue with a differentiable fluid solver, leveraging prior knowledge in solid mechanics to project the governing equation on a discrete eigen space. The algorithm uses a Long-short-term memory-based recurrent encoder-decoder connected with a fully connected neural network to capture the temporal dependence of flow-structure-interaction. The effectiveness and merit of the proposed algorithm is demonstrated on synthetic data from a canine vocal fold model and experimental data from excised pigeon syringes. The results showed that the algorithm accurately reconstructs 3D vocal dynamics, aerodynamics, and acoustics from sparse 2D vibration profiles.

Block-based compressed sensing for fast optic fiber bundle imaging with high spatial resolution.

The resolution of traditional fiber bundle imaging is usually limited by the density and the diameter of the fiber cores. To improve the resolution, compression sensing was introduced to resolve multiple pixels from a single fiber core, but current methods have the drawbacks of excessive sampling and long reconstruction time. In this paper, we present, what we believe to be, a novel block-based compressed sensing scheme for fast realization of high-resolution optic fiber bundle imaging. In this method, the target image is segmented into multiple small blocks, each of which covers the projection area of one fiber core. All block images are independently and simultaneously sampled and the intensities are recorded by a two-dimensional detector after they are collected and transmitted through corresponding fiber cores. Because the size of sampling patterns and the sampling numbers are greatly reduced, the reconstruction complexity and reconstruction time are also decreased. According to the simulation analysis, our method is 23 times faster than the current compressed sensing optical fiber imaging for reconstructing a fiber image of 128 × 128 pixels, while the sampling number is only 0.39%. Experiment results demonstrate that the method is also effective for reconstructing large target images and the number of sampling does not increase with the size of the image. Our finding may provide a new idea for high-resolution real-time imaging of fiber bundle endoscope.

Meso-mechanical anisotropy and fracture evolution of reef limestones from the Maldives Islands and the South China Sea

Reef limestone is a biogenic sedimentary rock widely distributed in coral reef areas, acting as an important foundation for coast construction. Due to its special biogenic origin, reef limestone is different from conventional rocks both in terms of rock structure and mechanical properties. In this study, mesoscale uniaxial compression experiments with five different loading directions were conducted on two kinds of reef limestones from the Maldives Islands and the South China Sea, respectively. The real-time high-resolution videos and images of failure processes were recorded simultaneously to investigate the fracture evolution and fracture surface roughness of reef limestones. It demonstrated that the reef limestones belonged to extremely soft to soft rocks, and their uniaxial compressive strength (UCS) values fluctuated with high discreteness. The mesoscale mechanical properties of reef limestones were highly anisotropic and mainly controlled by pore structure. The occurrence of dissolution pores in reef limestone tended to intensify mechanical anisotropy. With the integration of the fracture initiation and propagation features of reef limestones, it is supposed that the intrinsic mechanism of anisotropy was probably attributed to the differences in coral growth direction and dissolution. Furthermore, the quantified fracture surface roughness was revealed to have a good consistency with density and UCS for the reef limestones from the South China Sea. The findings are helpful for providing theoretical and experimental references for engineering construction in coral reef areas.

A Bright NIR-II Fluorescence Probe for Vascular and Tumor Imaging.

As an emerging imaging technology, near-infrared II (NIR-II, 1000-1700 nm) fluorescence imaging has significant potential in the biomedical field, owing to its high sensitivity, deep tissue penetration, and superior imaging with spatial and temporal resolution. However, the method to facilitate the implementation of NIR-II fluorescence imaging for some urgently needed fields, such as medical science and pharmacy, has puzzled relevant researchers. This protocol describes in detail the construction and bioimaging applications of a NIR-II fluorescence molecular probe, HLY1, with a D-A-D (donor-acceptor-donor) skeleton. HLY1 showed good optical properties and biocompatibility. Furthermore, NIR-II vascular and tumor imaging in mice was performed using a NIR-II optics imaging device. Real-time high-resolution NIR-II fluorescence images were acquired to guide the detection of tumors and vascular diseases. From probe preparation to data acquisition, the imaging quality is greatly improved, and the authenticity of the NIR-II molecular probes for data recording in intravital imaging is ensured.

Studying Oral Tissue via Real-Time High-Resolution Terahertz Spectroscopic Imaging

Terahertz (THz) waves are extremely sensitive to water content and biological composition (proteins, genes, and metabolites), which are the key regulator of cancer development. Hence, the application of THz spectroscopy and imaging is promising in the field of biomedicine, especially in cancer diagnosis. Currently, the diagnosis of cancer patients (including tumor borders, tumor stage, etc.) mainly rely on optical microscope observation of pathological slices. The preparation of the slices is complicated and time consuming, and the microscopic field of view is small, which cannot effectively guide the precise removal of the tumor during the operation in time. To solve this problem, a label-free real-time high-resolution near-field THz spectroscopy imaging technique was developed. In this study, we successfully apply this technique to the oral tissue. Compared with conventional point-by-point scanning terahertz time-domain spectroscopy imaging, this technique can exhibit a real-time imaging rate (as high as 20 frames/s at 512 \ifmmode\times\else\texttimes\fi{} 1024 pixels) and a field of view approximately 5 mm in diameter with a spatial resolution up to \ensuremath{\lambda}/10 at 1 THz in near-field condition. The experimental results show that the terahertz spectroscopic imaging in this paper can clearly detect and identify not only biological tissues with different components, but also normal and cancerous tissues, as well as tissues with the same composition but different slice directions. This work lays an experimental foundation for the application of THz spectroscopy imaging to rapid label-free intraoperative diagnosis, and it provides a basis for promoting the wide application of THz technology in the biomedical field.

Use of a three-dimensional head-mounted digital visualization platform in cataract surgery.

To report preliminary experience using the BeyeonicsOne (Beyeonics Vision, Haifa, Israel) digital visualization platform and the utilization of its three-dimensional (3D) head-mounted display(HMD) in cataract surgery. An interventional case series including patients who underwent cataract surgery using the 3D HMD platform at the Tel Aviv Medical Center. The system uses the HMD unit to display high-resolution real-time 3D surgical field images. Collected data included patient demographics, ocular comorbidities, risk factors for complex cataract surgery, cataract grading, preoperative and postoperative best-corrected visual acuity (BCVA), and intra- and postoperative complications. In total, 60 eyes of 60 subjects (mean age 73.1 ± 8.4 years) were included. Mean preoperative BCVA was 0.40 ± 0.30 logMAR (Snellen equivalent ~20/50) and improved to 0.10 ± 0.10 logMAR (Snellen equivalent ~20/25, p < 0.001). None of the patients suffered BCVA loss. All procedures and follow-ups were uneventful except for one case of a posterior capsular tear and one case of post-surgical cystoid macular edema. The visualization platform and its embedded 3D head-mounted display can be easily used in routine cataract surgery with the added benefits of improved ergonomics, high picture quality and enhanced image control.

Two-photon microscopy: application advantages and latest progress for invivo imaging of neurons and blood vessels after ischemic stroke.

Two-photon microscopy (TPM) plays an important role in the study of the changes of the two important components of neurovascular units (NVU)- neurons and blood vessels after ischemic stroke (IS). IS refers to sudden neurological dysfunction caused by focal cerebral ischemia, which is one of the leading causes of death and disability worldwide. TPM is a new and rapidly developing high-resolution real-time imaging technique used invivo that has attracted increasing attention from scientists in the neuroscience field. Neurons and blood vessels are important components of neurovascular units, and they undergo great changes after IS to respond to and compensate for ischemic injury. Here, we introduce the characteristics and pre-imaging preparations of TPM, and review the common methods and latest progress of TPM in the neuronal and vascular research for injury and recovery of IS in recent years. With the review, we clearly recognized that the most important advantage of TPM in the study of ischemic stroke is the ability to perform chronic longitudinal imaging of different tissues at a high resolution in vivo. Finally, we discuss the limitations of TPM and the technological advances in recent years.

A Cost-Effective Approach for Achieving Subwavelength THz Imaging Using Photoinduced Coded-Apertures on Mesa-Array Structures

A novel and cost-effective approach for high-resolution terahertz (THz) imaging using photoinduced (PI) coded-apertures on micromachined mesa-array structures is reported. The mesa-array structures are designed to have subwavelength electrically isolated mesas for generation of high-fidelity photopatterns for THz imaging. An Si mesa-array prototype structure was successfully fabricated and tested. Measurements show that a modulation depth of ∼22 dB was obtained in the frequency range of 740–750 GHz under a light intensity of 11.7 W/cm <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> , which agrees well with theoretical analysis and full-wave simulation. Initial imaging experiments were first performed using 64 pixels (over different areas) for validation and performance evaluation. More advanced imaging using quadrupled pixel number (256 pixels) was conducted in order to resolve subwavelength features. As a result, a wavelength-scale spatial resolution of 400 μm has been successfully demonstrated, and a subwavelength resolution as small as ∼250 μm (0.625 <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">λ</i> at 740 GHz) has been shown to be potentially achievable. The proposed PI coded-aperture imaging using mesa arrays is promising for developing real-time high-resolution THz imaging with simple system and low cost.

Preliminary study of confocal laser endomicroscopy for in vitro specimens of the endometrium

BackgroundThis study observed and described the morphological characteristics of the endometrium of the resected uterus using confocal laser endomicroscopy. This included benign endometrium, non-atypical endometrial hyperplasia, atypical endometrial hyperplasia, and endometrial carcinoma, thereby laying a foundation for finding the precise localization and resection of endometrial lesions, given the feasibility of confocal laser endomicroscopy-assisted hysteroscopy.MethodsThis prospective study included 32 patients who underwent hysterectomy. We used confocal laser endomicroscopy to observe the endometrium of resected uteruses and described the characteristics of endometrium in different states by comparing histopathological findings (primary objects). The secondary objects of observation were the myometrium, endocervical canal, and surface of the external os of the cervix.ResultsA total of 32 patients who underwent hysterectomy for different diseases were included: 9 with endometrial carcinoma (5 with endometrioid carcinoma, 1 with endometrial serous carcinoma, 2 with clear cell carcinoma, and 1 with carcinosarcoma), 2 with atypical endometrial hyperplasia, 9 with benign diseases, 7 with cervical cancer, and 5 with ovarian cancer and borderline tumor. The dynamic images of the endometrium were observed and recorded using probe-based confocal laser endomicroscopy (pCLE). Considering histopathology as the gold standard, the diagnostic concordance rate of pCLE was 96.9% in patients with endometrial carcinoma and precancerous lesions and 100% in patients with endometrial carcinoma.ConclusionConfocal laser endomicroscopy provides real-time high-resolution images of the benign endometrium and endometrial lesions. Compared with histopathology, confocal laser endomicroscopy has high diagnostic accuracy and may become an auxiliary examination tool for hysteroscopy, as it is useful for early identification of endometrial lesions, real-time diagnosis of tumor, and detection of tumor boundaries for complete tumor resection. These findings can lay a foundation for the feasible use of fertility-sparing local excision of tumor lesions by hysteroscopy.