Optical biopsy in gynecology

Optical biopsy allows living tissues to be visualized in situ and in real time. Confocal endomicroscopy is already used to detect neoplastic and pre-neoplastic gastrointestinal lesions, with a precision comparable to that of conventional biopsy. Likewise, precancerous cervical lesions can be identified with fluorescence endomicroscopy. More recently, confocal microlaparoscopy using fluorescent contrast agents has been used, both in vivo and in vitro, to identify healthy and cancerous ovaries. This technique could serve for early diagnosis of ovarian cancer and preinvasive ovarian dysplasia that has already been described by histology automated image analysis (morphometry) and immunohistochemistry, particularly in women with an elevated risk of ovarian cancer. Real-time diagnosis by optical biopsy would allow the surgeon to take appropriate action in case of positive findings, and would also help to avoid unnecessary surgery. This would particularly benefit younger women wishing to preserve their fertility.