Probe-based confocal laser endomicroscopy (PCLE)

Tiny space age probes -- those that can see inside single living cells -- are increasingly being used to diagnose illness in hard-to-reach areas of the body.

New York-Presbyterian Hospital/Weill Cornell Medical Center's Dr. Michel Kahaleh often threads a tiny microscope into the narrow bile ducts that connect the liver to the small intestine to hunt for cancer.

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The U.S. Food and Drug Administration approved pCLE diagnostic systems for use in the bile duct and pancreas two years ago. The pCLE is a mini microscopic probe that is threaded inside a larger "spy glass" probe. The pCLE can then image blood vessels, mucosal structures and epithelial tissue in real-time, broadcasting these images on a large monitor for physicians to examine.

But the vast majority of institutions may still use a rather hit-or-miss technique to determine if a bile duct is cancerous. The traditional technique is to thread a probe inside the duct to where it is abnormally narrowed and then to use a small brush or tiny forceps to gather some cells that can then be biopsied in a lab. "But we still miss 20-30 percent of bile duct cancer or other tumors in this way, and that is unacceptable," Dr. Kahaleh says.