Probe-based confocal laser endomicroscopy (pCLE) significantly improves real-time diagnosis during endoscopy for various gastrointestinal conditions.

• In Barrett’s esophagus, pCLE nearly doubles neoplasia detection sensitivity compared to conventional methods.
• For gastric intestinal metaplasia, sensitivity reached 97% and specificity 94%.
• Colorectal lesion evaluation shows sensitivity of 81-91% and specificity of 75-91%, reducing unnecessary resections.

PCLE can lead to fewer biopsies and earlier interventions, promoting better patient outcomes. Further standardization and AI integration will enhance its clinical adoption.