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In vivo risk analysis of pancreatic cancer through optical characterization of duodenal mucosa.

Mutyal NN, Radosevich AJ, Bajaj S, Konda V, Siddiqui UD, Waxman I, Goldberg MJ, Rogers JD, Gould B, Eshein A, Upadhye S, Koons A, Gonzalez-Haba Ruiz M, Roy HK, Backman V - Pancreas (2015)

Bottom Line: The LEBS parameters and optical properties were significantly altered in patients harboring adenocarcinomas (including early-stage) throughout the pancreas relative to healthy controls.Moreover, the LEBS prediction rule was not confounded by patients' demographics.This represents the next step in establishing duodenal LEBS analysis as a prescreening technique that identifies clinically asymptomatic patients who are at elevated risk of PC.

View Article: PubMed Central - PubMed

Affiliation: From the *Department of Biomedical Engineering, Northwestern University; †Department of Internal Medicine, NorthShore University HealthSystems, Evanston; ‡Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL; and §Department of Gastroenterology, Boston Medical Center, Boston, MA.

ABSTRACT

Objectives: To reduce pancreatic cancer mortality, a paradigm shift in cancer screening is needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to predict the presence of pancreatic cancer by interrogating the duodenal mucosa. A previous ex vivo study (n = 203) demonstrated excellent diagnostic potential: sensitivity, 95%; specificity, 71%; and accuracy, 85%. The objective of the current case-control study was to evaluate this approach in vivo.

Methods: We developed a novel endoscope-compatible fiber-optic probe to measure LEBS in the periampullary duodenum of 41 patients undergoing upper endoscopy. This approach enables minimally invasive detection of the ultrastructural consequences of pancreatic field carcinogenesis.

Results: The LEBS parameters and optical properties were significantly altered in patients harboring adenocarcinomas (including early-stage) throughout the pancreas relative to healthy controls. Test performance characteristics were excellent with sensitivity = 78%, specificity = 85%, and accuracy = 81%. Moreover, the LEBS prediction rule was not confounded by patients' demographics.

Conclusion: We demonstrate the feasibility of in vivo measurement of histologically normal duodenal mucosa to predict the presence of adenocarcinoma throughout the pancreas. This represents the next step in establishing duodenal LEBS analysis as a prescreening technique that identifies clinically asymptomatic patients who are at elevated risk of PC.

No MeSH data available.


Related in: MedlinePlus

Optical properties extracted from E′ and NSS. A, Mass density distribution D. B, Reduced scattering coefficient . A double red star indicates statistically significant difference from control at the 1% level.
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Figure 4: Optical properties extracted from E′ and NSS. A, Mass density distribution D. B, Reduced scattering coefficient . A double red star indicates statistically significant difference from control at the 1% level.

Mentions: Figure 4 shows the optical properties D and that were extracted from the empirical parameters, which form the LEBS marker. In Figure 4A, there is a highly significant 41% increase in D for patients with PC. The increase in D indicates a shift in tissue ultrastructure toward larger structures. In Figure 4B, there is a 39% decrease in for patients with PC (P = 0.26). Importantly, the directionality of these changes is consistent with 2 previous ex vivo biopsy studies.3,16


In vivo risk analysis of pancreatic cancer through optical characterization of duodenal mucosa.

Mutyal NN, Radosevich AJ, Bajaj S, Konda V, Siddiqui UD, Waxman I, Goldberg MJ, Rogers JD, Gould B, Eshein A, Upadhye S, Koons A, Gonzalez-Haba Ruiz M, Roy HK, Backman V - Pancreas (2015)

Optical properties extracted from E′ and NSS. A, Mass density distribution D. B, Reduced scattering coefficient . A double red star indicates statistically significant difference from control at the 1% level.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4464933&req=5

Figure 4: Optical properties extracted from E′ and NSS. A, Mass density distribution D. B, Reduced scattering coefficient . A double red star indicates statistically significant difference from control at the 1% level.
Mentions: Figure 4 shows the optical properties D and that were extracted from the empirical parameters, which form the LEBS marker. In Figure 4A, there is a highly significant 41% increase in D for patients with PC. The increase in D indicates a shift in tissue ultrastructure toward larger structures. In Figure 4B, there is a 39% decrease in for patients with PC (P = 0.26). Importantly, the directionality of these changes is consistent with 2 previous ex vivo biopsy studies.3,16

Bottom Line: The LEBS parameters and optical properties were significantly altered in patients harboring adenocarcinomas (including early-stage) throughout the pancreas relative to healthy controls.Moreover, the LEBS prediction rule was not confounded by patients' demographics.This represents the next step in establishing duodenal LEBS analysis as a prescreening technique that identifies clinically asymptomatic patients who are at elevated risk of PC.

View Article: PubMed Central - PubMed

Affiliation: From the *Department of Biomedical Engineering, Northwestern University; †Department of Internal Medicine, NorthShore University HealthSystems, Evanston; ‡Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL; and §Department of Gastroenterology, Boston Medical Center, Boston, MA.

ABSTRACT

Objectives: To reduce pancreatic cancer mortality, a paradigm shift in cancer screening is needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to predict the presence of pancreatic cancer by interrogating the duodenal mucosa. A previous ex vivo study (n = 203) demonstrated excellent diagnostic potential: sensitivity, 95%; specificity, 71%; and accuracy, 85%. The objective of the current case-control study was to evaluate this approach in vivo.

Methods: We developed a novel endoscope-compatible fiber-optic probe to measure LEBS in the periampullary duodenum of 41 patients undergoing upper endoscopy. This approach enables minimally invasive detection of the ultrastructural consequences of pancreatic field carcinogenesis.

Results: The LEBS parameters and optical properties were significantly altered in patients harboring adenocarcinomas (including early-stage) throughout the pancreas relative to healthy controls. Test performance characteristics were excellent with sensitivity = 78%, specificity = 85%, and accuracy = 81%. Moreover, the LEBS prediction rule was not confounded by patients' demographics.

Conclusion: We demonstrate the feasibility of in vivo measurement of histologically normal duodenal mucosa to predict the presence of adenocarcinoma throughout the pancreas. This represents the next step in establishing duodenal LEBS analysis as a prescreening technique that identifies clinically asymptomatic patients who are at elevated risk of PC.

No MeSH data available.


Related in: MedlinePlus