Endoscopic Fine-Needle Polarized Scanning Spectroscopy for Pancreatic Cystic Lesions Diagnosis

项目摘要 在这个应用中，我们建议开发内窥镜超声细针光学 诊断系统，可以确定胰腺囊肿的细胞组成在体内，并确定 具有早期癌症特征的囊性病变。 胰腺癌是美国癌症相关死亡的第三大原因。 超过了乳腺癌。中位生存期为3个月，死亡率最高 所有主要癌症的发病率。胰腺癌的预后差在很大程度上是由于无法 在早期阶段发现这种癌症，当治疗性手术切除的选择仍然是可能的。 据估计，800万美国人患有胰腺囊性病变。胰腺囊肿是唯一 胰腺癌的早期症状最常见的是，这些无症状的囊肿是 当出于其他目的进行MRI/CT成像，然后用 这些成像技术用于间隔生长，因为约十分之一的囊肿具有恶性潜力。而 CT和MRI可用于筛查囊性病变，但其准确性较差。 将癌性囊肿和癌前囊肿与良性囊肿区分开。目前尚无 准确的诊断技术，可以区分癌和癌前囊肿， 良性囊肿，导致可怕的后果，包括囊肿中的癌症发展， 良性，或不必要的胰腺良性囊肿手术，往往有显着的发病率， mortality.因此，迫切需要一种新的诊断方法， 那些需要手术干预的胰腺囊肿和那些不需要手术干预的胰腺囊肿。 最近我们介绍了一种基于光散射的新诊断技术 LSS是一种用于识别胰腺囊性病变恶性潜力的光谱学（LSS）， 常规诊断微创内镜超声引导细针穿刺（EUS- FNA）程序。它采用单点前视空间选通接触式探头， 插入标准的抽吸针中，并向前采集囊肿内表面的一部分 大约2分钟后到达半球。为了提高准确性并确保临床接受 技术，扫描整个内部囊肿表面在较短的时间将是一个重大的进步。 我们的初步结果是非常令人鼓舞的，表明拟议的技术可能是一个 对识别前驱病变和早期胰腺癌有巨大帮助。

Project Summary In this application we propose to develop the endoscopic ultrasound fine-needle optical diagnostic system that can determine the cellular composition of pancreatic cysts in vivo and identify cystic lesions with early stage cancer features. Pancreatic cancer is the 3rd leading cause of cancer-related death in the United States, surpassing breast cancer. With a median survival of 3 months, it has the highest mortality rate of all major cancers. The poor prognosis of pancreatic cancer is due in large part to the inability to detect this cancer at an early stage, when the option of a curative surgical resection is still possible. It is estimated that 8 million Americans have pancreatic cystic lesions. Pancreatic cysts are the only readily identifiable precursors of pancreatic cancer. Most commonly, these asymptomatic cysts are found incidentally when MRI/CT imaging is performed for other purposes and then monitored with these imaging techniques for interval growth since about 1 in 10 cysts have malignant potential. While CT and MRI could be used to screen for cystic lesions, they have poor accuracy with regard to distinguishing cancerous and pre-cancerous cysts from benign cysts. Currently, there is no accurate diagnostic technique that can distinguish cancerous and pre-cancerous cysts from benign cysts, resulting in dire consequences, including the development of cancer in cysts thought to be benign, or unnecessary pancreatic surgery for benign cysts, often with significant morbidity and mortality. Thus, there is a critical need for a new diagnostic approach that accurately identifies those pancreatic cysts that require surgical intervention and those that do not. Recently we introduced a new diagnostic technology based on light scattering spectroscopy (LSS) that identifies the malignant potential of pancreatic cystic lesions during routine diagnostic minimally invasive endoscopic ultrasound-guided fine needle aspiration (EUS- FNA) procedures. It employs a single-point forward looking spatial gating contact probe that fits into a standard aspiration needle and samples a fraction of the internal surface of the cyst forward hemisphere in approximately 2 minutes. To improve accuracy and ensure clinical acceptance of the technique, scanning the entire internal cyst surface in a shorter time would be a significant advance. Our preliminary results are very encouraging, indicating that the proposed technology could be a tremendous aid in identifying both precursor lesions and early stage pancreatic cancers.