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

内镜细针偏振扫描光谱诊断胰腺囊性病变

• 批准号: 10011802
• 负责人: Lev T Perelman
• 金额: $ 68.2万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10011802
• 关键词: Address; Adopted; Algorithms; American; Award; Benign; Biomedical Engineering; Caliber; Cancer Etiology; Cancerous; Cell Size; Cells; Cellular Morphology; Cessation of life; Chemicals; Clinical; Clinical Research; Cyst; Cyst Fluid; Cystic Lesion; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Disease Progression; Doctor of Philosophy; Elderly; Endoscopic Ultrasonography; Endoscopy; Ensure; Epithelial; Epithelial Cells; Esophageal Intraepithelial Neoplasia; Excision; Fiber; Fine needle aspiration biopsy; Foundations; Gastroenterologist; Goals; Gold; Growth; Histologic; Histopathology; Image; Imaging Techniques; Institutional Review Boards; International; Israel; Lead; Lesion; Life; Light; Light-Scattering Spectroscopy; Liquid substance; Location; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of pancreas; Measurement; Measures; Mechanics; Medical center; Medicine; Monitor; Morbidity - disease rate; Nature; Needles; Nuclear; Operative Surgical Procedures; Optics; Outcome; Pancreas; Pancreatectomy; Pancreatic Cyst; Pancreatic cystic neoplasia; Paper; Pathology; Patients; Prevalence; Principal Investigator; Procedures; Prognosis; Property; Reproducibility; Resected; Sampling; Savings; Scanning; Spectrum Analysis; Spottings; Surface; Survival Rate; Techniques; Technology; Testing; Time; Translating; United States; Validation; X-Ray Computed Tomography; accurate diagnosis; accurate diagnostics; base; cancer diagnosis; cell type; diagnostic platform; diagnostic technologies; follow-up; improved; in vivo; instrument; instrumentation; light scattering; malignant breast neoplasm; man; minimally invasive; mortality; non-invasive imaging; novel; novel diagnostics; performance tests; polarized light; premalignant; programs; tissue phantom

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.

项目概要 在此应用中，我们建议开发内窥镜超声细针光学 可以确定体内胰腺囊肿的细胞组成并识别的诊断系统 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 州，超越乳腺癌。中位生存期为 3 个月，死亡率最高 所有主要癌症的发病率。胰腺癌的预后不良很大程度上是由于无能力 以便在早期阶段发现这种癌症，此时仍然可以选择治愈性手术切除。 据估计，有 800 万美国人患有胰腺囊性病变。胰腺囊肿是唯一 容易识别的胰腺癌前兆。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 成像并随后进行监测时偶然发现 这些成像技术用于间歇性生长，因为大约十分之一的囊肿具有恶性潜力。尽管 CT和MRI可用于筛查囊性病变，但准确性较差 区分癌性囊肿和癌前囊肿与良性囊肿。目前，没有 准确的诊断技术，可以区分癌性和癌前性囊肿 良性囊肿，导致可怕的后果，包括被认为是囊肿发展成癌症 是良性的，或不必要的良性囊肿胰腺手术，通常具有显着的发病率和 死亡。因此，迫切需要一种新的诊断方法来准确识别 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。 最近我们推出了一种基于光散射的新诊断技术 光谱学（LSS）可识别胰腺囊性病变的恶性潜力 常规诊断微创超声内镜引导细针抽吸术（EUS- FNA）程序。它采用单点前视空间选通接触探头，适合 进入标准抽吸针并向前抽取囊肿内表面的一小部分样本 大约 2 分钟即可到达半球。提高准确性并确保临床接受 技术，在更短的时间内扫描整个内部囊肿表面将是一个重大进步。 我们的初步结果非常令人鼓舞，表明所提出的技术可能是 对识别前体病变和早期胰腺癌有巨大帮助。