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

项目摘要 在这一应用中，我们提出了开发内窥镜超声细针光学 一种能够在体内确定胰腺囊肿细胞成分并识别的诊断系统 囊性病变以早期癌症为特征。 胰腺癌是美国癌症相关死亡的第三大原因。 美国，超过乳腺癌。中位生存期为3个月，死亡率最高。 所有主要癌症的比率。胰腺癌的不良预后在很大程度上是由于 在根治性手术切除仍有可能的情况下，及早发现这种癌症。 据估计，有800万美国人患有胰腺囊性病变。胰腺囊肿是唯一的 胰腺癌的前驱症状很容易辨认。最常见的是，这些无症状的囊肿是 在为其他目的执行MRI/CT成像时偶然发现，然后通过 这些成像技术用于间歇性生长，因为大约十分之一的囊性病变具有恶性潜能。而当 CT和MRI可以用来筛查囊性病变，但对于囊性病变的准确性较差 鉴别癌性、癌前囊性和良性囊性。目前，没有 准确的诊断技术，可以区分癌和癌前病变 良性包囊，导致可怕的后果，包括被认为是 良性或不必要的胰腺良性囊性手术，通常有显著的发病率和 死亡率。因此，迫切需要一种新的诊断方法来准确地识别 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，我们介绍了一种基于光散射的新诊断技术 光谱学(LSS)识别胰腺囊性病变的恶性潜能 常规诊断性微创内窥镜超声引导细针抽吸(EUS- FNA)程序。它采用了单点前瞻性空间选通触点探头，符合 插入标准的吸引针，向前取样囊内表面的一小部分 在大约2分钟内到达半球。以提高准确性并确保临床接受该方法 如果采用这项技术，在更短的时间内扫描整个内囊表面将是一项重大的进步。 我们的初步结果非常令人鼓舞，表明拟议的技术可能是一种 在识别前驱病变和早期胰腺癌方面提供了巨大的帮助。

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.