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Single fiber reflectance spectroscopy for pancreatic cancer detection during endoscopic ultrasound guided fine needle biopsy: a prospective cohort study
endoscopic ultrasound fine needle biopsy (EUS-FNB) procedures in the pancreas to distinguish benign
and malignant pancreatic tissue in patient with pancreatic masses suspected for malignancy.
Methods: This study was designed as a prospective observational single center study and included
consecutive adult patients, who were scheduled for EUS-FNB of a solid pancreatic mass suspected for
pancreatic ductal adenocarcinoma (PDAC). In total, seven optical parameters, derived from the
absorption acquired spectra, were analyzed: blood volume fraction (BVF), microvascular saturation,
average vessel diameter, bilirubin concentration (BIL), Mie amplitude, Mie slope and Rayleigh amplitude.
Results: Forty-five patients with a suspicious pancreatic lesion undergoing EUS-FNB were included, of
which most of the patients (N=34) were ultimately diagnosed with PDAC....Show moreThis study aimed to determine the ability of single fiber reflectance (SFR) spectroscopy incorporated in
endoscopic ultrasound fine needle biopsy (EUS-FNB) procedures in the pancreas to distinguish benign
and malignant pancreatic tissue in patient with pancreatic masses suspected for malignancy.
Methods: This study was designed as a prospective observational single center study and included
consecutive adult patients, who were scheduled for EUS-FNB of a solid pancreatic mass suspected for
pancreatic ductal adenocarcinoma (PDAC). In total, seven optical parameters, derived from the
absorption acquired spectra, were analyzed: blood volume fraction (BVF), microvascular saturation,
average vessel diameter, bilirubin concentration (BIL), Mie amplitude, Mie slope and Rayleigh amplitude.
Results: Forty-five patients with a suspicious pancreatic lesion undergoing EUS-FNB were included, of
which most of the patients (N=34) were ultimately diagnosed with PDAC. Finally, 27 out of 45 (60.0%)
patients were used for the final analysis of the optical parameters. The median (IQR) BVF differed
significantly in benign compared to malignant tissue (0.86 [0.30-2.03] and 4.49 [1.28-15.47]; p=0.046).
Combining BVF and BIL to a new parameter (θ) improved the discrimination between PDAC and benign
pancreatic tissue (p=0.026). The area under the curve of θ was 0.84, resulting in a 92.8%, 75.0%, 97.5%,
50.0% and 91.3% sensitivity, specificity, positive predictive value, negative predictive value and diagnostic
accuracy for detection of PDAC.
Conclusion: Differentiation between PDAC and benign pancreatic tissue using SFR spectroscopy during
EUS-FNB procedures is promising. Future work should focus on comparing the diagnostic performance
combining SFR spectroscopy with EUS-FNB and EUS-FNB alone.
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- All authors
- Manen, L. van; Schmidt, I.; Inderson, A.; Houvast, R.D.; Boonstra, J.J.; Dijkstra, J.; Hooft, J.E. van; Nagengast, W.B.; Robinson, D.J.; Vahrmeijer, A.L.; Mieog, J.S.D.
- Date
- 2022-01-01
- Volume
- 19
- Issue
- 2
- Pages
- 205 - 212