The integration of single fiber reflectance (SFR) spectroscopy during endoscopic ultrasound-guided fine needle aspirations (EUS-FNA) in pancreatic masses: a feasibility study

Paulien L. Stegehuis; Leonora S. F. Boogerd M.D.; Akin Inderson; Roeland A. Veenendaal; Bert A. Bonsing; Arjen Amelink; Alexander L. Vahrmeijer M.D.; Jouke Dijkstra; Dominic J. Robinson

doi:10.1117/12.2212623

8 March 2016 The integration of single fiber reflectance (SFR) spectroscopy during endoscopic ultrasound-guided fine needle aspirations (EUS-FNA) in pancreatic masses: a feasibility study

Paulien L. Stegehuis, Leonora S. F. Boogerd M.D., Akin Inderson, Roeland A. Veenendaal, Bert A. Bonsing, Arjen Amelink, Alexander L. Vahrmeijer M.D., Jouke Dijkstra, Dominic J. Robinson

Author Affiliations +

Proceedings Volume 9691, Endoscopic Microscopy XI; and Optical Techniques in Pulmonary Medicine III; 96910J (2016) https://doi.org/10.1117/12.2212623
Event: SPIE BiOS, 2016, San Francisco, California, United States

Abstract

EUS-FNA can be used for pathological confirmation of a suspicious pancreatic mass. However, performance depends on an on-site cytologist and time between punction and final pathology results can be long. SFR spectroscopy is capable of extracting biologically relevant parameters (e.g. oxygenation and blood volume) in real-time from a very small tissue volume at difficult locations. In this study we determined feasibility of the integration of SFR spectroscopy during EUSFNA procedures in pancreatic masses. Patients with benign and malignant pancreatic masses who were scheduled for an EUS-FNA were included. The working guide wire inside the 19 gauge endoscopic biopsy needle was removed and the sterile single fiber (300 μm core and 700 μm outer diameter, wide-angle beam, NA 0.22) inserted through the needle. Spectroscopy measurements in the visiblenear infrared wavelength region (400-900 nm) and autofluorescence measurements (excitation at 405 nm) were taken three times, and subsequently cytology was obtained. Wavelength dependent optical properties were compared to cytology results. We took measurements in 13 patients with corresponding cytology results (including mucinous tumor, ductal adenocarcinoma, neuroendocrine tumor, and pancreatitis). In this paper we show the first analyzed results comparing normal pancreatic tissue with cancerous tissue in the same patient. We found a large difference in blood volume fraction, and blood oxygenation was higher in normal tissue. Integration of SFR spectroscopy is feasible in EUS-FNA procedures, the workflow hardly requires changes and it takes little time. The first results differentiating normal from tumor tissue are promising.

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Paulien L. Stegehuis, Leonora S. F. Boogerd M.D., Akin Inderson, Roeland A. Veenendaal, Bert A. Bonsing, Arjen Amelink, Alexander L. Vahrmeijer M.D., Jouke Dijkstra, and Dominic J. Robinson "The integration of single fiber reflectance (SFR) spectroscopy during endoscopic ultrasound-guided fine needle aspirations (EUS-FNA) in pancreatic masses: a feasibility study", Proc. SPIE 9691, Endoscopic Microscopy XI; and Optical Techniques in Pulmonary Medicine III, 96910J (8 March 2016); https://doi.org/10.1117/12.2212623

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