First assessment of needle-based confocal laser endomicroscopy during EUS-FNA procedures of the pancreas (with videos)
Background: Challenges in EUS-guided FNA (EUS-FNA) include sampling error, nondiagnostic cytology, and limited on-site cytological evaluation. A prototype needle-based confocal laser endomicroscopy (nCLE) probe is a submillimeter probe that provides real-time imaging at the microscopic level through...
| Publicado en: | Gastrointestinal Endoscopy Vol. 74; no. 5; pp. 1049 - 1061 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Nov2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=67013978&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 67013978 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00165107 4A9 jtl: Gastrointestinal Endoscopy issn: 00165107 maglogo: N pubinfo: dt: Nov2011 vid: 74 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 67013978 104637786 104637786 10.1016/j.gie.2011.07.018 67013978 ppf: 1049 ppct: 12 formats: tig: atl: First assessment of needle-based confocal laser endomicroscopy during EUS-FNA procedures of the pancreas (with videos) aug: au: Konda, Vani J.A. Aslanian, Harry R. Wallace, Michael B. Siddiqui, Uzma D. Hart, John Waxman, Irving affil: Center for Endoscopic Research and Therapeutics, Section of Gastroenterology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA sug: subj: Endosonography Methods Biopsy, Needle Methods Pancreatic Diseases Diagnosis Human Videorecording Multicenter Studies Academic Medical Centers Treatment Outcomes ab: Background: Challenges in EUS-guided FNA (EUS-FNA) include sampling error, nondiagnostic cytology, and limited on-site cytological evaluation. A prototype needle-based confocal laser endomicroscopy (nCLE) probe is a submillimeter probe that provides real-time imaging at the microscopic level through the FNA needle. Objective: To evaluate the feasibility of nCLE during EUS-FNA of pancreatic lesions. Design: Feasibility study. Setting: Multicenter, tertiary care. Patients: Eighteen patients presenting for EUS-FNA. Interventions: Patients were injected with 2.5 mL of 10% fluorescein. The lesion was interrogated with the nCLE probe positioned at the tip of a 19-gauge FNA needle. Main Outcome Measurements: Device integrity, technical ease, safety, and image acquisition. Results: Cases included 16 cysts and 2 masses. There were no device malfunctions. Technical challenges were encountered in 6 of 18 attempts to image and reflected challenges with a postloading technique, the longer ferule tip, and a transduodenal approach. Technical feasibility to perform imaging with nCLE during a pancreatic EUS-FNA procedure was achieved in 17 of 18 cases. Ten cases had good to very good image quality. Two serious adverse events occurred; both were pancreatitis requiring hospitalization. Limitations: Limited sample size, small number of patients with confirmed pathological diagnosis, lack of coregistered pathology and images. Conclusions: nCLE in the pancreas is technically feasible via a 19-gauge needle under endosonographic guidance. Future studies will address identification of structures, diagnostic accuracy, and complication profiles. The rate of pancreatitis needs to be further clarified and mitigated. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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