Feasibility and preliminary accuracy of high-resolution imaging of the liver and pancreas using FNA compatible microendoscopy (with video)
Background: EUS-guided FNA is one of the few techniques that can obtain cells and tissue from the liver and pancreas. However, the technique remains vulnerable to poor specimen quality and sampling error. Objective: To evaluate the ability of a high-resolution microendoscope (HRME) to visualize the...
| Publicado en: | Gastrointestinal Endoscopy Vol. 76; no. 2; pp. 293 - 301 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | CEU pictorial research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Aug2012
|
| 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=77975338&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 77975338 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00165107 4A9 jtl: Gastrointestinal Endoscopy issn: 00165107 maglogo: N pubinfo: dt: Aug2012 vid: 76 iid: 2 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 77975338 104480770 104480770 10.1016/j.gie.2012.04.445 77975338 ppf: 293 ppct: 8 formats: tig: atl: Feasibility and preliminary accuracy of high-resolution imaging of the liver and pancreas using FNA compatible microendoscopy (with video) aug: au: Regunathan, Renu Woo, Jenny Pierce, Mark C. Polydorides, Alexandros D. Raoufi, Mohammad Roayaie, Sasan Schwartz, Myron Labow, Daniel Shin, Dongsuk Suzuki, Rei Bhutani, Manoop S. Coghlan, Lezlee G. Richards-Kortum, Rebecca Anandasabapathy, Sharmila Kim, Michelle Kang affil: Department of Medicine, Columbia University, New York, New York sug: subj: Endosonography Methods Liver Analysis Pancreas Analysis Human United States Multicenter Studies Biopsy In Vivo Studies Swine Animal Studies Academic Medical Centers Videorecording Education, Continuing (Credit) ab: Background: EUS-guided FNA is one of the few techniques that can obtain cells and tissue from the liver and pancreas. However, the technique remains vulnerable to poor specimen quality and sampling error. Objective: To evaluate the ability of a high-resolution microendoscope (HRME) to visualize the cellular and architectural features of normal and malignant liver and pancreatic tissue ex vivo, to assess the ability of endosonographers to identify normal and neoplastic tissue by using HRME images, and to demonstrate preliminary technical feasibility of in vivo HRME imaging via EUS fine-needle puncture (FNP). Design: Ex vivo pilot feasibility study in human tissue; in vivo swine model. Setting: Two academic medical centers. Patients: Co-registered HRME images and biopsies were obtained from surgically resected hepatic and pancreatic tissues from 44 patients. Intervention: Images were divided into training (12 images) and test (80 images) sets containing a range of normal and pathologic conditions for each organ. After viewing the training sets, 9 endosonographers attempted to distinguish malignant tissue from normal or benign lesions in the test sets, each of which contained 40 unique images with individual diagnoses from pathology. Main Outcome Measurements: Image acquisition feasibility, ex vivo and in vivo. Ability of endosonographers to recognize features of normal/benign or malignant tissue from the liver and pancreas. Results: Overall, the 9 endosonographers achieved median accuracy figures of 85% in the liver and 90% in the pancreas. The endosonographers with prior experience in reading HRME images achieved accuracy rates between 90% and 95%. Technical feasibility of HRME imaging through a 19-gauge EUS-FNP needle was demonstrated in an in vivo swine model. Limitations: Ex vivo study. Conclusion: High-resolution microendoscopy allows real-time imaging of cellular-level morphology and tissue architecture in the liver and pancreas. The technique appears to have a short learning curve, after which endosonographers achieved high accuracy rates in distinguishing malignant tissue from normal and benign pathology in both organs. Translating this imaging platform to the in vivo setting appears technically feasible. pubtype: Academic Journal doctype: CEU pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|