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Biomedical Optics Express

Biomedical Optics Express

  • Editor: Joseph A. Izatt
  • Vol. 2, Iss. 8 — Aug. 1, 2011
  • pp: 2372–2382

Optics InfoBase > Biomedical Optics Express > Volume 2 > Issue 8 > Page 2372

Differentiation of pancreatic cysts with optical coherence tomography (OCT) imaging: an ex vivo pilot study

Nicusor Iftimia, Sevdenur Cizginer, Vikram Deshpande, Martha Pitman, Servet Tatli, Nicolae-Adrian Iftimia, Daniel X Hammer, Mircea Mujat, Teoman Ustun, R. Daniel Ferguson, and William R. Brugge  »View Author Affiliations


Biomedical Optics Express, Vol. 2, Issue 8, pp. 2372-2382 (2011)
http://dx.doi.org/10.1364/BOE.2.002372


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Abstract

We demonstrate for the first time that optical coherence tomography (OCT) imaging can reliably distinguish between morphologic features of low risk pancreatic cysts (i.e., pseudocysts and serous cystadenomas) and high risk pancreatic cysts (i.e., mucinous cystic neoplasms and intraductal papillary mucinous neoplasms). In our study fresh pancreatectomy specimens (66) from patients with cystic lesions undergoing surgery were acquired and examined with OCT. A training set of 20 pathology-OCT correlated tissue specimens were used to develop criteria for differentiating between low and high risk cystic lesions. A separate (validation) set of 46 specimens were used to test the OCT criteria by three clinicians, blinded to histopathology findings. Histology was finally used as a ‘gold’ standard for testing OCT findings. OCT was able to reveal specific morphologic features of pancreatic cysts and thus to differentiate between low-risk and high-risk cysts with over 95% sensitivity and specificity. This pilot study suggests that OCT could be used by clinicians in the future to more reliably differentiate between benign and potentially malignant pancreatic cysts. However, in vivo use of OCT requires a probe that has to fit the bore of the pancreas biopsy needle. Therefore, we have developed such probes and planned to start an in vivo pilot study within the very near future.

© 2011 OSA

OCIS Codes
(170.0170) Medical optics and biotechnology : Medical optics and biotechnology
(170.4500) Medical optics and biotechnology : Optical coherence tomography
(170.4580) Medical optics and biotechnology : Optical diagnostics for medicine
(170.6935) Medical optics and biotechnology : Tissue characterization

ToC Category:
Optics in Cancer Research

History
Original Manuscript: June 14, 2011
Revised Manuscript: July 11, 2011
Manuscript Accepted: July 20, 2011
Published: July 25, 2011

Citation
Nicusor Iftimia, Sevdenur Cizginer, Vikram Deshpande, Martha Pitman, Servet Tatli, Nicolae-Adrian Iftimia, Daniel X Hammer, Mircea Mujat, Teoman Ustun, R. Daniel Ferguson, and William R. Brugge, "Differentiation of pancreatic cysts with optical coherence tomography (OCT) imaging: an ex vivo pilot study," Biomed. Opt. Express 2, 2372-2382 (2011)
http://www.opticsinfobase.org/boe/abstract.cfm?URI=boe-2-8-2372


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References

  1. W. R. Brugge, G. Y. Lauwers, D. Sahani, C. Fernandez-del Castillo, and A. L. Warshaw, “Cystic neoplasms of the pancreas,” N. Engl. J. Med. 351(12), 1218–1226 (2004). [CrossRef] [PubMed]
  2. K. S. Lee, A. Sekhar, N. M. Rofsky, and I. Pedrosa, “Prevalence of incidental pancreatic cysts in the adult population on MR imaging,” Am. J. Gastroenterol. 105(9), 2079–2084 (2010). [CrossRef] [PubMed]
  3. D. V. Sahani, J. C. Miller, C. Fernàndez del Castillo, W. R. Brugge, J. H. Thrall, and S. I. Lee, “Cystic pancreatic lesions: classification and management,” J. Am. Coll. Radiol. 6(5), 376–380 (2009). [CrossRef] [PubMed]
  4. J. A. Wargo, C. Fernandez-del-Castillo, and A. L. Warshaw, “Management of pancreatic serous cystadenomas,” Adv. Surg. 43(1), 23–34 (2009). [CrossRef] [PubMed]
  5. M. P. Federle and K. M. McGrath, “Cystic neoplasms of the pancreas,” Gastroenterol. Clin. North Am. 36(2), 365–376, ix (2007). [CrossRef] [PubMed]
  6. R. H. Hruban, M. B. Pitman, and D. S. Klimstra, Tumors of the Pancreas, AFIP Atlas of Tumor Pathology; 4th Series Fascicle 6 (American Registry of Pathology, 2007).
  7. A. J. Megibow, F. P. Lombardo, A. Guarise, G. Carbognin, J. Scholes, N. M. Rofsky, M. Macari, E. J. Balthazar, and C. Procacci, “Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up,” Abdom. Imaging 26(6), 640–647 (2001). [CrossRef] [PubMed]
  8. C. Procacci, C. Biasiutti, G. Carbognin, S. Accordini, E. Bicego, A. Guarise, E. Spoto, I. A. Andreis, R. De Marco, and A. J. Megibow, “Characterization of cystic tumors of the pancreas: CT accuracy,” J. Comput. Assist. Tomogr. 23(6), 906–912 (1999). [CrossRef] [PubMed]
  9. N. A. Ahmad, M. L. Kochman, C. Brensinger, W. R. Brugge, D. O. Faigel, F. G. Gress, M. B. Kimmey, N. J. Nickl, T. J. Savides, M. B. Wallace, M. J. Wiersema, and G. G. Ginsberg, “Interobserver agreement among endosonographers for the diagnosis of neoplastic versus non-neoplastic pancreatic cystic lesions,” Gastrointest. Endosc. 58(1), 59–64 (2003). [CrossRef] [PubMed]
  10. M. Pelaez-Luna and S. T. Chari, “Cyst fluid analysis to diagnose pancreatic cystic lesions: an as yet unfulfilled promise,” Gastroenterology 130(3), 1007–1009, discussion 1009 (2006). [CrossRef] [PubMed]
  11. B. G. Turner, S. Cizginer, D. Agarwal, J. Yang, M. B. Pitman, and W. R. Brugge, “Diagnosis of pancreatic neoplasia with EUS and FNA: a report of accuracy,” Gastrointest. Endosc. 71(1), 91–98 (2010). [CrossRef] [PubMed]
  12. M. B. Pitman, K. Lewandrowski, J. Shen, D. Sahani, W. Brugge, and C. Fernandez-del Castillo, “Pancreatic cysts: preoperative diagnosis and clinical management,” Cancer Cytopathol 118(1), 1–13 (2010). [CrossRef] [PubMed]
  13. P. J. Michaels, E. F. Brachtel, B. C. Bounds, W. R. Brugge, and M. Bishop Pitman, “Intraductal papillary mucinous neoplasm of the pancreas: cytologic features predict histologic grade,” Cancer 108(3), 163–173 (2006). [CrossRef] [PubMed]
  14. N. A. Belsley, M. B. Pitman, G. Y. Lauwers, W. R. Brugge, and V. Deshpande, “Serous cystadenoma of the pancreas: limitations and pitfalls of endoscopic ultrasound-guided fine-needle aspiration biopsy,” Cancer 114(2), 102–110 (2008). [CrossRef] [PubMed]
  15. P. L. Hsiung, D. R. Phatak, Y. Chen, A. D. Aguirre, J. G. Fujimoto, and J. L. Connolly, “Benign and malignant lesions in the human breast depicted with ultrahigh resolution and three-dimensional optical coherence tomography,” Radiology 244(3), 865–874 (2007). [CrossRef] [PubMed]
  16. D. Huang, E. A. Swanson, C. P. Lin, J. S. Schuman, W. G. Stinson, W. Chang, M. R. Hee, T. Flotte, K. Gregory, C. A. Puliafito, and J. Fujimoto, “Optical coherence tomography,” Science 254(5035), 1178–1181 (1991). [CrossRef] [PubMed]
  17. L. P. Hariri, G. T. Bonnema, K. Schmidt, A. M. Winkler, V. Korde, K. D. Hatch, J. R. Davis, M. A. Brewer, and J. K. Barton, “Laparoscopic optical coherence tomography imaging of human ovarian cancer,” Gynecol. Oncol. 114(2), 188–194 (2009). [CrossRef] [PubMed]
  18. M. Kraft, H. Glanz, S. von Gerlach, H. Wisweh, H. Lubatschowski, and C. Arens, “Clinical value of optical coherence tomography in laryngology,” Head Neck 30(12), 1628–1635 (2008). [CrossRef] [PubMed]
  19. R. A. McLaughlin, L. Scolaro, P. Robbins, S. Hamza, C. Saunders, and D. D. Sampson, “Imaging of human lymph nodes using optical coherence tomography: potential for staging cancer,” Cancer Res. 70(7), 2579–2584 (2010). [CrossRef] [PubMed]
  20. R. G. Michel, G. T. Kinasewitz, K. M. Fung, and J. I. Keddissi, “Optical coherence tomography as an adjunct to flexible bronchoscopy in the diagnosis of lung cancer: a pilot study,” Chest 138(4), 984–988 (2010). [CrossRef] [PubMed]
  21. J. A. Evans, B. E. Bouma, J. Bressner, M. Shishkov, G. Y. Lauwers, M. Mino-Kenudson, N. S. Nishioka, and G. J. Tearney, “Identifying intestinal metaplasia at the squamocolumnar junction by using optical coherence tomography,” Gastrointest. Endosc. 65(1), 50–56 (2007). [CrossRef] [PubMed]
  22. P. A. Testoni, A. Mariani, B. Mangiavillano, P. G. Arcidiacono, S. Di Pietro, and E. Masci, “Intraductal optical coherence tomography for investigating main pancreatic duct strictures,” Am. J. Gastroenterol. 102(2), 269–274 (2007). [CrossRef] [PubMed]
  23. R. Leitgeb, C. K. Hitzenberger, and A. F. Fercher, “Performance of Fourier domain vs. time domain optical coherence tomography,” Opt. Express 11(8), 889–894 (2003). [CrossRef] [PubMed]
  24. T. E. Ustun, N. V. Iftimia, R. D. Ferguson, and D. X. Hammer, “Real-time processing for Fourier domain optical coherence tomography using a field programmable gate array,” Rev. Sci. Instrum. 79(11), 114301 (2008). [CrossRef] [PubMed]
  25. G. H. R. Zamboni and D. S. Longnecker, “Mucious cystic neoplasms of the pancreas,” in: S. R. Hamilton, L. A. Aaltonen, eds., World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System (IARC Press, 2000).
  26. B. C. Visser, B. M. Yeh, A. Qayyum, L. W. Way, C. E. McCulloch, and F. V. Coakley, “Characterization of cystic pancreatic masses: relative accuracy of CT and MRI,” AJR Am. J. Roentgenol. 189(3), 648–656 (2007). [CrossRef] [PubMed]
  27. B. Khurana, K. J. Mortelé, J. Glickman, S. G. Silverman, and P. R. Ros, “Macrocystic serous adenoma of the pancreas: radiologic-pathologic correlation,” AJR Am. J. Roentgenol. 181(1), 119–123 (2003). [PubMed]
  28. M. Macari, M. E. Finn, G. L. Bennett, K. C. Cho, E. Newman, C. H. Hajdu, and J. S. Babb, “Differentiating pancreatic cystic neoplasms from pancreatic pseudocysts at MR imaging: value of perceived internal debris,” Radiology 251(1), 77–84 (2009). [CrossRef] [PubMed]
  29. J. S. Mallery, B. A. Centeno, P. F. Hahn, Y. Chang, A. L. Warshaw, and W. R. Brugge, “Pancreatic tissue sampling guided by EUS, CT/US, and surgery: a comparison of sensitivity and specificity,” Gastrointest. Endosc. 56(2), 218–224 (2002). [CrossRef] [PubMed]
  30. M. D’Onofrio, A. J. Megibow, N. Faccioli, R. Malagò, P. Capelli, M. Falconi, and R. P. Mucelli, “Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses,” AJR Am. J. Roentgenol. 189(6), 1435–1442 (2007). [CrossRef] [PubMed]
  31. N. A. Ahmad, M. L. Kochman, J. D. Lewis, and G. G. Ginsberg, “Can EUS alone differentiate between malignant and benign cystic lesions of the pancreas?” Am. J. Gastroenterol. 96(12), 3295–3300 (2001). [CrossRef] [PubMed]
  32. W. R. Brugge, K. Lewandrowski, E. Lee-Lewandrowski, B. A. Centeno, T. Szydlo, S. Regan, C. F. del Castillo, and A. L. Warshaw, “Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study,” Gastroenterology 126(5), 1330–1336 (2004). [CrossRef] [PubMed]
  33. S. Cizginer, V. Deshpande, N. Iftimia, C. Karaca, and W. R. Brugge, “Optical coherence tomography (OCT) imaging can detect fine morphologic features of pancreatic cystic neoplasms and differentiate between mucinous and non-mucinous cysts,” Gastroenterology 136(5), A-45 (2009). [CrossRef]

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