Your browser doesn't support javascript.
loading
Optical coherence tomography of the pancreatic and bile ducts: are we ready for prime time?
Tyberg, Amy; Raijman, Isaac; Novikov, Aleksey A; Sejpal, Divyesh V; Benias, Petros C; Trindade, Arvind J; Das, Ananya; Sachdev, Mankanwal; Khosravi, Farhoud; Tarnasky, Paul; Kedia, Prashant; Gaidhane, Monica; Kahaleh, Michel; Joshi, Virendra.
Afiliação
  • Tyberg A; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, United States.
  • Raijman I; Greater Houston Gastroenterology, Houston, Texas, United States.
  • Novikov AA; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, United States.
  • Sejpal DV; Northshore University Hospital, Manhasset, New York, United States.
  • Benias PC; Northshore University Hospital, Manhasset, New York, United States.
  • Trindade AJ; Northshore University Hospital, Manhasset, New York, United States.
  • Das A; Arizona Center for Digestive Health, Phoenix, Arizona, United States.
  • Sachdev M; Arizona Center for Digestive Health, Phoenix, Arizona, United States.
  • Khosravi F; Arizona Center for Digestive Health, Phoenix, Arizona, United States.
  • Tarnasky P; Methodist Hospital, Dallas, Texas, United States.
  • Kedia P; Methodist Hospital, Dallas, Texas, United States.
  • Gaidhane M; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, United States.
  • Kahaleh M; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, United States.
  • Joshi V; Ochsner, New Orleans, Louisiana, United States.
Endosc Int Open ; 8(5): E644-E649, 2020 May.
Article em En | MEDLINE | ID: mdl-32355883
Background and study aims First-generation optical coherence tomography (OCT) has been shown to increase diagnostic sensitivity for malignant biliary and pancreatic-duct strictures. A newer OCT imaging system, NVision Volumetric Laser Endomicroscopy (VLE), allows for in vivo cross-sectional imaging of the ductal wall at the microstructure level during endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to identify and evaluate characteristics on OCT that are predictive of benign and malignant strictures. Patients and methods Consecutive patients from six centers who underwent OCT between September 2016 and September 2017 were included in a dedicated registry. OCT images were analyzed, and nine recurring characteristics were further assessed. Final diagnosis was based on histology and/or surgical pathology. Results 86 patients were included (49 % male, mean age 64.7). OCT was performed in the bile duct in 79 patients and the pancreatic duct in seven. Nine OCT characteristics were identified: dilated hypo-reflective structures (n = 7), onion-skin layering (n = 8), intact layering (n = 17), layering effacement (n = 25), scalloping (n = 20), thickened epithelium (n = 42), hyper-glandular mucosa (n = 13), prominent blood vessels (n = 6), and a hyper-reflective surface (n = 20). Presence of hyper-glandular mucosa, hyper-reflective surface and scalloping significantly increased the odds of malignancy diagnosis by 6 times more ( P  = 0.0203; 95 % CI 1.3 to 26.5), 4.7 times more ( P  = 0.0255; 95 % CI 1.2 to 18.0) and 7.9 times more ( P  = 0.0035; 95 % CI 1.97 to 31.8) respectively. Conclusion By providing in-vivo cross-sectional imaging of the pancreatic and biliary duct wall, OCT technology may improve sensitivity in diagnosing malignant strictures and provide standardizable criteria predictive of malignancy.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Endosc Int Open Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Endosc Int Open Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos