Polarization gating spectroscopy of normal-appearing duodenal mucosa to detect pancreatic cancer

Mihir Patel, Andrew Gomes, Sarah Ruderman, Darla Hardee, Sergio Crespo, Massimo Raimondo, Timothy Woodward, Vadim Backman, Hemant Roy, Michael Wallace

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: According to the field effect theory, by detecting microvasculature changes such as early increase in blood supply (EIBS) in the surrounding tissue, neoplastic lesions can be identified from a distance. Objective: To determine the feasibility and efficacy of a fiberoptic probe containing novel polarization gating spectroscopy technology to identify patients with pancreatic adenocarcinoma (PAC) by the field effect theory. Design: Prospective cohort (pilot) study. Setting: Outpatient tertiary care center. Patients: Adult (R18 years) patients undergoing EGD-EUS were screened. Patients with PAC were included in the "cancer" group and patients without PAC were included in the "control" group. We excluded patients with other known malignancies and gastroduodenal premalignant lesions. Interventions and Main Outcome Measures: Spectroscopic measurements of EIBS variables, such as deoxyhemoglobin concentration (DHb) and mean blood vessel radius (BVR), were obtained from 5 periampullary locations. The Mann-Whitney rank sum test was used for the statistical analysis (P % .05). Results: Fourteen patients (mean age 72 years, 79% male) in the cancer group and 15 patients (mean age 63 years, 60% male) in the control group were included in the final analysis. At the ampullary site, both DHb (P Z .001) and BVR (P Z .03) were higher in PAC patients than in the control subjects. The DHb alone (92% sensitivity, 86% specificity) or in combination with BVR (92% sensitivity, 79% specificity) can differentiate PAC from control subjects with high accuracy. Limitations: Small sample size, unmatched control subjects. Conclusions: Spectroscopic measurements of EIBS by fiberoptic probes are feasible. Preliminary evidence suggests that in vivo measurement of normal-appearing duodenal tissue can differentiate PAC patients from a distance with high accuracy.

Original languageEnglish (US)
Pages (from-to)786-793.e2
JournalGastrointestinal Endoscopy
Volume80
Issue number5
DOIs
StatePublished - 2014

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Pancreatic Neoplasms
Spectrum Analysis
Mucous Membrane
Adenocarcinoma
Blood Vessels
Sensitivity and Specificity
Neoplasms
Control Groups
Ambulatory Care
Nonparametric Statistics
Microvessels
Tertiary Care Centers
Sample Size
Cohort Studies
Outcome Assessment (Health Care)
Technology

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Polarization gating spectroscopy of normal-appearing duodenal mucosa to detect pancreatic cancer. / Patel, Mihir; Gomes, Andrew; Ruderman, Sarah; Hardee, Darla; Crespo, Sergio; Raimondo, Massimo; Woodward, Timothy; Backman, Vadim; Roy, Hemant; Wallace, Michael.

In: Gastrointestinal Endoscopy, Vol. 80, No. 5, 2014, p. 786-793.e2.

Research output: Contribution to journalArticle

Patel, M, Gomes, A, Ruderman, S, Hardee, D, Crespo, S, Raimondo, M, Woodward, T, Backman, V, Roy, H & Wallace, M 2014, 'Polarization gating spectroscopy of normal-appearing duodenal mucosa to detect pancreatic cancer', Gastrointestinal Endoscopy, vol. 80, no. 5, pp. 786-793.e2. https://doi.org/10.1016/j.gie.2014.03.031
Patel, Mihir ; Gomes, Andrew ; Ruderman, Sarah ; Hardee, Darla ; Crespo, Sergio ; Raimondo, Massimo ; Woodward, Timothy ; Backman, Vadim ; Roy, Hemant ; Wallace, Michael. / Polarization gating spectroscopy of normal-appearing duodenal mucosa to detect pancreatic cancer. In: Gastrointestinal Endoscopy. 2014 ; Vol. 80, No. 5. pp. 786-793.e2.
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AU - Patel, Mihir

AU - Gomes, Andrew

AU - Ruderman, Sarah

AU - Hardee, Darla

AU - Crespo, Sergio

AU - Raimondo, Massimo

AU - Woodward, Timothy

AU - Backman, Vadim

AU - Roy, Hemant

AU - Wallace, Michael

PY - 2014

Y1 - 2014

N2 - Background: According to the field effect theory, by detecting microvasculature changes such as early increase in blood supply (EIBS) in the surrounding tissue, neoplastic lesions can be identified from a distance. Objective: To determine the feasibility and efficacy of a fiberoptic probe containing novel polarization gating spectroscopy technology to identify patients with pancreatic adenocarcinoma (PAC) by the field effect theory. Design: Prospective cohort (pilot) study. Setting: Outpatient tertiary care center. Patients: Adult (R18 years) patients undergoing EGD-EUS were screened. Patients with PAC were included in the "cancer" group and patients without PAC were included in the "control" group. We excluded patients with other known malignancies and gastroduodenal premalignant lesions. Interventions and Main Outcome Measures: Spectroscopic measurements of EIBS variables, such as deoxyhemoglobin concentration (DHb) and mean blood vessel radius (BVR), were obtained from 5 periampullary locations. The Mann-Whitney rank sum test was used for the statistical analysis (P % .05). Results: Fourteen patients (mean age 72 years, 79% male) in the cancer group and 15 patients (mean age 63 years, 60% male) in the control group were included in the final analysis. At the ampullary site, both DHb (P Z .001) and BVR (P Z .03) were higher in PAC patients than in the control subjects. The DHb alone (92% sensitivity, 86% specificity) or in combination with BVR (92% sensitivity, 79% specificity) can differentiate PAC from control subjects with high accuracy. Limitations: Small sample size, unmatched control subjects. Conclusions: Spectroscopic measurements of EIBS by fiberoptic probes are feasible. Preliminary evidence suggests that in vivo measurement of normal-appearing duodenal tissue can differentiate PAC patients from a distance with high accuracy.

AB - Background: According to the field effect theory, by detecting microvasculature changes such as early increase in blood supply (EIBS) in the surrounding tissue, neoplastic lesions can be identified from a distance. Objective: To determine the feasibility and efficacy of a fiberoptic probe containing novel polarization gating spectroscopy technology to identify patients with pancreatic adenocarcinoma (PAC) by the field effect theory. Design: Prospective cohort (pilot) study. Setting: Outpatient tertiary care center. Patients: Adult (R18 years) patients undergoing EGD-EUS were screened. Patients with PAC were included in the "cancer" group and patients without PAC were included in the "control" group. We excluded patients with other known malignancies and gastroduodenal premalignant lesions. Interventions and Main Outcome Measures: Spectroscopic measurements of EIBS variables, such as deoxyhemoglobin concentration (DHb) and mean blood vessel radius (BVR), were obtained from 5 periampullary locations. The Mann-Whitney rank sum test was used for the statistical analysis (P % .05). Results: Fourteen patients (mean age 72 years, 79% male) in the cancer group and 15 patients (mean age 63 years, 60% male) in the control group were included in the final analysis. At the ampullary site, both DHb (P Z .001) and BVR (P Z .03) were higher in PAC patients than in the control subjects. The DHb alone (92% sensitivity, 86% specificity) or in combination with BVR (92% sensitivity, 79% specificity) can differentiate PAC from control subjects with high accuracy. Limitations: Small sample size, unmatched control subjects. Conclusions: Spectroscopic measurements of EIBS by fiberoptic probes are feasible. Preliminary evidence suggests that in vivo measurement of normal-appearing duodenal tissue can differentiate PAC patients from a distance with high accuracy.

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