Su1347 Endoscopic Ultrasonography-Guided Needle Based Confocal Laser Endomicroscopy Has Improved Accuracy Compared to the Current Standard of Care for Differentiating Mucinous From Non-Mucinous Pancreatic Cystic Lesions

2017 ◽  
Vol 85 (5) ◽  
pp. AB344
Author(s):  
Somashekar G. Krishna ◽  
Rohan Modi ◽  
Samer El-Dika ◽  
Jon Walker ◽  
Sean T. McCarthy ◽  
...  
Keyword(s):  
Endoscopic Ultrasonography ◽  
Standard Of Care ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Cystic Lesions ◽  
Current Standard ◽  
Improved Accuracy

scholarly journals Needle-based confocal laser endomicroscopy of pancreatic cystic lesions: a prospective multicenter validation study in patients with definite diagnosis

Endoscopy ◽  
2018 ◽  
Vol 51 (09) ◽  
pp. 825-835 ◽  
Author(s):  
Bertrand Napoleon ◽  
Maxime Palazzo ◽  
Anne-Isabelle Lemaistre ◽  
Fabrice Caillol ◽  
Laurent Palazzo ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Needle Aspiration ◽  
Serous Cystadenoma ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Cystic Lesions ◽  
Ultrasound Guided ◽  
Cystic Fluid ◽  
Post Procedure ◽  
Mean Size

Abstract Background Needle-based confocal laser endomicroscopy (nCLE) enables observation of the inner wall of pancreatic cystic lesions (PCLs) during an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). This study prospectively evaluated the diagnostic performance of nCLE for large, single, noncommunicating PCLs using surgical histopathology or EUS-FNA cytohistopathology as a reference diagnosis. Methods From April 2013 to March 2016, consecutive patients referred for EUS-FNA of indeterminate PCLs without evidence of malignancy or chronic pancreatitis were prospectively enrolled at five centers. EUS-FNA and nCLE were performed and cystic fluid was aspirated for cytohistopathological and carcinoembryonic antigen (CEA) analysis. The diagnostic performance of nCLE was assessed against the reference standard and compared with that of EUS and CEA. This study was registered on ClinicalTrials.gov (NCT01563133). Results 206 patients underwent nCLE and 78 PCLs (mean size 40 mm, range 20 – 110 mm) had reference diagnoses (53 premalignant and 25 benign PCLs). Post-procedure pancreatitis occurred in 1.3 % of the patients. nCLE was conclusive in 71 of the 78 cases (91 %). The sensitivies and specifities of nCLE for the diagnosis of serous cystadenoma, mucinous PCL, and premalignant PCL were all ≥ 0.95 (with 95 % confidence interval from 0.85 to 1.0). The AUROC was significantly larger for nCLE than for CEA or EUS. Conclusions nCLE had excellent diagnostic performance that surpassed that of CEA and EUS for the diagnosis of large, single, noncommunicating PCLs. The nCLE procedure should be considered in patients with indeterminate PCLs to ensure a more specific diagnosis.

scholarly journals A new needle-based confocal laser endomicroscopy pattern of malignant pancreatic mucinous cystic lesions (with video)

2020 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Aiming Yang ◽  
Yunlu Feng ◽  
Xiaoyan Chang ◽  
Yu Zhao ◽  
Dong Wu ◽  
...  
Keyword(s):  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Cystic Lesions

Needle-Based Confocal Laser Endomicroscopy Examination of Autoimmune Pancreatitis With Cystic Lesions (With Video)

Pancreas ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. e28-e29
Author(s):  
Yunlu Feng ◽  
Yu Zhao ◽  
Zhilan Meng ◽  
Xi Wu ◽  
Tao Guo ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Cystic Lesions

scholarly journals Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 505
Author(s):  
Jorge D. Machicado ◽  
Eugene J. Koay ◽  
Somashekar G. Krishna
Keyword(s):  
Predictive Accuracy ◽  
Quantitative Imaging ◽  
Standard Of Care ◽  
Small Sample ◽  
Cystic Lesions ◽  
Current Standard ◽  
Cross Sectional ◽  
Small Sample Sizes ◽  
Insight Into

Radiomics, also known as quantitative imaging or texture analysis, involves extracting a large number of features traditionally unmeasured in conventional radiological cross-sectional images and converting them into mathematical models. This review describes this approach and its use in the evaluation of pancreatic cystic lesions (PCLs). This discipline has the potential of more accurately assessing, classifying, risk stratifying, and guiding the management of PCLs. Existing studies have provided important insight into the role of radiomics in managing PCLs. Although these studies are limited by the use of retrospective design, single center data, and small sample sizes, radiomic features in combination with clinical data appear to be superior to the current standard of care in differentiating cyst type and in identifying mucinous PCLs with high-grade dysplasia. Combining radiomic features with other novel endoscopic diagnostics, including cyst fluid molecular analysis and confocal endomicroscopy, can potentially optimize the predictive accuracy of these models. There is a need for multicenter prospective studies to elucidate the role of radiomics in the management of PCLs.

scholarly journals Endomicroscopy of the Pancreaticobiliary System

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Shajan Peter ◽  
Ji Young Bang ◽  
Klaus Mönkemuller ◽  
Shyam Varardarajulu ◽  
C. Mel Wilcox
Keyword(s):  
Imaging Techniques ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Future Research ◽  
Imaging Tool ◽  
Long Term Impact ◽  
Improved Accuracy ◽  
Precise Interpretation

It is often difficult to accurately differentiate between benign and malignant pancreaticobiliary strictures, and some are interpreted as indeterminate despite ERCP, EUS, or radiological imaging techniques, thereby making it difficult for the clinician to make appropriate management decisions. Probe-based confocal laser endomicroscopy (pCLE) is an innovative imaging tool integrating real-time in vivo imaging of these difficult-to-interpret strictures in the pancreaticobiliary system during endoscopy. Recent studies of endomicroscopy have shown a promising role with improved accuracy in distinguishing these lesions, thus paving the way for future research addressing improving precise interpretation, training, and long long-term impact.

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