Pancreatic Cysts Clinical Trial
Official title:
Detection of Neoplastic Pancreatic Cysts Using Probe Based Confocal Laser Endomicroscopy: A Prospective in Vivo Study
Confocal laser endomicroscopy (CLE) is a novel and highly promising imaging method for that
allows in vivo imaging of the mucosal layer at resolution of approximately 1 micron.
Cellular and sub-cellular structures as well as capillaries and single red blood cells can
be visualized. CLE is now well established as a highly accurate method for distinguishing
neoplasia in the gastrointestinal tract lumen via endoscopy. A major new breakthrough is the
development of sub-millimeter CLE probes that can be passed via an image guided needle
(nCLE) into solid organs and cysts.
It is hypothesized that nCLE will help distinguish the benign, premalignant and malignant
cystic lesions of pancreas by visualizing the cellular lining of the cysts, thereby,
avoiding unnecessary surgery in patient with benign cysts and guiding to early and effective
surgical removal of high risk neoplastic lesions.
A prototype minimal risk nCLE system has been developed that can be passed via standard
endoscopic ultrasound needles into the pancreas but FDA clearance for in vivo use is not
expected until late 2010. The investigators propose to evaluate this prototype nCLE system
in vivo during endoscopic ultrasound (EUS), as an initial pilot study.
Hypothesis: the confocal laser endomicroscopy imaging of the nCLE can differentiate between
non-mucinous, mucinous non- malignant and malignant pancreatic cysts in vivo and has
increased sensitivity compared to endoscopic ultrasound-fine needle aspiration (EUS-FNA)
tissue sampling. In this pilot study the investigators will primarily evaluate technical
feasibility and interobserver agreement.
1. In patients undergoing EUS for suspected pancreatic cysts, the investigators will
evaluate the key nCLE image features of non mucinous, mucinous, and malignant
pancreatic cystic neoplasms (PCN).
2. The investigators will estimate the initial image quality, feasibility, and
interobserver agreement of nCLE
3. The investigators will establish the preliminary accuracy of nCLE to be used for
planning a larger comparative trial
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Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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