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Optical coherence tomography: Expanding use in the bile duct
Author(s) -
Perkins James D.
Publication year - 2007
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21162
Subject(s) - medicine , optical coherence tomography , radiology , bile duct , cytology , endoscopic retrograde cholangiopancreatography , pancreatitis , pancreatic duct , catheter , tomography , biopsy , pathology , surgery
Background and Study Aims Optical coherence tomography (OCT) permits high‐resolution imaging of tissue microstructures using a probe that can be inserted into the main pancreatic duct (MPD) through a standard endoscopic retrograde cholangiopancreatography (ERCP) catheter. This prospective study was designed to assess the diagnostic capacity of OCT to differentiate between nonneoplastic and neoplastic lesions in patients with MPD segmental strictures. Patients and Methods Twelve consecutive patients with documented MPD segmental stricture were investigated by endoscopic ultrasonography (EUS), with fine‐needle aspiration cytology if necessary, and ERCP, followed by brush cytology and OCT scanning. Results OCT recognized a differentiated three‐layer architecture in all cases with normal MPD or chronic pancreatitis, while in all the neoplastic lesions the layer architecture appeared totally subverted, with heterogeneous backscattering of the signal. The accuracy of OCT for detection of neoplastic tissue was 100% compared with 66.7% for brush cytology. In one case, neither OCT scanning nor brush cytology was possible because of the severity of the stricture. Conclusions This pilot study showed that OCT is feasible during ERCP, in cases of MPD segmental stricture, and was superior to brush cytology in distinguishing nonneoplastic from neoplastic lesions.