New study shows that needle-based Confocal Laser Endomicroscopy (nCLE) has an 87% accuracy in differentiating mucinous from non-mucinous pancreatic cysts
The differentiation of mucinous from non-mucinous cysts is important to guide patient management. nCLE allows for
real-time observation of the cyst wall and identification of patterns specific to mucinous or non-mucinous cysts.
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“Diagnosis of pancreatic cysts: Endoscopic ultrasound-guided, through-the-needle confocal laser-induced endomicroscopy and cystoscopy trial: DETECT study” was just published by the Gastrointestinal Endoscopy journal (1).
In the DETECT study, 30 patients were prospectively enrolled and had EUS-FNA of a pancreatic cyst with nCLE, as well as through the needle visualization with Spyglass (cystoscopy). The image findings of nCLE were classified using the image criteria developed in former studies. In the INSPECT trial, finger-like papillary projections were shown to be 100% specific to mucinous cysts (2). The Superficial Vascular Network criteria, 100% specific to Serous Cystadenoma according to the recently published CONTACT trial, was also identified (3).
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The authors concluded that nCLE may have a role to play in the identification of mucinous cysts, thus guiding patient management.
View the GIE author interview of Pr. Kenneth Chang presenting the DETECT study:
(1): Nakai Y. et al. Diagnosis of pancreatic cysts: EUS-guided, through the needle confocal laser-induced endomicroscopy and cystoscopy trial: DETECT study. Gastrointestinal Endoscopy, 2015.
http://dx.doi.org/10.1016/j.gie.2014.10.025
(2): Konda VJA, et al. A pilot study of in vivo identification of pancreatic cystic neoplasms with needle-based confocal laser endomicroscoscopy under endosonographic guidance. Endoscopy, 2013.
http://dx.doi.org/10.1055/s-0033-1344714
(3): Napoléon B. et al. A novel approach to the diagnosis of pancreatic serous cystadenoma: needle-based confocal laser endomicroscopy. Endoscopy 2015.
http://dx.doi.org/ 10.1055/s-0034-1390693
