A low-cost microendoscope could eliminate the need for costly biopsies for many patients undergoing endoscopic screening for esophageal cancer, scientists, including one of Indian-origin, have found.
The findings come from a clinical study which included 147 patients in the US and China undergoing examination for potentially malignant squamous cell tumours.
The study explored whether the new low-cost, high-resolution fibre-optic imaging system developed by Rice University bioengineers could reduce the need for unnecessary biopsies when used in combination with a conventional endoscope - the worldwide standard of care for esophageal cancer diagnoses.
The study involved patients from two US and two Chinese hospitals: Mt Sinai Medical Center in New York, the University of Texas MD Anderson Cancer Center in Houston, the Cancer Institute and Hospital of the Chinese Academy of Medical Sciences in Beijing and First University Hospital in Jilin.
In the study, all 147 patients with suspect lesions were examined with both a traditional endoscope and Rice's microendoscope. Biopsies were obtained based upon the results of the traditional endoscopic exam.
A pathology exam showed that more than half of those receiving biopsies - 58 per cent - did not have high-grade precancer or cancer.
The researchers found that the microendoscopic exam could have spared unnecessary biopsies for about 90 per cent of the patients with benign lesions.
To determine whether a biopsy is needed for a histological exam, health professionals often use endoscopes, small cameras mounted on flexible tubes that can be inserted into the body to visually examine an organ or tissue without surgery.
Rice's high-resolution microendoscope uses a 1-millimetre-wide fibre-optic cable that is attached to the standard endoscope.
The cable transmits images to a high-powered fluorescence microscope, and the endoscopist uses a tablet computer to view the microscope's output.
The microendoscope provides images with similar resolution to traditional histology and allows endoscopists to see individual cells and cell nuclei in lesions suspected of being cancerous.
By providing real-time histological data to endoscopists, Rice's microendoscope can help rule out malignancy in cases that would otherwise require a biopsy.
"While traditional endoscopy can rule out malignancy and eliminate the need for biopsies for some patients, in a significant number of cases the difference between malignant and benign lesions only becomes apparent through a histological analysis," said study co-author Dr Sharmila Anandasabapathy, professor of medicine and gastroenterology at Baylor College of Medicine and director of Baylor Global Initiatives and the Baylor Global Innovation Center.
