Cellvizio imaging system could improve bile duct cancer detection

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A new imaging system that allows physicians to examine tissue at the cellular level from inside the body may enable them to more effectively diagnose cancer of the bile ducts, according to a new study in the September issue of Clinical Gastroenterology and Hepatology.

The cancer cholangiocarcinoma is one of the most difficult to detect and treat. Lead investigator Alexander Meining, MD, of the Technical University of Munich, Germany, said that adding this non-invasive tool that “allows us to view abnormal bile duct tissue while it’s still inside the body increases diagnostic accuracy of cancer of the bile duct.”

Meining and his colleagues conducted the 14-patient study to evaluate the ability of the Cellvizio confocal microscopy system to detect neoplasia in biliary tract tissue by examining tissue at the cellular level during endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to diagnose cancer of the bile ducts and pancreas.

They found that Cellvizio predicted neoplasia with a sensitivity of 83 percent, considerably better than the 50 percent seen with standard histopathological analysis of biopsied tissue taken from strictures. In addition, Cellvizio predicted neoplasia with an accuracy rate of 86 percent, which was superior to the 79 percent accuracy rate of standard histopathology.

He added that Cellvizio also might facilitate the detection of other cancers arising from ductal structures in the pancreas, breast and urogenital area. Cellvizio images captured with the dye fluorescein enabled researchers to better differentiate between patients with bile duct cancer and those without it by allowing them to see abnormal blood vessels present only in patients with cancer, he said.