Light Scattering Spectroscopy Identifies Malignant Cysts

A new light scattering spectroscopy (LSS) device can distinguish between harmless pancreatic cysts and those with malignant potential with high accuracy, according to a new study.

Developed by researchers at Beth Israel Deaconess Medical Center, the new tool, half a millimeter in diameter, detects structural changes in cancerous or pre-cancerous cells by using a spatial gating fiberoptic probe inserted into a fine-needle aspiration (FNA) needle. The miniature fiberoptic probe measures optical spectra from the internal cyst surface to predict malignant potential, before collecting cystic fluid as part of routine diagnostic endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) procedures.

To test the accuracy of the LSS system, the researchers collected and analyzed the reflected light from 13 cysts; they then compared their findings with the results from pre-operative imaging, FNA biopsies, and post-operative tissues analysis. In all cases, the LSS diagnosis agreed with the post-operative analysis. In a second experiment, the LSS tool was tested in 14 patients with pancreatic cysts who were undergoing standard FNA biopsy. Out of nine patients whose cysts had been definitely diagnosed as either cancerous or benign, all were correctly identified by LSS. The study was published on March 13, 2017, in the Nature Biomedical Engineering.

“About one-fifth of pancreatic cancers develop from cysts, but not all lesions are cancerous,” said senior author Lev Perelman, PhD, director of the BIDMC center for advanced biomedical imaging and photonics. “Considering the high risk of pancreatic surgeries and the even higher mortality from untreated pancreatic cancers, there's an obvious need for new diagnostic methods to accurately identify the pancreatic cysts that need surgical intervention, and those that do not.”

Pancreatic cysts are fluid-filled growths that develop in the pancreas. Sometimes pancreatic cysts grow as a result of pancreatitis, an inflammation in the pancreas; but most develop for no apparent reason and are discovered by chance during a computerized tomography (CT) or magnetic resonance imaging (MRI) scan done for another purpose. Most pancreatic cysts are benign, but some have the potential to develop into pancreatic cancer.