Abstract
We developed a novel technology capable of detecting early-stage pancreatic cancers using high-resolution three-dimensional endoscopic optical coherence tomography (Endo-OCT), and treating them using high dose rate brachytherapy (HDR) under the Endo-OCT image guidance. This technology integrates our custom-built ultra-high resolution endoscopic three-dimensional OCT diagnostic imaging device with a commercial high dose rate brachytherapy system (HDR), resulting in a compact, portable, easy-to-operate, and low-cost Endo-OCT image-guided high dose rate brachytherapy (OCT-IGHDR) system. The system has the dual functions of diagnosis and treatment that can precisely detect and measure the location and size of the early-stage pancreatic cancer or premalignant lesions and then treat them from the inside of the pancreatic duct with an accurate and focused dose while greatly reducing the radiation toxicity to the neighboring tissues and organs. This minimally-invasive treatment technology could avoid the potential complications from surgery and reduces the high operation cost. This technology could also be applied to treat diseases of the esophagus, rectum, bronchus, and other aerodigestive organs that are suitable for use with an endoscopic device. In this article, we describe the concept of this technology and the preliminary experiments that could demonstrate the concept by using this homemade Endo-OCT machine to image the pancreatic duct for diagnosis of early-stage pancreatic cancer or premalignant lesions and to perform Endo-OCT image-guided brachytherapy.
Highlights
Reason for Early Detection of Pancreatic CancerMore than 57,600 estimated new pancreatic cancer cases were diagnosed in the United States in 2020, and the estimated deaths are more than 47,050 [1]
Using our proposed technology and the funding supported by Pelotonia Idea Grant Award [15], we built an ultra-highresolution three-dimensional endoscopic Optical Coherence Tomography (OCT) imaging device to possess the dual functions of 1) detection of early-stage pancreatic cancer or premalignant lesions and 2) OCT-guided high dose rate brachytherapy (HDR) brachytherapy for such lesions
We present a promising catheter-based application of endoscopic OCT to aid the early detection and treatment of pancreatic cancer or premalignant lesions
Summary
Reason for Early Detection of Pancreatic Cancer. More than 57,600 estimated new pancreatic cancer cases were diagnosed in the United States in 2020, and the estimated deaths are more than 47,050 [1]. The 5-year overall survival rate for pancreatic cancer is 9% and on average the survival time is less than 12 months after diagnosis [2]. The 5-year survival rate strongly links to the disease stages at diagnosis making it important to develop methods to aid in earlier diagnosis (Figures 1A, B) [1]. The poor survival rate is mainly due to the late diagnosis of the cancer which advances very aggressively leaving few options for treatment. Detection and treatment of the disease is the key to prolonging patients’ lives but in current clinical practice there are still no satisfactory techniques available for early detection.
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