Groundbreaking Mini-Microscope Allows for Real-Time Analysis and Treatment of Gastrointestinal Diseases
Amy Weitz, 510-206-1855
CPMC doctors using miniature device for early cancer detection and immediate therapy
San Francisco, CA, November 14, 2012 – A tiny microscope smaller than the tip of a pen is allowing doctors to better identify pre-cancerous or malignant lesions during endoscopic procedures, and in some cases perform what can amount to life-saving treatment right there on the spot. This latest technology, called endomicroscopy, is being hailed as a major advance in early cancer detection.
"When we performed an endoscopy or colonoscopy in the past, we’d have to rely on a visual assessment of tissue," said Yasser M. Bhat, MD, medical director of Esophageal Imaging and Therapy, Interventional Endoscopy Services (IES) at the California Pacific Medical Center (CPMC, a Sutter Health affiliate). "Now, we can use this microscope to examine the gastrointestinal lining at the cellular level in real time. We can better target any suspicious lesions for biopsy, and possibly remove all of the problem cells right then and there." The IES group at CPMC is the first in the Bay Area to offer endomicroscopy in routine gastroenterological patient care.
The imaging tool, called a confocal endomicroscope, is being used with a wide range of GI endoscopy procedures, including those involving the esophagus, stomach, colon, bile duct and pancreas. After a patient has been diagnosed by a doctor with a pre-cancerous condition or a malignancy, he or she undergoes a follow-up procedure by a physician trained to use the tiny microscope, which is threaded through the instrumentation channel of a standard endoscope and allows for magnification up to 1000 times. The miniature tool permits the physician to more accurately differentiate between normal and pre-cancerous or malignant cells, and in some instances perform a minimally invasive treatment that can preclude the need for a major surgical procedure. For the patient, it can mean a better chance for definitive and early therapy.
"It’s really a remarkable device," said Janak Shah, MD, medical director of Pancreatico-Biliary Endoscopy at CPMC. "Because the endomicroscope can be inserted through catheters we routinely use in the bile and pancreatic ducts, we can also diagnose pancreas and biliary cancers at earlier stages, when cure is still possible."
Kenneth Binmoeller, MD, medical director of IES, added that "this significant advance in the diagnosis of cancerous change will allow more patients to benefit from endoscopic therapy, which is curative when cancer is detected at a sufficiently early stage." The IES doctors emphasized that this procedure does not take the place of a biopsy performed in the pathology lab, but rather allows the GI specialist to work more closely with the pathologist to assure a correct and timely diagnosis.
The microscope is being used to help detect precancerous and cancerous change in a wide range of GI conditions, including Barrett’s esophagus (damage caused by acid reflux), colon and gastric polyps, inflammatory bowel disease, pancreatic cysts, and stricture (narrowing) of the bile and pancreatic ducts. The IES doctors believe that this is just the first of many advances using the endomicroscope.
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