In vivo detection of bile duct pre-cancer with endoscopic light scattering spectroscopy

Douglas K. Pleskow, Mandeep S. Sawhney, Paul K. Upputuri, Tyler M. Berzin, Mark F. Coughlan, Umar Khan, Maria Glyavina, Xuejun Zhang, Liming Chen, Conor J. Sheil, Jonah M. Cohen, Edward Vitkin, Yuri N. Zakharov, Irving Itzkan, Lei Zhang (), Le Qiu () and Lev T. Perelman ()
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Douglas K. Pleskow: Harvard University
Mandeep S. Sawhney: Harvard University
Paul K. Upputuri: Harvard University
Tyler M. Berzin: Harvard University
Mark F. Coughlan: Harvard University
Umar Khan: Harvard University
Maria Glyavina: Harvard University
Xuejun Zhang: Harvard University
Liming Chen: Harvard University
Conor J. Sheil: Harvard University
Jonah M. Cohen: Harvard University
Edward Vitkin: Harvard University
Yuri N. Zakharov: Harvard University
Irving Itzkan: Harvard University
Lei Zhang: Harvard University
Le Qiu: Harvard University
Lev T. Perelman: Harvard University

Nature Communications, 2023, vol. 14, issue 1, 1-12

Abstract: Abstract Bile duct cancer is the second most common primary liver cancer, with most diagnoses occurring in the advanced stages. This leads to a poor survival rate, which means a technique capable of reliably detecting pre-cancer in the bile duct is urgently required. Unfortunately, radiological imaging lacks adequate accuracy for distinguishing dysplastic and benign biliary ducts, while endoscopic techniques, which can directly assess the bile duct lining, often suffer from insufficient sampling. Here, we report an endoscopic optical light scattering technique for clinical evaluation of the malignant potential of the bile duct. This technique employs an ultraminiature spatial gating fiber optic probe compatible with cholangioscopes and endoscopic retrograde cholangiopancreatography (ERCP) catheters. The probe allowed us to investigate the internal cellular composition of the bile duct epithelium with light scattering spectroscopy (LSS) and phenotypic properties of the underlying connective tissue with diffuse reflectance spectroscopy (DRS). In a pilot in vivo double-blind prospective study involving 29 patients undergoing routine ERCP procedures, the technique detected malignant transformation with 97% accuracy, showing that biliary duct pre-cancer can be reliably identified in vivo non-invasively.

Date: 2023
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DOI: 10.1038/s41467-022-35780-7

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