Affiliations: Biomedical Engineering Department, Northwestern
University, Evanston, IL, USA | Department of Internal Medicine, Evanston Northwestern
Healthcare, Evanston, IL, USA
Abstract: Pancreatic cancer screening has been hampered by the high rate of
complications associated with interrogating the pancreas. The closest
non-invasively accessible mucosa available for pancreatic cancer screening is
the periampullary duodenal tissue. Our earlier report has shown the potential
of using optical markers to interrogate this tissue for the presence of
pancreatic cancer. In this study, we report a larger data set of low-coherence
enhanced backscattering (LEBS) and elastic light scattering fingerprinting
(ELF) optical markers from the periampullary duodenal mucosa. Optical
measurements from biopsy samples were acquired from a total of 203 patients
with varying clinical classification including healthy controls, a family
history of pancreatic cancer, pancreatitis, mucinous cystic precursor lesions,
pancreatic cancer, and other pancreatic malignancies. Evaluation of the
performance of an independent testing set for discriminating healthy control
patients from pancreatic cancer patients showed a 95% sensitivity, 71%
specificity, and 85% area under the receiver operator characteristic (AUROC)
curve. Importantly, this performance was uncompromised for detecting
potentially curable stages of the disease. Additionally, optical markers in
higher risk populations such as family history and pancreatitis had values
between those of healthy control and pancreatic cancer patients, thus allowing
for future investigations of screening from these high risk groups.
Keywords: Pancreatic cancer screening, field effect, duodenum, backscattering spectroscopy
