New imaging method can eliminate unnecessary biopsies

A new low-cost, portable, battery-powered microendoscope could eventually eliminate the need for costly biopsies for many cancer patients, shows a clinical study of patients in the US and China. "For patients, biopsies are stressful and sometimes painful," said lead researcher Rebecca Richards-Kortum, professor at Rice University where the new microendoscope was developed.

"In addition, in low-resource settings, pathology costs frequently exceed endoscopy costs. So the microendoscope could both improve patient outcomes and provide a significant cost-saving advantage if used in conjunction with a traditional endoscope," Richards-Kortum said.

To determine whether a biopsy is needed, health professionals often use endoscopes, small cameras mounted on flexible tubes that can be inserted into the body to visually examine an organ or tissue without surgery. The new high-resolution micro endoscope uses a one-millimetre-wide fibre-optic cable that is attached to the standard endoscope.

The cable transmits images to a high-powered fluorescence microscope, and the endoscopist uses a tablet computer to view the microscope's output. The clinical study involved 147 US and Chinese patients undergoing examination for potential esophageal cancer.

In the study, all the patients with suspect lesions were examined with both a traditional endoscope and the new micro endoscope. Biopsies were obtained based upon the results of the traditional endoscopic exam. A pathology exam revealed that more than half of those receiving biopsies -- 58 per cent -- did not have high-grade pre-cancer or cancer.

The researchers found that the microendoscopic exam could have spared unnecessary biopsies for about 90 per cent of the patients with benign lesions. Clinical studies of the microendoscope are either planned or underway for a dozen types of cancer including cervical, bladder, oral and colon cancers. (The findings were detailed online in the journal Gastroenterology)