A feasibility study of full-field optical coherence tomography for rapid evaluation of EUS-guided microbiopsy specimens

Background: Rapid on-site evaluation of cytologic specimens is a way of determining the adequacy of fine-needle aspiration (FNA). However, alternatives may be useful when the presence of a cytotechnologist and/or pathologist is not possible. Objective: To evaluate the feasibility of using full-field optical coherence tomography (FFOCT) for FNA specimen quality assessment. Design: FFOCT images were acquired on gastric, pancreatic, pelvic, and lymph-node formalin-fixed FNA specimens and were compared with histology of the same samples. Setting: Pathology suite in a hospital. Patients: Fourteen patients undergoing gastric, pancreatic, pelvic, or lymph-node EUS-guided FNA biopsy. Interventions: FFOCT imaging on formalin-fixed samples before histologic procedures. Main Outcome Measurements: FFOCT imaging feasibility and visibility of normal and abnormal features on images. Results: FFOCT imaging was possible. Blood, mucus, muscle, collagen, and digestive mucosa could be identified as well as abnormal architectural features including infiltrative pancreatic ductal carcinoma and a neuroendocrine neoplasm. Lesions at the individual cell level could not be detected. Limitations: The study was performed on a limited number of cases. Conclusion: FFOCT offers rapid, noninvasive, nondestructive imaging of FNA biopsy specimens. In the future, it could be performed in the endoscopy suite to improve detection of satisfactory specimens and obviate the need for rapid on-site evaluation.