Doctor's Life Magazine, Tampa Bay Doctor's Life Tampa Bay Vol. 2 Issue 2, 201 | Page 13

By Cynthia L. Harris, M.D.
Gastroenterologist, Division of Endoscopic Oncology
Moffitt Cancer Center

P

ancreatic and esophageal cancers are associated with a very high mortality rate, which
can be markedly improved through early diagnosis. In addition, the development of these
cancers is a stepwise process. Therefore, advances in technology that can permit physicians to
image and identify the early stages of these cancers can have a significant impact in the outcomes
of such patients. The world’s smallest microscope is having a big impact at Moffitt Cancer Center,
assisting our gastroenterology team in the identification of early esophageal cancer arising
in Barrett esophagus and differentiating benign from precancerous cysts that might lead to
pancreatic cancer. The technology is called confocal laser endomicroscopy (CLE) with Cellvizio
as the trade name. It is a welcome addition to our experience in biopsy and cytology with the
potential to reduce the risk of misdiagnosis and to help make real-time treatment decisions.
Moffitt Cancer Center is the first hospital in the Tampa Bay
region to offer “optical biopsy,” whereby a very small microscope
probe is threaded through a traditional endoscope to assess
the esophageal mucosa, or through a needle used to puncture
pancreatic cysts for real-time cellular analysis to detect early
cancer. Although currently an adjunct to traditional surgical
biopsies, this technology has the potential to replace traditional
surgical biopsies, making it less invasive. This technology is
helping our team improve detection time, supporting more rapid
and often less invasive intervention in the treatment of precancerous conditions and early cancers.

OPENING UP A MICROSCOPIC VIEW

In a standard endoscopic procedure, gastroenterologists use
endoscopy to analyze the surface of the mucosa (GI tract
lining) at a tissue level. As a result, multiple traditional
biopsies of the mucosa are often taken in an effort
to capture any diseased tissue. Even with tissue
from multiple locations, there is a risk that a
biopsy will fail to provide an adequate sample
and that analysis could result in a “false
negative” or missed confirmation of cancer.
Optical biopsy allows physicians to do
a real-time assessment of the mucosa at a
cellular level, providing immediate and
precise visual cellular images during the
procedure. The microcellular structure
of the esophagus or the lining of a
pancreatic cyst appears on a screen,
allowing the physician to identify and
assess features that can indicate healthy
or diseased tissue. The integration of
Cellvizio is seamless, as it fits directly
through the endoscope or through a
needle through the endoscope, without
interrupting the standard endoscopic
procedure or significantly lengthening
the time of the procedure. This
technology has a proven safety record
in over 15,000 cases.

Issue 2, 2014

DETECTING CANCER FASTER

A growing body of published clinical data shows that by adding
Cellvizio to gastrointestinal endoscopy procedures, physicians are
often able to differentiate cancerous and pre-cancerous changes in
tissue in real time. This is because certain criteria, indicative of cancer,
are easily identifiable at the cellular level than at the tissue level.
In Barrett esophagus, optical biopsy has the potential to detect
more malignant lesions through better sampling, especially

Moffitt Cancer Center is the first
hospital in the Tampa Bay region
to offer “optical biopsy,” whereby
a very small microscope probe
is threaded through a traditional
endoscope to assess the
esophageal mucosa, or through a
needle used to puncture pancreatic
cysts for real-time cellular analys