Overcoming the Barriers of Fine-Needle Aspiration

Författare: Filipe Marques; Niclas Roxhed; Heikki J. Nieminen; Kth; []

Nyckelord: MEDICAL AND HEALTH SCIENCES; MEDICIN OCH HÄLSOVETENSKAP; MEDICAL AND HEALTH SCIENCES; MEDICIN OCH HÄLSOVETENSKAP; ENGINEERING AND TECHNOLOGY; TEKNIK OCH TEKNOLOGIER; TEKNIK OCH TEKNOLOGIER; MEDICIN OCH HÄLSOVETENSKAP; ENGINEERING AND TECHNOLOGY; MEDICAL AND HEALTH SCIENCES; Cysts; Cystic fluid; Pancreatic Cancer; Fine-needle Aspiration; Early diagnosis; Surgical instruments; Nitinol; Absorbable sutures; Loop brush; Cythopathology; Rapid on-site evaluation; Microfluidics; Electrical Engineering; Elektro- och systemteknik;

Sammanfattning: Cysts, closed sac-like structures filled with fluid or air, can form anywhere in the body. In the majority of cases, cysts are benign (not cancerous). However, these structures can also be precursors of cancer, pointing to the location where cancer can originate. This makes cysts a prime location for examination, especially when they occur in the pancreas. Pancreatic cancer has the lowest survival rate after five years in 2023 (12%) due to the late diagnosis, limiting treatment options. Fine-Needle Aspiration (FNA) is a diagnostic technique used to aspirate the liquid content of cysts. The liquid may possess cells used to determine cyst malignancy, yet up to 66% of samples have little to no cells.Firstly, we introduce a new concept of brush: the loop brush. Unlike traditional brushes with a handle and a block of bristles, the loop brush consists of a handle and a loop-shaped wire. The loop of loop brushes can be compressed within the inner diameter of an FNA needle and autonomously expanded to the size of cysts. Loops can be made of nitinol or commercially available absorbable sutures such as Monocryl, PDS II, and Catgut. Loop brushes increase the cell yield of modeled cysts by an order of magnitude and are, apparently, as safe as standard FNA (FNA without a loop brush). Such brushes could present a promising solution to the lack of cells in liquid samples of cysts, increasing treatment options and producing better, cost-effective care for patients.Secondly, we present a hand-sized microfluidic device to prepare rapid on-site evaluation(ROSE) of FNA samples. During ROSE, FNA samples are prepared by cytopathologists in the operating room for further inspection with a microscope. However, cytopathologists are often time-limited, preventing the dissemination of ROSE. Our device allows sample preparation with minimum chemical quantities and the potential to be implemented by all healthcare providers. This microfluidic device would allow the dissemination of ROSE, preventing the need for patients to return to the OR and accelerating diagnosis.

  KLICKA HÄR FÖR ATT SE AVHANDLINGEN I FULLTEXT. (PDF-format)