Tethered capsule endomicroscopy-guided sampling of pancreatic fluid

A screening test for early detection of pancreatic cancer (PC) is a critical unmet need as PC is usually detected late when mortality is unavoidable. Pancreatic fluid (PF), excreted to the duodenum by the Ampulla of Vater (AoV), offers a promising sample for early stage pancreatic cancer screening as it is the richest source of PC bioanalytes. The successful identification of the AoV is critical to develop a minimally invasive and inexpensive capsule-based PC screening test. With our recently developed tether capsule endomicroscopy (TCE) technique, we imaged 27 subjects and analyzed 353 duodenal OCT-TCE datasets. Using relative positions of the major and minor ampulla, and influx of bile into the duodenum, we distinguished the major from the minor. At least one ampulla was identified in 100%, major ampulla identified in 85%, and minor ampulla identified in 67% of all subjects. The measured mean max. diameter of the major ampulla was 6.49 ± 2.23 mm, and 6.09 ± 2.05 mm for the minor.