A novel way to enhance the diagnosis of early stage of colorectal cancer through micro-computed tomography imaging

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Patients with long-term (>8 years) inflammatory bowel disease (IBD) have a 20% lifetime risk of developing colorectal cancer (CRC). Early diagnosis of CRC is essential as it leads to better therapy and survival. Therefore, IBD patients are currently screened by using regular surveillance colonoscopies (camera test) and biopsies (tissue sampling) for diagnosis at a pre-cancerous or early cancer stage. Despite surveillance screening and biochemical tests, advanced cancers are still reported and the value of surveillance program remains controversial. On this account, reliable markers for early diagnosis of CRC are still required for better therapy and increased survival rate.To this end, we propose a novel way to enhance the early diagnosis of colorectal cancer through micro-computed tomography (microCT):- AIM 1: We will use a mouse model for inflammatory-induced CRC to image the colon by microCT at different time points of CRC progression. New microstructural markers for early-stage CRC will be derived from microCT data, such as lesion textures. CRC specificity of these microstructural markers will be tested by cross-correlation with co-registered histological sections.- AIM 2: We will develop a microCT protocol for imaging microstructures of un-contrasted colon tissue, by adapting previous work at UoS on imaging of un-contrasted lung tissue using lab-based microCT. This is aligned with our current Wellcome Pathfinder Award (2016 - 2017), where in collaboration with Nikon Metrology UK, we develop the first microCT system that is fully compatible with existing histopathological workflows.- AIM 3: As the presence of dysplasia-associated lesion mass (DALM) is highly indicative of underlying or associated CRC, we will recruit IBD patients attending the surveillance screening program with long-term (>8 years) IBD for a small study. MicroCT results from DALM samples, non-DALM, and CRC advanced stage will be validated through proof of diagnosis, already obtained through histology, which will provide evidence for the utility of microCT imaging in CRC diagnosis.