Fiber Optic In Vivo Confocal Microscopy

光子技术的最新发展提供了在体内非侵入性成像的能力;这些新的细胞成像技术具有显著改善上皮癌的预防、检测和治疗的潜力。 活体共聚焦显微镜是一种能够近真实的实时观察活体组织结构和细胞形态的新技术。 初步临床试验表明，上皮组织的共聚焦图像可以以前所未有的特异性和敏感性诊断发育异常。 此外，已经开发了允许高分辨率体内成像的柔性光纤仪器。 在这次更新中，提出了一系列的合作，综合临床和工程研究，探讨在体内共聚焦成像在口腔癌的检测，管理和治疗中的临床作用，并开发具有成本效益的方法，为多中心试验提供临床仪器。 该提案的目的是：1）进行一项大型前瞻性试验，以评估基于反射的共聚焦成像检测口腔中发育异常的灵敏度和特异性; 2）进行一项临床试验，以评估体内反射共聚焦成像的作用，以通过辅助口腔中肿瘤切除的边缘检测来最大化手术疗效并最小化手术发病率; 3）进行临床试验以检查体内反射共焦成像监测一组年轻舌癌患者对诱导化疗的反应的能力; 4）评估体内反射共焦显微镜提供在不需要活检的情况下监测危险区域的工具的能力，提供了一个强大的新的中间终点标记，以帮助化学预防研究。 最后，在我们以前的工作中设计的小型化的目标，使在体内成像，但昂贵的制造和难以组装。 本提案的第五个目的是设计和构造廉价的、注射成型的光学元件，其可以容易地与当前原型中使用的廉价光纤成像束集成。

DESCRIPTION (provided by applicant) Recent developments in photonic technology provide the ability to non-invasively image in vivo; these new cellular imaging technologies have the potential to dramatically improve the prevention, detection and therapy of epithelial cancers. In vivo confocal microscopy is a new technology that can provide detailed images of tissue architecture and cellular morphology in living tissue near real time. Pilot clinical trials show that confocal images of epithelial tissues can diagnose dysplasia with unprecedented specificity and sensitivity. Furthermore, flexible fiber optic instrumentation that permits high resolution in vivo imaging has been developed. In this renewal, a series of collaborative, integrated clinical and engineering studies are proposed to explore the clinical role of in vivo confocal imaging in the detection, management and therapy of caners of the oral cavity and to develop cost-effective approaches to provide clinical instrumentation for multi-center trials. The aims of this proposal are to: 1) Conduct a large prospective trial to estimate the sensitivity and specificity of reflectance based confocal imaging for detection of dysplasia in the oral cavity; 2) conduct a clinical trial to evaluate the role of in vivo reflectance confocal imaging to maximize surgical efficacy and minimize surgical morbidity by assisting in margin detection for tumor resection in the oral cavity; 3) conduct a clinical trial to examine the ability of in vivo reflectance confocal imaging to monitor response to induction chemotherapy in a group of young patients with cancer of the tongue; 4) assess the ability of in vivo reflectance confocal microscopy to provide a tool to monitor the field at risk without the need for biopsy, providing a powerful new intermediate endpoint marker to aid in chemoprevention studies. Finally, the miniaturized objectives designed in our previous work enable in vivo imaging but are expensive to manufacture and difficult to assemble. The fifth aim of this proposal is to design and construct inexpensive, injection-modeled optical elements that can be easily integrated with the inexpensive fiber optic imaging bundles used in current prototypes.