Fiber Optic In Vivo Confocal Microscopy

描述（由申请人提供）光子技术的最新发展提供了在体内进行非侵入性成像的能力；这些新的细胞成像技术有可能极大地改善上皮性癌症的预防、检测和治疗。活体共聚焦显微技术是一种能够提供活体组织结构和细胞形态的实时详细图像的新技术。初步临床试验表明，上皮组织的共聚焦图像可以诊断异常增生前所未有的特异性和敏感性。此外，允许高分辨率体内成像的柔性光纤仪器已经开发出来。在这篇更新中，我们提出了一系列的合作，整合临床和工程研究，以探索体内共聚焦成像在口腔癌症的检测，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。本提案的目的是：1)进行一项大型前瞻性试验，评估基于反射的共聚焦成像检测口腔发育不良的灵敏度和特异性；2)开展临床试验，评价体内反射共聚焦成像通过辅助口腔肿瘤切除边缘检测，实现手术疗效最大化、手术发病率最小化的作用；3)对一组年轻舌癌患者进行体内反射共聚焦成像监测诱导化疗反应的临床试验；4)评估体内反射共聚焦显微镜的能力，以提供一种工具来监测有风险的领域，而不需要活检，为化学预防研究提供一个强大的新的中间终点标记。最后，在我们之前的工作中设计的小型化物镜能够在体内成像，但制造成本高，组装困难。该提案的第五个目标是设计和构建廉价的注入式光学元件，可以很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.