Optical guidance of surgical excision of skin cancer

光学引导皮肤癌手术切除

• 批准号: 7394945
• 负责人: Ken Kyung-Hoon Lee
• 金额: $ 12.56万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-05 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7394945
• 关键词: Algorithms; Back; Basal cell carcinoma; Biopsy; Blood; Cancerous; Characteristics; Clinical; Clinical assessments; Cold Therapy; Collagen; Cutaneous; Depth; Dermis; Disruption; Equipment; Evaluation; Excision; Eye; Glare; Hand; Human; Image; Image Analysis; Imagery; Imaging Techniques; Invaded; Invasive; Lateral; Libraries; Light; Lighting; Malignant Neoplasms; Melanins; Metric; Microscope; Modality; Movement; Normal tissue morphology; Operative Surgical Procedures; Optics; Papillary; Pathologic; Pathology; Pattern; Photons; Preparation; Process; Protocols documentation; Radiosurgery; Randomized Clinical Trials; Relative (related person); Resolution; Skin; Skin Cancer; Skin Tissue; Specimen; Squamous cell carcinoma; Standards of Weights and Measures; Surface; System; Techniques; Testing; Texture; Time; Tissues; Topical Chemotherapy; United States; Variant; Vision; Visual; absorption; base; cancer therapy; charge coupled device camera; digital; improved; melanoma; new technology; pol genes; polarized light; tumor

DESCRIPTION (provided by applicant): Skin cancer is the most common cancer in the United States. There are over 1 million cases per year of basal cell carcinoma, squamous cell carcinoma and malignant melanoma. The treatment of these cancers include topical chemotherapy, cryotherapy, radiation, and surgery. By far, surgery is the most common treatment modality. One of the limitations of the traditional excisional surgery is the lack of precise tumor margin control resulting in removal of excess normal skin. Polarized light imaging is a non-invasive skin imaging technique that uses polarized white light and a high-resolution digital camera to enhance visualization of the superficial skin where skin cancers arise. Using this technique, optical guidance of the surgical excision of skin cancers can be achieved by noninvasively visualizing skin cancer margins. The reflectance of obliquely illuminating polarized light from the skin is acquired by a CCD camera through a polarizing filter that either accepts or blocks the polarization of the illumination light, and two images are taken. The difference in the images yields the "polarized image". Such imaging accepts photons backscattered from the subsurface and superficial layers of skin, but rejects surface glare and deeply penetrating photons that have been multiply scattered. Hence, the images use only about 10% of the photons reflected from the skin but these photons provide enhanced image contrast for visualizing the upper 300 um of the skin where skin pathology arises. Preliminary studies suggest that subtle disruption of the collagen matrix by either lateral or vertical movement of the cancer is visualized by the polarized images. This proposal will utilize this new technology in a pilot randomized clinical trial testing the efficacy of including the polarized light camera in visualizing the margins of skin cancer so as to guide the surgical excision. The hypothesis is that polarized light imaging can identify skin cancer margins not seen by normal vision and guide surgery. A library of images of normal and cancer will be accrued and an image analysis algorithm developed to assist the visualization of the cancer margin.

描述（由申请人提供）： 皮肤癌是美国最常见的癌症。每年有超过100万例基底细胞癌、鳞状细胞癌和恶性黑色素瘤。这些癌症的治疗包括局部化疗、冷冻疗法、放疗和手术。到目前为止，手术是最常见的治疗方式。传统的切除手术的局限性之一是缺乏精确的肿瘤边缘控制，导致切除多余的正常皮肤。偏振光成像是一种非侵入性皮肤成像技术，其使用偏振白色光和高分辨率数码相机来增强出现皮肤癌的浅表皮肤的可视化。使用这种技术，可以通过非侵入性地可视化皮肤癌边缘来实现皮肤癌手术切除的光学引导。 来自皮肤的倾斜照明偏振光的反射率由CCD相机通过偏振滤光器获取，该偏振滤光器接受或阻挡照明光的偏振，并且拍摄两个图像。图像中的差异产生“偏振图像”。这种成像接受从皮肤的次表面和表层反向散射的光子，但拒绝表面眩光和已经多次散射的深度穿透光子。因此，图像仅使用从皮肤反射的光子的约10%，但是这些光子提供了增强的图像对比度，用于可视化皮肤病理出现的皮肤的上部300 μ m。初步研究表明，通过偏振图像可以观察到癌细胞横向或垂直运动对胶原基质的细微破坏。 这项建议将利用这项新技术进行一项随机临床试验，以测试包括偏振光摄像机在内的皮肤癌边缘可视化的功效，从而指导手术切除。假设偏振光成像可以识别正常视力看不到的皮肤癌边缘并指导手术。将积累正常和癌症的图像库，并开发图像分析算法以辅助癌症边缘的可视化。