Pixel-accurate oncologic therapy using a scanning fiber endoscope

因为大多数癌症起源于上皮，所以提出了开发微创激光治疗内窥镜用于治疗早期癌症， 癌前病变在治疗膀胱癌的过程中，许多早期癌症会 未被诊断，导致任何癌症的复发率最高。一种新型扫描光纤 内窥镜将被开发用于集成激光成像，早期肿瘤识别，分期， 以及使用局部施用的光敏剂染料进行治疗。为了提供对激光治疗的精确控制，相同的微型光纤扫描仪用于体内成像和激光治疗。这种双重功能将确保高强度激光的像素精确传输。光纤扫描仪位于内窥镜（外径1.2 mm）和软式内窥镜的远端。初步测试将在活的人工组织模型和接种了培养的癌细胞的大鼠膀胱癌模型上进行。将使用荧光图像引导的激光治疗以单像素精度破坏上皮内产生的浅表肿瘤。两种治疗激光波长和光学癌症指标的性能评估将用于选择最有效的系统，同时考虑效率和安全性。所有受试系统在实践中将具有高性能和低临床成本。此外，该技术广泛应用于肺癌、结肠直肠癌、食道癌、胰腺癌和胆管癌的早期治疗。由于本项目的长度缩短，将不会开发交互式计算机界面，该界面可在实时反馈控制下估计图像引导介入的剂量测定，以最大限度地减少对组织的附带损伤。

Because a majority of cancers originate in the epithelium, the development of a minimally invasive laser therapy endoscope is proposed for the treatment of early cancer and precancerous lesions. During treatment for bladder cancer, many early cancers go undiagnosed, resulting in the highest recurrence rate of any cancer. A new scanning fiber endoscope will be developed for integrated laser imaging, early tumor identification, staging, and treatment, using topically applied photosensitizer dyes. To provide accurate control of the laser treatment, the same micro-optical fiber scanner is used for both in vivo imaging and laser therapy. This dual functionality will insure pixel-accurate delivery of the high-intensity laser light. The fiber scanner is located at the distal tip of an ultrathin (1.2 mm outer diameter) and flexible endoscope. Initial testing will be conducted on living artificial tissue models and a rat bladder cancer model that have been seeded with cancer cells from culture. The resulting superficial tumors within the epithelium will be destroyed using fluorescence image-guided laser therapy at single pixel accuracy. Performance evaluations of two therapeutic laser wavelengths and optical cancer indicators will be used to choose the most effective system, taking into account efficiency and safety. All systems under testing will have a high performance versus low clinical cost in practice. Furthermore, there is broad application of this technology to earlier treatments among lung, colorectal, esophageal, pancreatic, and bile duct cancers. Due to the reduced length of this project there will be no development of an interactive computer interface that estimates dosimetry of the image-guided intervention under real-time feedback control for the purpose of minimizing collateral damage to the tissue.