Fiber bundle-based divided-pupil confocal endoscope

基于光纤束的分瞳共焦内窥镜

• 批准号: 8122281
• 负责人: MILIND RAJADHYAKSHA
• 金额: $ 56.84万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-06 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8122281
• 关键词: Alcohol consumption; American Cancer Society; Area; Back; Basal cell carcinoma; Benign; Biopsy; Blood flow; Cancerous; Cellular Morphology; Cessation of life; Cheek structure; Clinic; Clinical; Clinical Research; Confocal Microscopy; Connective Tissue; Country; Dermatologic; Detection; Development; Diagnosis; Diagnostic; Distal; Elements; Endoscopes; Engineering; Epithelium; Excision; Face; Fiber; Goals; Hand; Head and Neck Cancer; Head and Neck Surgery; Hour; Human Papillomavirus; Image; Incidence; India; Inflammatory; Iron; Lamina Propria; Lateral; Lesion; Light; Lighting; Lip structure; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Maps; Microscope; Modification; Mohs Surgery; Molecular; Motivation; Noise; Normal tissue morphology; Nuclear; Oncogenic Viruses; Operative Surgical Procedures; Optics; Oral cavity; Oral mucous membrane structure; Pain; Pathology; Patients; Performance; Premalignant; Primary Neoplasm; Pupil; Radiation; Radiation therapy; Reporting; Resolution; Risk; Scanning; Screening procedure; Sensitivity and Specificity; Skin Cancer; Smoker; Smoking; Squamous cell carcinoma; Staging; Surgeon; Survival Rate; Syphilis; Technology; Testing; Time; Tissues; Tongue; Translating; Tumor Suppressor Genes; Visual; Work; World Health Organization; advanced disease; base; clinically relevant; cost; design; human subject; human tissue; imaging modality; imaging probe; improved; in vivo; instrument; instrumentation; light scattering; malignant breast neoplasm; malignant mouth neoplasm; melanoma; optical imaging; oral lesion; oral premalignancy; prototype

The goal of this project is to create a divided-pupil line-scanning fiber bundle-based confocal endoscope for imaging nuclear and cellular morphology in oral mucosa in vivo with reflectance contrast, and to test feasibility for screening oral precancers and cancers versus normal tissue in a clinical study on patients in vivo. The endoscope is based on a divided-pupil configuration that may overcome the major limitation of existing fiber bundle-based and scanned single fiber-based confocal endoscopes: strong back-reflections from the proximal and distal faces of the fiber element, which produces strong background noise in the images. Quantitative endpoints will be determined in terms of sensitivity and specificity to validate the feasibility of the technology and justify further development toward clinical utility. The motivation is to create confocal endoscopes for real-time noninvasive imaging in reflectance for detection of oral precancers in vivo and intra-operative mapping to guide surgery of head-and-neck cancers. Oral cancer is the fifth most common malignancy in the world. Visual examination is routinely performed but remains deficient in detecting early-stage precancers or potentially cancerous lesions. Biopsy and pathology are the current standard. However, routine biopsies in the oral cavity are neither desirable nor practical. Consequently, patients are often seriously late in seeking and/or receiving treatment and the survival rate is much lower when the cancer is more advanced. Confocal microscopy, as a noninvasive optical imaging modality that shows pathology-like nuclear and cellular detail, may enable early screening of precancers, while minimizing the need for biopsy, minimizing pain and minimizing expense. During head-and-neck surgery which includes the oral cavity, intra-operative mapping may be possible directly on the patient, to enable adequate and rapid examination of cancer-to-normal tissue margins and to guide accurate and complete excision during surgery, while preserving normal tissue. Preliminary results with a divided-pupil line-scanning confocal microscope demonstrate excellent imaging in reflectance of nuclear and cellular detail in the epithelium, deeper connective tissue and blood flow in the inside lip-buccal mucosa in vivo. The optical sectioning is 1.7 ?m and lateral resolution is 1 ?m, which is comparable to that of pathology. Our hypothesis is that a divided-pupil line-scanning confocal endoscope with the use of two fiber bundles, one for illumination and one for detection, may overcome the major limitation of strong back-reflections in recently developed coaxial fiber-based confocal endoscopes. The divided-pupil configuration may enable imaging in reflectance contrast. Nuclear and cellular detail in the epithelium, connective tissue and blood flow may be noninvasively visualized in the oral cavity in vivo with sufficiently high contrast for diagnostic as well as for intra-operative use. The proposed technology may have broad clinical impact with long-term applications in detection in vivo and intra-operative mapping to guide surgery of skin, cervical and breast cancers.

该项目的目的是创建一个划分的学生线扫描纤维束共聚焦内窥镜，用于在体内口服粘膜中成像核和细胞形态，并在体内进行反射对比，并测试筛查口腔前类药物和癌症与正常组织的可行性。内窥镜基于分裂的学生配置，该配置可能会克服现有基于纤维束和扫描的基于单光纤的共聚焦内窥镜的主要局限性：来自光纤元件的近端和远端面的强反向反射，从而产生图像中强烈背景噪声。定量终点将根据敏感性和特异性来确定，以验证技术的可行性并证明对临床实用性的进一步发展是合理的。动机是为实时非侵入性成像创建共聚焦内窥镜，以反射率，以检测体内口服预科剂和术内映射，以指导头颈癌的手术。口腔癌是世界上第五大最常见的恶性肿瘤。视觉检查通常进行，但仍缺乏检测早期预科剂或潜在癌变病变。活检和病理是当前的标准。但是，口腔中的常规活检既不是可取的也不是实际的。因此，患者在寻求和/或接受治疗时通常会认真对待，并且当癌症更晚期时，生存率要低得多。共聚焦显微镜作为一种无创的光学成像方式，显示了病理样的核和细胞细节，可以使precancers早期筛查，同时最大程度地减少对活检的需求，最大程度地减少疼痛并最大程度地减少费用。在包括口腔的头颈手术期间，可能直接在患者身上进行术中映射，以便对癌症到正态的组织边缘进行足够的快速检查，并在手术过程中指导准确，完整切除，同时保留正常组织。划分的学生线扫描共聚焦显微镜的初步结果表现出出色的成像，以反射上皮的核和细胞细节，内部唇部粘膜内部粘膜内部深层结缔组织以及体内的血液流动。光学截面为1.7？m，横向分辨率为1？m，与病理相媲美。我们的假设是，使用两个纤维束的划分的学生线扫描共聚焦内窥镜内窥镜，一种用于照明，一个用于检测，可能会克服最近开发的基于同轴纤维的共聚焦内窥镜的重新反转的主要限制。划分的学生配置可能会在反射率对比中进行成像。上皮，结缔组织和血流中的核和细胞细节可以在体内口腔中可视化，并在体内可视化，并且在诊断和术中使用足够高的对比度。提出的技术可能具有广泛的临床影响，并在体内检测和术中映射方面的长期应用，以指导皮肤，宫颈和乳腺癌的手术。