Diagnosis of Ovarian Cancer by Confocal Microendoscopy

描述（由申请人提供）：本研究的目的是进一步开发和临床验证用于卵巢癌体内诊断的实时多光谱共聚焦显微内窥镜。共聚焦显微内窥镜是一种在细胞水平上观察组织的新型仪器，在进行光学活检方面显示出很大的前景。共聚焦显微内窥镜有可能为医生提供对组织的即时评估，并调查更大范围的组织，减少传统组织提取活检的采样误差。在之前的资助期间，共聚焦显微腹腔镜系统被构建并在人体体内进行了测试。这项工作的一个具体目的是现在验证该系统，并表明它可以用于在腹腔镜手术中检测卵巢癌。这项工作的其他目标是扩大该仪器的使用范围，以检测整个腹腔的卵巢癌腹膜植入物，并开发和测试一种能够在输卵管内成像的系统。进一步的技术发展旨在提高共聚焦成像性能，并增加光学相干层析成像作为一种补充成像方式。新仪器将两种成像模式整合到一个单一的紧凑探头中，在操作模式之间无缝和快速切换。除了技术开发和临床转化，该项目的另一个目的是开发和测试靶向对比剂，以提供更安全，更有效的卵巢癌体内鉴定。

DESCRIPTION (provided by applicant): The objective of this research is to further develop and clinically validate a real-time multispectral confocal microendoscope for in vivo diagnosis of ovarian cancer. The confocal microendoscope is a new type of instrument for visualizing tissue at the cellular level and has shown great promise for performing optical biopsy. Confocal microendoscopy has the potential to provide a physician with an immediate evaluation of tissue and to survey a much greater area of tissue, reducing the sampling error of traditional tissue extraction biopsy. A confocal microlaparoscope system was constructed and tested in vivo in humans during the prior funding period. A specific aim of this work is to now validate the system and show that it can be used to detect cancer of the ovary during a laparoscopic procedure. Additional objectives of the work are to expand the use of the instrument to the detection of peritoneal implants of ovarian cancer throughout the abdominal cavity and to develop and test a system capable of imaging inside the fallopian tubes. Further technical development is aimed at improving the confocal imaging performance and adding optical coherence tomography as a complimentary imaging modality. The new instrument will incorporate the two imaging modalities into a single compact probe with seamless and rapid switching between modes of operation. In addition to the technology development and clinical translation, another aim of the project is to develop and test targeted contrast agents that provide safer and more effective in vivo identification of ovarian cancer. PUBLIC HEALTH RELEVANCE: The goal of this research is to demonstrate the clinical potential of the confocal microlaparoscope for the diagnosis of ovarian cancer. The confocal microlaparoscope is an instrument for performing optical biopsy of tissue. The technology was developed and clinically demonstrated in the context of ovarian cancer detection during the previous funding period. Continuing work is aimed at validating the clinical performance of the instrument for the detection of ovarian cancer and expanding the clinical applications to imaging of the fallopian tube and metastatic ovarian cancer in the peritoneal cavity. Work is also proposed to improve and expand the capability of the instrument and to develop targeted contrast agents that can be used safely and effectively in the clinical setting.