Office based Real-time high Speed 3-D OCT system for Diagnosis of EarlyLaryngeal

基于办公室的实时高速 3-D OCT 系统用于诊断早期喉癌

• 批准号: 8053291
• 负责人: Tirunelveli Ramalingam
• 金额: $ 34.7万
• 依托单位: OCT MEDICAL IMAGING, INC.
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8053291
• 关键词: 3-Dimensional; Abattoirs; Address; Animals; Appearance; Area; Benign; Biopsy; California; Clinical; Clinical Trials; Coughing; Detection; Development; Diagnosis; Diagnostic; Disease; Disease Progression; Dysphonia; Early Diagnosis; Emerging Technologies; Endoscopes; Endoscopic Surgical Procedures; Endoscopy; Epithelial; Family; Family suidae; Fiber Optics; Focus Groups; Funding; General Anesthesia; Goals; Hand; Head and Neck Cancer; Head and neck structure; Health; Histology; Hoarseness; Human; Image; Imaging technology; Laboratories; Laryngoscopes; Larynx; Legal patent; Lesion; Licensing; Light; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of larynx; Marketing; Medical Imaging; Microanatomy; Microsurgery; Monitor; Morbidity - disease rate; Nose; Operative Surgical Procedures; Optical Coherence Tomography; Otolaryngologist; Outcome; Pain; Patients; Penetration; Pharyngeal structure; Phase; Physical Examination; Positioning Attribute; Premalignant; Principal Investigator; Probability; Reporting; Research Personnel; Resolution; Risk; Sampling; Scanning; Screening procedure; Secure; Sedation procedure; Site; Solid Neoplasm; Source; Speed; Staging; Structure; Symptoms; System; Systems Development; Techniques; Technology; Testing; Three-Dimensional Imaging; Time; Tissues; Tremor; Universities; Work; base; cancer diagnosis; cancer site; clinical application; cost; cost effective; flexibility; imaging modality; improved; in vivo; instrument; instrumentation; larynx Carcinoma; mortality; optical imaging; programs; public health relevance; research clinical testing; success; two-dimensional; user friendly software; vibration; vocal cord

Laryngeal carcinoma is the most common primary head and neck malignancy. Flexible fiber-optic or rigid endoscopes are normally inserted through the nose or into the pharynx for conventional physical examinations, but endoscopy alone cannot be used to differentiate between benign, pre-malignant and early malignant lesions, which are characterized by identical symptoms such as throat pain, coughing, or hoarseness, and nearly identical physical appearance. Both conventional examination and endoscopy lack the ability to visualize the depth of penetration of disease into the deeper layers of the tissue, and provide information on vocal fold epithelial structure. Therefore, laryngeal cancer diagnosis has to rely on biopsies, which requires general anesthesia and surgical endoscopy. Multiple and repeated biopsies are common in order to increase diagnostic yield, and with this increasing morbidity form surgery. Regardless of the toll exacted on patients and their families, there are major costs associated with surgery, and significant patient time away from work. Hence, there is a huge need to develop a fast, mobile and noninvasive technology to aid in the early detection and monitoring of laryngeal malignant lesions, assist in selecting patients to undergo surgical biopsy. The use of OCT in managing early laryngeal epithelial cancer will be analogous to the use of macroscopic imaging modalities (i.e., MR, CT) in managing large solid tumors in the body. Using several licensed patents, OCT Medical Imaging Inc (OCTMI) proposes to address the treatment and diagnosis of early laryngeal cancer using light based fiber optic imaging technology known as optical Coherence tomography (OCT), which produces a cross- sectional images at near histopathological resolution(Fujimoto et.al 2000). The first in vivo endoscopic OCT images in animals and humans were reported in 1997 (Tearney et.al., 1997)). Many clinical applications require a large area or 3-D imaging, which is difficult to achieve with the Time Domain (TD) OCT. Hence, OCTMI proposes to use advanced Fourier domain (FD) OCT technology which provides 3D imaging at high speed and sensitivity (Leitgeb et.al, 2003). Second, the paradigm shift from OR based to office-based imaging is necessary to make OCT a useful technology for head and neck cancer screening, early detection, and monitoring of disease progression. Incorporating this technology, OCTMI proposes to develop an advanced compact, cost-effective office based real-time 3D-functional Fourier domain functional OCT system that will not only acquire images at near histopathological resolution, but also will provide clinically important structural information on suspect lesions, potential biopsy sites, and cancer margins of larynx in the office without the need for general anesthesia or sedation. OCTMI is well positioned to develop this technology since its founders and collaborators have developed several office-based real-time 3D-OCT systems and were first to conduct large scale clinical trials on laryngeal cancer to the best of our knowledge.

喉癌是最常见的原发头部和 颈部恶性肿瘤。柔性光纤内窥镜或刚性内窥镜通常通过鼻子插入或插入 咽部常规体检，但仅用内窥镜检查不能 区分良性、癌前病变和早期恶性病变，其特征是 症状相同，如喉咙痛、咳嗽或声音嘶哑，以及几乎相同的身体状况 外表。常规检查和内窥镜检查都缺乏显示病变深度的能力。 疾病对组织深层的渗透，并提供有关声带的信息 上皮性结构。因此，喉癌的诊断必须依赖于活检，这需要 全身麻醉和外科内窥镜检查。多次和重复的活组织检查很常见，以便 提高诊断率，并由此增加外科手术的发病率。不计代价 对患者及其家属施加压力，与手术相关的主要费用，以及 耐心休息的时间。因此，迫切需要开发一种快速、可移动、非侵入性的 帮助早期发现和监测喉部恶性病变的技术，帮助选择 患者需要接受手术活检。OCT在早期喉上皮癌治疗中的应用 类似于使用宏观成像方式(即，MR、CT)来管理大型固体 身体里的肿瘤。OCT医学成像公司(OCTMI)利用几项授权专利，提议 应用基于光的光纤成像技术治疗和诊断早期喉癌 这项技术被称为光学相干层析成像(OCT)，它可以产生横断面图像 接近组织病理学分辨率(Fujimoto等人，2000年)。第一个活体内窥镜OCT图像 1997年报告了动物和人类(Tearney等人，1997年)。许多临床应用需要一种 大面积或三维成像，这是用时间域(TD)OCT难以实现的。因此，OCTMI 建议使用高级傅里叶域(FD)OCT技术，该技术可提供 速度和敏感度(Leitgeb等人，2003年)。第二，范式从基于OR向基于Office的转变 要使OCT成为头颈部癌症早期筛查的有用技术，成像是必要的 检测和监测疾病进展情况。结合这项技术，OCTMI建议 开发基于实时3D函数傅里叶域的高级紧凑、经济高效的办公室 功能性OCT系统，不仅可以获得接近组织病理分辨率的图像，而且还可以 将提供有关可疑病变、潜在的活检部位以及 不需要全身麻醉或镇静的办公室喉癌边缘。OCTMI是 由于它的创始人和合作者已经开发了几个 基于Office的实时3D-OCT系统，并首次在喉部进行大规模临床试验 据我们所知是癌症。