Academic-Industrial Partnership to Develop & Test Esophageal Cancer Imaging Tools

描述（由申请人提供）：食管腺癌（EAC）是美国发病率上升最快的疾病之一。不幸的是，诊断为EAC的患者的5年生存率仅为10%。EAC主要发生在巴雷特食管（BE）患者。建议高危人群进行内窥镜筛查和活检。然而，标准的白光内镜检查经常遗漏早期肿瘤的区域，这些区域在临床上通常与正常粘膜和/或炎症变化难以区分。研究表明，通过这种方法可以遗漏多达43-57%的早期癌症。因此，迫切需要新的内镜技术，以提高临床医生识别癌前病变和早期癌症的能力，并具有高灵敏度和特异性。本课题的目标是开发、优化和验证基于光学成像的新型多模式、多尺度光学成像平台，用于无创、早期检测食管肿瘤。我们将与Pentax公司的同事合作，设计和测试多模态内窥镜成像系统，用于早期检测Barrett食管的肿瘤。广角内窥镜成像将首先用于筛选有风险的表面区域，以高灵敏度识别异常部位；然后，可疑区域将以更高的空间分辨率成像，以达到高诊断特异性。宽视场和高分辨率技术将集成到一个内窥镜平台中，以增加内窥镜癌症筛查和监测的便利性和准确性。在后续的临床研究中，我们将首先分别优化大视场内窥镜成像和高分辨率成像的性能。然后，我们将整合宽视场和高分辨率成像系统，并验证其在Barrett食管（食管腺癌的前兆）患者中检测肿瘤的准确性。最后，我们将开发一个典型的宽视场和高分辨率图像的图像图集，解释标准和组织病理学，以培训未来的用户并作为教育资源。

DESCRIPTION (provided by applicant): Esophageal adenocarcinoma (EAC) has one of the fastest rising rates of incidence in the US. Unfortunately, the five-year-survival for patients diagnosed with EAC is only 10%. EAC develops primarily in patients with Barrett's esophagus (BE). Endoscopic screening and biopsy is recommended for at-risk individuals. However, standard white-light endoscopic examination frequently misses areas of early neoplasia, which are often clinically indistinguishable from normal mucosa and/or inflammatory changes. Studies have shown that as many as 43-57% of early cancers can be missed by this method. Thus, there is an important need for new endoscopic technologies which improve the ability of clinicians to identify precancerous lesions and early cancers with high sensitivity and specificity. The goal of this proposal is to develop, optimize and validate novel multi-modal, multi-scale optical imaging platforms for non-invasive, early detection of esophageal neoplasia based on optical imaging. We will collaborate with colleagues at Pentax, Inc. to design and test multi-modal endoscopic imaging systems for early detection of neoplasia in Barrett's esophagus. Widefield endoscopic imaging will be used initially to screen the surface area at risk to identify abnormal sites with high sensitivity; suspicious areas will then be imaged with much higher spatial resolution to achieve high diagnostic specificity. Both wide field and high resolution technologies will be integrated into a single endoscopic platform to increase the ease and accuracy of endoscopic cancer screening and surveillance. In sequential clinical studies, we will first separately optimize the performance of wide field endoscopic imaging and high resolution imaging. We will then integrate the wide field and high resolution imaging systems and validate their accuracy for the detection of neoplasia in subjects with Barrett's esophagus, the precursor to esophageal adenocarcinoma. Lastly, we will develop an image atlas of typical wide-field and high-resolution images, interpretation criteria, and histopathology to train future users and serve as an educational resource. PUBLIC HEALTH RELEVANCE: Improved identification and treatment of early cancers and precancerous lesions represents the most important opportunity to reduce the morbidity and mortality of cancer. This is particularly true for esophageal adenocarcinoma, a malignancy with a rapidly rising incidence rate and uniformly poor survival, primarily due to diagnosis at a late, incurable stage.