Automated, Augmented Reality High Resolution Microendoscopy for the Management of Esophageal Neoplasia

用于治疗食管肿瘤的自动化增强现实高分辨率显微内窥镜检查

• 批准号: 9236004
• 负责人: Sharmila Anandasabapathy
• 金额: $ 49.74万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-17 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9236004
• 关键词: Area; Augmented Reality; Benign; Biopsy; Cell Nucleus; Cellular Phone; Characteristics; China; Chinese People; Clinical; Clinical Trials; Computer software; Cost Analysis; Devices; Diagnosis; Diagnostic; Disease model; Endoscopy; Epithelial; Epithelium; Esophageal; Esophageal Squamous Cell; Galaxy; Goals; Healthcare Systems; Human; Image; Image Analysis; Inflammation; Iodine; Light; Malignant Neoplasms; Malignant neoplasm of esophagus; Microscopic; Morphologic artifacts; Mucous Membrane; Neoplasms; Optical Biopsy; Optics; Performance; Procedures; Randomized Clinical Trials; Randomized Controlled Trials; Reproducibility; Research Infrastructure; Resolution; Resources; Screening for cancer; Severe dysplasia; Site; Specificity; Staining method; Stains; Surveillance Program; Survival Rate; System; Tablet Computer; Tablets; Time; Tissues; base; chemoradiation; chromoscopy; clinical decision-making; cost; cost effective; cost effectiveness; diagnostic accuracy; experience; global health; high risk population; imaging system; in vivo; innovation; mHealth; microendoscope; microendoscopy; microscopic imaging; mortality; neoplastic; outcome forecast; portability; prospective; screening; standard of care

Project Summary: Despite advances in chemoradiation therapy, the five-year survival rate for esophageal squamous cell neoplasia (ESCN) remains a dismal 15% due to diagnosis at a late, incurable stage. Endoscopic screening is typically performed in high-risk populations with Lugol’s iodine staining of the mucosa and targeted biopsy of abnormal (unstained) areas. While Lugol’s significantly increases the sensitivity of white light endoscopy (>95%), specificity remains poor (<65%) as inflammation and other benign mucosal changes mimic neoplasia. While confocal microendoscopy has been shown to dramatically enhance the diagnostic accuracy and yield of Lugol’s chromoendoscopy, existing platforms are costly (>$150,000) and only available in a handful of tertiary centers worldwide. In an ongoing RO1 (2014-2019) of 1300 subjects in China and the USA, our group is evaluating a portable, battery-powered, high-resolution microendoscope that provides subcellular, 1100x-magnified images of the esophageal epithelium.This low-cost (< $1,500) device uses a Samsung Galaxy tablet computer to display microscopic epithelial images and image-analysis software to highlight abnormal nuclei allowing a more objective, real-time means of differentiating benign from neoplastic epithelium. In our current prospective, randomized, controlled trial of ESCN screening/surveillance, our goal is to determine whether this portable device increases the accuracy, diagnostic yield and clinical impact of routine endoscopic screening by providing a more objective, accurate, in vivo diagnosis that can direct a clinician’s decision to biopsy, not biopsy, or perform endoscopic therapy. The goal of this Revision R01 is to refine and validate a low-cost (HRME + glasses < $2,100) mobile, augmented reality (AR) platform that facilitates accurate, rapid, real-time endoscopic screening by non-expert clinicians worldwide. Using AR glasses and a small tablet computer (or cell phone), microendoscopic images with a quantitative, software interpretation (neoplasia vs. no neoplasia) will be displayed in real-time, colocalized with white light endoscopic images, allowing easier, more accurate biopsy and treatment.

项目总结：尽管放化疗取得了进展，但食管癌的5年生存率