Endogenous fluorescence lifetime endoscopy for early detection of oral cancer and dysplasia

内源性荧光终生内窥镜检查用于口腔癌和不典型增生的早期检测

• 批准号: 9470668
• 负责人: Javier Antonio Jo
• 金额: $ 16.25万
• 依托单位: TEXAS ENGINEERING EXPERIMENT STATION
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-02-02 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9470668
• 关键词: Adopted; Algorithms; American Cancer Society; Benign; Biological Markers; Biomedical Engineering; Biopsy; Blinded; Cancer Patient; Carcinoma; Characteristics; Chicago; Clinic; Clinical; Clinical Management; Clinical Research; Coenzymes; Collagen; Data; Databases; Dentists; Detection; Diagnosis; Diagnostic; Diagnostic Imaging; Disease; Drops; Dysplasia; Early Diagnosis; Endoscopes; Endoscopy; Epithelial; Evaluation; Excision; Face; Fluorescence; Frequencies; Future; Geometry; Goals; Gold; Health Professional; Histopathology; Image; Imaging Device; In Situ; Intraepithelial Neoplasia; Lesion; Life Expectancy; Machine Learning; Malignant Epithelial Cell; Malignant Neoplasms; Metabolic; Metabolism; Mild Dysplasia; Minor Surgical Procedures; Mitochondria; Modality; Monitor; Monitoring for Recurrence; Neck; Operative Surgical Procedures; Optics; Oral; Oral Stage; Oral cavity; Pathologic; Patient Recruitments; Patients; Pharyngeal structure; Pilot Projects; Predictive Value; Quality of life; Recurrence; Reporting; Research Personnel; Research Project Grants; Salivary; Screening for Oral Cancer; Screening for cancer; Screening procedure; Sensitivity and Specificity; Specificity; Speed; Stains; Survival Rate; System; Technology; Testing; Time; Tissues; Work; base; cancer invasiveness; clinically relevant; computerized tools; cost; cost effective; design; early screening; exfoliative cytology; experience; fluorescence lifetime imaging; image processing; imaging biomarker; improved; in vivo; in vivo imaging; malignant mouth neoplasm; novel; optical imaging; oral dysplasia; oral lesion; precision medicine; prospective; success; tool; tumor; tumor progression; volunteer

The American Cancer Society estimates that 48,330 new cases of cancer in the oral cavity and pharynx will be reported this year. When diagnosed at early stages, the 5-year survival rate is 83%. However, when diagnosed at intermediate or advance stages, the 5-year survival rate drops to 62% and 38%, respectively. In addition, while early stage treatment may only require minor surgery to remove the localized tumor, later stage treatment could require surgical removal of parts of the face and neck, hence drastically reducing the patient’s quality of life. Unfortunately, benign oral lesions are sometimes difficult to distinguish from dysplasia or early invasive cancer even for healthcare professionals. As a result, only 31% of patients are diagnosed at early stages despite the fact that the oral cavity is easily accessible for direct examination. Hence, there is a critical need for new clinical technologies for reliable early diagnosis of oral cancer and dysplasia. Several screening tools for oral cancer have been commercially available, including exfoliative cytology, vital staining, salivary test, and optical interrogation; however, none of them have been demonstrated to be capable of clinically relevant sensitivity and specificity. We hypothesize that several biomarkers for oral cancer and dysplasia can be accurately quantified by endogenous fluorescence lifetime imaging (FLIM) thus enabling levels of sensitivity and specificity adequate for early detection. This bioengineering research grant focuses on developing and validating a cost-effective wide-field multispectral FLIM endoscope for noninvasive in situ detection of oral cancer and dysplasia. To that end we have developed three specific aims. Aim 1: To design and build a cost-effective multispectral FLIM endoscope for in vivo imaging of epithelial tissue in the oral cavity. Aim 2: To develop algorithms for fast and automated FLIM based early detection of oral epithelial cancer and dysplasia. Aim 3: To quantify prospectively in a pilot clinical study the capability of the proposed FLIM endoscopic tools for noninvasively early detection of oral epithelial cancer and dysplasia. The successful completion of these aims will result in a novel, accurate and cost-effective clinical tool for noninvasive in situ early detection of cancer and dysplasia. Such a tool could potentially help to improve significantly both the life expectancy and the quality of life for the more than 33,000 oral cancer patients being diagnosed each year at intermediate and advance stages. Beyond early diagnosis, this tool could also assist at every step involved on the clinical management of oral cancer patients, including treatment guidance and monitoring of disease recurrence. Finally, the demonstrated success of this clinical tool in oral epithelial cancer will herald future success with other cancers of epithelial origin, which accounts for more than 80% of all cancers.

美国癌症协会估计，今年将报告 48,330 例口腔和咽部癌症新病例。如果早期诊断，5 年生存率为 83%。然而，当在中期或晚期诊断时，5年生存率分别降至62%和38%。此外，虽然早期治疗可能只需要进行小手术来切除局部肿瘤，但后期治疗可能需要手术切除部分面部和颈部，从而大大降低患者的生活质量。不幸的是，即使对于医疗保健专业人员来说，良性口腔病变有时也很难与发育不良或早期浸润性癌症区分开来。因此，尽管口腔很容易进行直接检查，但只有 31% 的患者能够在早期得到诊断。因此，迫切需要新的临床技术来可靠地早期诊断口腔癌和不典型增生。几种口腔癌筛查工具已经上市，包括脱落细胞学、活体染色、唾液检测和光学检查；然而，它们均未被证明具有临床相关的敏感性和特异性。我们假设口腔癌和不典型增生的几种生物标志物可以通过内源荧光寿命成像（FLIM）准确量化，从而达到足以进行早期检测的灵敏度和特异性水平。这项生物工程研究资助的重点是开发和验证一种经济高效的宽视场多光谱 FLIM 内窥镜，用于口腔癌和不典型增生的无创原位检测。为此，我们制定了三个具体目标。目标 1：设计和构建一种经济高效的多光谱 FLIM 内窥镜，用于口腔上皮组织的体内成像。目标 2：开发基于 FLIM 的快速、自动化口腔上皮癌和发育不良早期检测算法。目标 3：在一项试点临床研究中前瞻性地量化所提出的 FLIM 内窥镜工具用于无创早期检测口腔上皮癌和发育不良的能力。这些目标的成功实现将为癌症和不典型增生的非侵入性原位早期检测提供一种新颖、准确且具有成本效益的临床工具。这样的工具可能有助于显着提高每年超过 33,000 名中期和晚期口腔癌患者的预期寿命和生活质量。除了早期诊断之外，该工具还可以协助口腔癌患者临床管理的每一步，包括治疗指导和疾病复发监测。最后，该临床工具在口腔上皮癌中所取得的成功将预示着未来在其他上皮来源癌症（占所有癌症的 80% 以上）方面的成功。