Endoscope development for the clinical use of near infrared fluorescence molecular probes in the GI tract

通过使用分子探针增强对比度， 荧光。在癌症成像中的应用非常广泛，从癌症的早期诊断到癌症的早期诊断。 指导干预措施，如活检。宽场荧光成像提供的高灵敏度， 扫描激光正被开发用于这些广泛的应用。平台技术是SFE - 扫描光纤内窥镜，它将一个低于1毫米的扫描仪放置在一个高度灵活的轴的尖端。因为 几种不同的激光波长可以混合在一起扫描，全色反射成像将 结合4通道多模式SFE中的近红外（NIR）荧光成像。这个目标 项目是开发一个原型VerAvanti 4通道多模式SFE（mmSFE）的特定癌症成像 这对食管癌的早期检测和内镜治疗具有重要影响。 VerAvanti是一家位于华盛顿雷德蒙的初创公司，成立并配备了工程师 来自华盛顿大学（UW）的毕业生，在那里发明了SFE并在试点临床中进行了测试 审判VerAvanti拥有将SFE技术商业化用于医学成像的独家许可， 通道全色SFE（使用红色、绿色和蓝色反射率）已经在试生产和测试中。 该项目将快速将4通道mmSFE技术转化为特定产品， 引导胃肠道中的内窥镜介入。此外，VerAvanti mmSFE将设计用于 模块化形式的有效制造，减少了零件数量，并降低了成本。 该应用程序使用的是密歇根大学开发的近红外荧光分子探针 (UM)结合高度异型增生（HGD）和食管腺癌（EAC）的肿瘤细胞。的 mmSFE产品通过传统内窥镜的工作通道引入，以识别 过度表达EGFR和ErbB 2的下食管，它们是跨膜酪氨酸激酶 刺激上皮细胞生长、增殖和分化的受体。这些目标的过度表达 反映了生物侵袭性的增加和进展为巴雷特食管，HGD， 和EAC。mmSFE诊断算法的设计基于荧光的高度相关性 与UW和UM合作进行病变靶向背景测量。其他mmSFE导引工具 将使用近红外荧光分子探针开发用于更准确的内窥镜干预。两 软件和硬件将被制造和测试，用于使用mmSFE的多点临床试验的开始。

Minimally-invasive optical imaging is being advanced by molecular probes that enhance contrast using fluorescence. The applications in cancer imaging are very broad, ranging from early diagnosis of cancer to the guiding of interventions, such as biopsy. The high-sensitivity afforded by wide-field fluorescence imaging using scanning laser light is being developed for these broad applications. The platform technology is the SFE – Scanning Fiber Endoscope, which places a sub-1-mm scanner at the tip of a highly flexible shaft. Because several different laser wavelengths can be mixed and scanned together, full-color reflectance imaging will be combined with near infrared (NIR) fluorescence imaging in a 4-channel multimodal SFE. The goal of this project is to develop a prototype VerAvanti 4-channel multimodal SFE (mmSFE) for a specific cancer imaging application that can have significant impact in early detection and endoscopic treatment of esophageal cancer. VerAvanti is a start-up company located in Redmond, Washington and is founded and staffed with engineering graduates from the University of Washington (UW), where the SFE was invented and tested in pilot clinical trials. VerAvanti has exclusive license to commercialize the SFE technology for medical imaging and a 3- channel full color SFE (using red, green, and blue reflectance) is already in pilot manufacturing and testing. This project will rapidly translate the 4-channel mmSFE technology into a specific product for fluorescently guiding endoscopic interventions in the GI tract. Furthermore, the VerAvanti mmSFE will be designed for efficient manufacturing in a modular format with reduced part numbers and expected lower cost. The application is using NIR fluorescence molecular probes that were developed at the University of Michigan (UM) that bind to high grade dysplasia (HGD) and neoplastic cells of esophageal adenocarcinoma (EAC). The mmSFE product is introduced through the working channel of a conventional endoscope to identify regions of the lower esophagus that are over-expressing EGFR and ErbB2, which are transmembrane tyrosine kinase receptors that stimulate epithelial cell growth, proliferation, and differentiation. Overexpression of these targets reflects an increase in biological aggressiveness and higher risk for progression to Barrett's esophagus, HGD, and EAC. The design of the mmSFE diagnostic algorithm is based on the high correlation of the fluorescence lesion target-to-background measurement in collaboration with UW and UM. Additional mmSFE guided tools will be developed for more accurate endoscopic interventions using NIR fluorescence molecular probes. Both software and hardware will be fabricated and tested for the start of a multisite clinical trial using the mmSFE.