Comprehensive Confocal Microscopy for Image Guided Biopsy

用于图像引导活检的综合共聚焦显微镜

• 批准号: 7749783
• 负责人: Guillermo J Tearney
• 金额: $ 31.5万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-10 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7749783
• 关键词: Area; Barrett Esophagus; Biopsy; Bladder; Caliber; Cellular Morphology; Clinical; Clinical Research; Colon; Computer software; Confocal Microscopy; Coupled; Custom; Data; Detection; Development; Devices; Diagnosis; Diagnostic; Disease; Distal; Dysplasia; Endoscopes; Endoscopic Biopsy; Endoscopy; Engineering; Epithelial; Esophageal; Esophageal Adenocarcinoma; Esophagus; Excision biopsy; Eye; Family suidae; Foundations; Gastrointestinal Endoscopy; Gastrointestinal tract structure; Goals; Grant; Head; Human; Image; Image Guided Biopsy; Intraepithelial Neoplasia; Lasers; Length; Location; Lung; Malignant Neoplasms; Metaplasia; Methods; Microscopic; Microscopy; Motor; Needles; Operating System; Optics; Organ; Pathologist; Pathology; Patients; Performance; Physics; Premalignant; Principal Investigator; Problem Solving; Procedures; Research; Resolution; Safety; Sampling; Scanning; Screening procedure; Site; Specimen; Speed; Surface; System; Techniques; Technology; Testing; Time; Tissues; Tube; Writing; base; bench to bedside; body system; clinical application; cohort; data acquisition; experience; improved; in vivo; interest; lens; minimally invasive; mortality; new technology; public health relevance; standard of care; tumor; wound

DESCRIPTION (provided by applicant): There is a clear need for guiding biopsy procedures, especially for epithelial dysplasia and early cancer that commonly arise focally within large tissue areas and cannot be identified by the naked eye. Endoscopic optical microscopy technologies are promising candidates for such image-guided biopsy as they provide information that is similar to that used by pathologists for the current standard of care. Unfortunately, as currently configured, these microscopies have small fields of view and are "point sampling" methods, making them unsuitable for the large area imaging required for biopsy guidance. We have developed a reflectance confocal microscopy technique, termed SECM that solves this problem by acquiring microscopic image data at very high speeds to automatically and comprehensively screen extremely large tissue areas. In addition, we have developed a laser method for marking locations on the tissue that correspond to images of interest identified by SECM. Taken together, these technologies provide a foundation for a new image-guided biopsy platform that is based on microscopic morphologic information. In this proposal, we will take this technology from the bench to the bedside by fabricating an endoscopic probe that incorporates these technologies and by testing its capability to guide biopsy in a cohort of 20 patients. Due to the considerable need for better methods to diagnose Barrett's esophagus (BE) and our expertise in esophageal imaging, the clinical focus of this grant will be the development of a device for improving surveillance of BE patients. While targeted to reduce the mortality of esophageal adenocarcinoma, this technology will also serve as a platform for large-area microscopic screening in other organ systems, such as the colon, lung, and bladder, where screening large tissue areas for dysplasia and early cancer is not well served by existing diagnostic paradigms. PUBLIC HEALTH RELEVANCE: This proposal will develop a biopsy guidance system based on microscopic images obtained over large epithelial surfaces. Using this device, we will determine the safety and feasibility of microscopic image guided biopsy in a cohort of 20 patients with Barrett's esophagus.

描述（由申请人提供）：显然需要指导活检程序，特别是对于通常集中出现在大组织区域且肉眼无法识别的上皮发育不良和早期癌症。内窥镜光学显微镜技术是此类图像引导活检的有希望的候选者，因为它们提供的信息类似于病理学家在当前护理标准中使用的信息。不幸的是，按照目前的配置，这些显微镜的视野较小，并且是“点采样”方法，使得它们不适合活检引导所需的大面积成像。我们开发了一种反射共焦显微镜技术，称为 SECM，它通过以非常高的速度获取显微图像数据来自动全面地筛选极大的组织区域来解决这个问题。此外，我们还开发了一种激光方法，用于标记组织上与 SECM 识别的感兴趣图像相对应的位置。总而言之，这些技术为基于微观形态信息的新型图像引导活检平台奠定了基础。在本提案中，我们将通过制造包含这些技术的内窥镜探头，并测试其在 20 名患者中引导活检的能力，将这项技术从实验室带到临床。由于对更好的方法来诊断巴雷特食管 (BE) 的巨大需求以及我们在食管成像方面的专业知识，本次资助的临床重点将是开发一种用于改善 BE 患者监测的设备。虽然该技术的目标是降低食管腺癌的死亡率，但该技术也将作为其他器官系统（如结肠、肺和膀胱）大面积显微镜筛查的平台，在这些器官系统中，现有的诊断范式无法很好地筛查大组织区域的不典型增生和早期癌症。 公共健康相关性：该提案将开发一种基于大上皮表面获得的显微图像的活检引导系统。使用该设备，我们将确定在 20 名巴雷特食管患者中进行显微图像引导活检的安全性和可行性。