Low-cost mobile colposcopy and confocal imaging for global prevention of cervical cancer

低成本移动阴道镜和共焦成像在全球宫颈癌预防中的应用

• 批准号: 10031954
• 负责人: Rebecca R. Richards-Kortum
• 金额: $ 61.45万
• 依托单位: RICE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10031954
• 关键词: Ablation; Acetic Acids; Algorithmic Analysis; Algorithms; Area; Biomedical Engineering; Biopsy; Brazil; Cancer Center; Cancer Etiology; Cancer Hospital; Cellular Phone; Cervical; Cervical Intraepithelial Neoplasia; Cervix Uteri; Cessation of life; Clinical; Clinical Research; Cold Therapy; Collaborations; Colposcopes; Colposcopy; Country; Cytology; Detection; Devices; Diagnosis; Diagnostic; Disease; Equipment; Excision; Fiber Optics; Gold; HPV-High Risk; Health Sciences; Hospitals; Human Papillomavirus; Human Resources; Image; Image Analysis; Imaging technology; Incidence; Infrastructure; Institution; Instruction; Lead; Lesion; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Medical Imaging; Medically Underserved Area; Medicine; Modeling; Morbidity - disease rate; Multimodal Imaging; Nuclear Atypia; Pathology; Patients; Performance; Prevention program; Provider; Research Personnel; Resolution; Resources; Rice; Sensitivity and Specificity; Services; Site; Specificity; Testing; Thermal Ablation Therapy; Time; Training; United States; Universities; University of Texas M D Anderson Cancer Center; Visit; Visual; Woman; World Health Organization; accurate diagnosis; automated algorithm; automated image analysis; automated visual evaluation; base; cancer epidemiology; cancer prevention; cancer therapy; cervical biopsy; cervical cancer prevention; college; confocal imaging; cost; digital; experience; follow-up; global health; high resolution imaging; image archival system; imaging capabilities; imaging modality; imaging probe; improved; industry partner; innovation; low and middle-income countries; microendoscope; microscopic imaging; morphometry; mortality; multimodality; nuclear imaging; overtreatment; point of care; premalignant; programs; prospective; public health relevance; screening; screening program; standard of care; tool; treatment program; usability

Abstract: Cervical cancer was once the leading cause of cancer death among women in the United States (U.S.). The implementation of comprehensive programs for screening, diagnosis, and treatment over the past 60 years has reduced cervical cancer incidence and mortality by more than 70% in the U.S. In contrast, cervical cancer remains the 1st or 2nd leading cause of cancer death among women in many low-and middle-income countries (LMICs). Cervical cancer prevention programs in low-resource settings are hampered by a lack of personnel with appropriate clinical expertise, lack of pathology services, and lack of associated infrastructure. Programs that involve multiple patient visits have a high rate of loss to follow-up. Screen-and-Treat approaches have been implemented in LMICs and include screening by HPV testing or visual inspection with acetic acid (VIA) followed by immediate treatment, reducing loss to follow-up; but these approaches lead to massive over-treatment due to the poor specificity of VIA and HPV testing. There is an urgent need for appropriate diagnostic tools to enable the implementation of a sensitive and specific Screen-Diagnose-Treat strategy that can be performed in a single patient visit in LMICs and in medically underserved areas of the U.S. We propose to develop and validate a low-cost Multimodal Mobile Colposcope (MMC) for global cervical Screen-Diagnose-Treat programs. This new device will combine the imaging capabilities of a smartphone- based colposcope developed by MobileODT with the microscopic imaging capabilities of a fiber-optic confocal imaging probe developed by Rice University. The MMC will image the entire cervix, automatically identify suspicious regions, and acquire co-registered high-resolution images of nuclear morphometry from suspicious areas. Multimodal image analysis algorithms will be developed in a study of 300 women referred for colposcopy at two sites in Brazil. The performance of the MMC with automated image analysis for detection of cervical precancer will be validated in a study of an additional 760 women referred for colposcopy in Brazil. We will determine the feasibility and usability of the MMC among low-resource setting providers by carrying out cancer prevention training courses using the MMC in Brazil. Our academic-industrial partnership includes expertise in bioengineering (Rice University), colposcopy and medical imaging (MobileODT), cervical cancer prevention and treatment (MD Anderson Cancer Center), and cervical cancer prevention and epidemiology (Albert Einstein College of Medicine), as well as the clinical expertise of our Brazilian clinical partners: Barretos Cancer Hospital and the Federal University of Health Sciences of Porto Alegre/Hospital Santa Casa. The innovative imaging technologies to be developed in this proposal will enable effective single-visit Screen-Diagnose-Treat programs to diagnose and treat women with cervical precancer while minimizing overtreatment.

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