Office based Real-time high Speed 3-D OCT system for Diagnosis of EarlyLaryngeal

基于办公室的实时高速 3-D OCT 系统用于诊断早期喉癌

• 批准号: 7804402
• 负责人: Tirunelveli Ramalingam
• 金额: $ 34.62万
• 依托单位: OCT MEDICAL IMAGING, INC.
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7804402
• 关键词: 3-Dimensional; Abattoirs; Address; Animals; Appearance; Area; Benign; Biopsy; California; Clinical; Clinical Trials; Computer Systems Development; Coughing; Detection; Development; Diagnosis; Diagnostic; Disease; Disease Progression; Dysphonia; Early Diagnosis; Emerging Technologies; Endoscopes; Endoscopic Surgical Procedures; Endoscopy; Epithelial; Family; Family suidae; Fiber Optics; Focus Groups; Funding; General Anesthesia; Goals; Hand; Head and Neck Cancer; Head and neck structure; Histology; Hoarseness; Human; Image; Imaging technology; Knowledge; Laboratories; Laryngoscopes; Larynx; Legal patent; Lesion; Licensing; Light; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of larynx; Marketing; Medical Imaging; Microanatomy; Microsurgery; Monitor; Morbidity - disease rate; Nose; Operative Surgical Procedures; Optical Coherence Tomography; Otolaryngologist; Outcome; Pain; Patients; Penetration; Pharyngeal structure; Phase; Physical Examination; Positioning Attribute; Premalignant; Principal Investigator; Probability; Reporting; Research Personnel; Resolution; Risk; Sampling; Scanning; Screening procedure; Secure; Sedation procedure; Site; Solid Neoplasm; Source; Speed; Staging; Structure; Symptoms; System; Techniques; Technology; Testing; Three-Dimensional Imaging; Time; Tissues; Tremor; Universities; Work; base; cancer diagnosis; cancer site; clinical application; cost; flexibility; imaging modality; improved; in vivo; instrument; instrumentation; larynx Carcinoma; mortality; optical imaging; programs; public health relevance; research clinical testing; success; two-dimensional; user friendly software; vibration; vocal cord

Laryngeal carcinoma is the most common primary head and neck malignancy. Flexible fiber-optic or rigid endoscopes are normally inserted through the nose or into the pharynx for conventional physical examinations, but endoscopy alone cannot be used to differentiate between benign, pre-malignant and early malignant lesions, which are characterized by identical symptoms such as throat pain, coughing, or hoarseness, and nearly identical physical appearance. Both conventional examination and endoscopy lack the ability to visualize the depth of penetration of disease into the deeper layers of the tissue, and provide information on vocal fold epithelial structure. Therefore, laryngeal cancer diagnosis has to rely on biopsies, which requires general anesthesia and surgical endoscopy. Multiple and repeated biopsies are common in order to increase diagnostic yield, and with this increasing morbidity form surgery. Regardless of the toll exacted on patients and their families, there are major costs associated with surgery, and significant patient time away from work. Hence, there is a huge need to develop a fast, mobile and noninvasive technology to aid in the early detection and monitoring of laryngeal malignant lesions, assist in selecting patients to undergo surgical biopsy. The use of OCT in managing early laryngeal epithelial cancer will be analogous to the use of macroscopic imaging modalities (i.e., MR, CT) in managing large solid tumors in the body. Using several licensed patents, OCT Medical Imaging Inc (OCTMI) proposes to address the treatment and diagnosis of early laryngeal cancer using light based fiber optic imaging technology known as optical Coherence tomography (OCT), which produces a cross- sectional images at near histopathological resolution(Fujimoto et.al 2000). The first in vivo endoscopic OCT images in animals and humans were reported in 1997 (Tearney et.al., 1997)). Many clinical applications require a large area or 3-D imaging, which is difficult to achieve with the Time Domain (TD) OCT. Hence, OCTMI proposes to use advanced Fourier domain (FD) OCT technology which provides 3D imaging at high speed and sensitivity (Leitgeb et.al, 2003). Second, the paradigm shift from OR based to office-based imaging is necessary to make OCT a useful technology for head and neck cancer screening, early detection, and monitoring of disease progression. Incorporating this technology, OCTMI proposes to develop an advanced compact, cost-effective office based real-time 3D-functional Fourier domain functional OCT system that will not only acquire images at near histopathological resolution, but also will provide clinically important structural information on suspect lesions, potential biopsy sites, and cancer margins of larynx in the office without the need for general anesthesia or sedation. OCTMI is well positioned to develop this technology since its founders and collaborators have developed several office-based real-time 3D-OCT systems and were first to conduct large scale clinical trials on laryngeal cancer to the best of our knowledge.

喉癌是最常见的原发性头颈部癌， 颈部恶性肿瘤柔性光纤或刚性内窥镜通常通过鼻子插入或插入到鼻内。 咽部进行常规体格检查，但不能单独使用内窥镜检查， 区分良性、癌前病变和早期恶性病变，其特征在于： 相同的症状，如咽喉疼痛，咳嗽或声音嘶哑，以及几乎相同的身体状况。 外观.常规检查和内窥镜检查都缺乏可视化深度的能力。 疾病渗透到组织的深层，并提供声带信息 上皮结构因此，喉癌的诊断必须依靠活检，这需要 全身麻醉和内窥镜手术。多次和重复活检是常见的， 增加诊断率，并由此增加外科手术的发病率。不管付出多少代价 对病人和他们的家庭，有与手术相关的主要费用， 耐心工作时间。因此，迫切需要开发一种快速、移动的和非侵入性的 技术，以帮助早期发现和监测喉恶性病变，协助选择 患者进行手术活检。OCT在早期喉上皮癌治疗中的应用 类似于宏观成像方式的使用（即，MR、CT）管理大固体 体内的肿瘤。OCT Medical Imaging Inc（OCTMI）利用多项授权专利， 使用基于光的光纤成像解决早期喉癌的治疗和诊断 一种被称为光学相干断层扫描（OCT）的技术， 接近组织病理学分辨率（Fujimoto et.al 2000）。第一个体内内窥镜OCT图像， 动物和人在1997年报道（Tearney等，1997年））。许多临床应用需要 大面积或3-D成像，这是难以实现的时域（TD）OCT。因此，OCTMI 提出使用先进的傅立叶域（FD）OCT技术，该技术在高分辨率下提供3D成像， 速度和灵敏度（Leitgeb et.al，2003年）。第二，从以手术室为基础到以办公室为基础的模式转变 成像是必要的，使OCT成为头颈癌筛查的有用技术， 检测和监测疾病进展。为了推广这项技术，OCTMI建议 开发一个先进的紧凑型，具有成本效益的办公室为基础的实时三维功能傅立叶域 功能性OCT系统，不仅能够以接近组织病理学分辨率采集图像， 将提供关于可疑病变、潜在活检部位的临床重要结构信息， 在不需要全身麻醉或镇静的情况下，OCTMI是 我们非常有能力开发这项技术，因为它的创始人和合作者已经开发了几个 基于办公室的实时3D-OCT系统，并首次对喉部进行大规模临床试验 据我们所知是癌症