Advanced Salpingoscope for Minimally-Invasive Imaging of the Fallopian Tubes

用于输卵管微创成像的先进输卵管镜

• 批准号: 9175237
• 负责人: Jennifer Kehlet Barton
• 金额: $ 32.99万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9175237
• 关键词: Adhesions; Biopsy; Caliber; Cancerous; Carcinoma in Situ; Cell Nucleus; Collagen; Collagen Fiber; Detection; Diagnostic; Disease; Distal; Dyes; Early Diagnosis; Endoscopes; Environment; Epithelial cyst; Epithelium; FDA approved; Fallopian Tube Diseases; Fertility; Fiber; Fluorescence; General Anesthesia; Generations; Health; High Risk Woman; Hospitalization; Human; Image; Imagery; Imaging technology; Infertility; Investigation; Irrigation; Laparoscopy; Laparotomy; Lasers; Life; Light; Local anesthesia; Magnetic Resonance Imaging; Malignant neoplasm of ovary; Mammalian Oviducts; Mechanics; Medical; Medical Device; Methods; Microscopy; Modality; Modeling; Neoplasms; Operating Rooms; Optical Coherence Tomography; Optics; Organ; Organism; Ovarian Serous Adenocarcinoma; Ovary; Pelvic Inflammatory Disease; Pelvic cavity structure; Pelvis; Performance; Photons; Physiologic pulse; Pilot Projects; Preparation; Procedures; Recovery; Research Personnel; Resolution; Saline; Salpingitis; Salpingo-Oophorectomy; Screening for Ovarian Cancer; Sensitivity and Specificity; Series; Serous; Sheep; Source; Structural Genes; Structure; Structure of rectouterine pouch; Surface; Surgical incisions; System; Techniques; Testing; Time; Tissue Sample; Tissues; Ultrasonography; Uterus; Vagina; Woman; base; cost; design; human tissue; imaging modality; imaging system; in vivo; microscopic imaging; miniaturize; minimally invasive; mortality; non-invasive imaging; novel; optical imaging; prevent; prophylactic; screening; tool; two-photon; usability; whole body imaging

The fallopian tubes harbor serous tubal intraepithelial carcinoma (STIC), the putative precursor to high- grade serous ovarian carcinoma, the deadliest form of this disease with a 70% mortality rate. Early detection of STIC could save lives as well as prevent thousands of unnecessary prophylactic salpingo-oophorectomies. Unfortunately, early disease of the fallopian tubes is undetectable via conventional whole-body imaging technologies, and noninvasive methods of screening for ovarian cancer are not effective. The fallopian tubes can be visualized during laparoscopy using high resolution techniques such as optical coherence tomography (OCT) and multiphoton microscopy (MPM). The investigators have clearly shown the ability of these techniques to differentiate normal from diseased tissues and have demonstrated laparoscopic imaging systems in women. However, the general anesthesia needed for laparoscopy makes its use as a diagnostic or surveillance technique unattractive, even in high risk women. We propose to enable high-sensitivity, high-resolution imaging of the fallopian tube in an office setting. Our salpingoscope will be inserted under local anesthesia through the vagina into the rectouterine pouch, providing minimally-invasive access to the distal fallopian tube and also enabling imaging of the ovaries and exterior uterine wall. White light, large field-of-view imaging for navigation will be combined with sensitive OCT and MPM imaging for early detection of neoplasia. Steering and biopsy capability will further enhance the utility and usability of this system. The proposed specific aims are: Specific Aim 1: Develop a multipurpose near-infrared laser. A novel, compact, robust, femtosecond fiber-based laser operating at a center wavelength of 1300 nm will be developed, which will function as an ideal source for both the OCT and MPM subsystems, and be highly functional in a fiber-based endoscopic system in a medical office environment. Specific Aim 2: Develop an advanced transvaginal salpingoscope. A 3 mm diameter, steerable, high capability salpingoscope will be developed which will include a white light imaging channel for navigation, an OCT/MPM channel for high resolution investigation of tissue microstructure and function in suspicious regions, a biopsy channel for tissue sampling and an irrigation port to enable organ floatation or apply dye. Specific Aim 3. Evaluate the operational and diagnostic capability of the salpingoscope. The mechanical and operational performance of the salpingoscope will be assessed with ex vivo human tissues, in vivo in a sheep model, and finally in vivo in women in a limited pilot study. In the near term, we will provide the of hundreds of thousands of women at high risk for ovarian cancer an opportunity to detect early disease and delay or avoid the life-altering (and possibly shortening) prophylactic salpingo-oophorectomy. The salpingoscope may also find broad utility for imaging of other pelvic disorders.

输卵管带有浆液管内癌（Stic），这是高 - 高的前体 浆液卵巢癌级，这种疾病的最致命形式，死亡率为70％。早期检测 Stic可以挽救生命，并防止成千上万的不必要的预防性Salpingo-Opophorcortomies。 不幸的是，输卵管的早期疾病是通过常规的全身成像无法检测到的 卵巢癌筛查的技术和无创方法无效。输卵管 可以使用高分辨率技术（例如光学相干断层扫描）在腹腔镜检查期间可视化 （OCT）和多光子显微镜（MPM）。调查人员清楚地表明了这些能力 将正常与患病组织区分开的技术并显示了腹腔镜成像 女性系统。但是，腹腔镜检查所需的全身麻醉可以用作诊断或 即使在高风险女性中，监视技术也没有吸引力。 我们建议在办公室环境中对输卵管的高敏性，高分辨率成像。我们的 Saltingoscope将在局部麻醉下通过阴道插入直肠袋中，提供 最小侵入性进入远端输卵管，还可以实现卵巢和外部成像 子宫墙。白光，导航的大型视野成像将与敏感的OCT和 MPM成像以早期检测肿瘤。转向和活检能力将进一步增强效用 该系统的可用性。拟议的具体目的是： 特定目标1：开发多功能近红外激光。小说，紧凑，健壮，飞秒 将开发在基于1300 nm的中心波长的基于纤维的激光器，这将充当 OCT和MPM子系统的理想来源，并且在基于纤维的内窥镜中非常有效 在医疗办公室环境中的系统。 特定目的2：开发晚期经阴道的Salingoscope。直径为3毫米 将开发功能Saltingoscope，其中包括一个白光成像通道进行导航， 对可疑区域组织微结构和功能进行高分辨率研究的OCT/MPM通道， 组织采样和灌溉端口的活检通道，以实现器官浮动或施加染料。 特定目的3。评估Salpingoscope的操作和诊断能力。这 Salingsoscope的机械和操作性能将通过体内人体组织进行评估 在有限的试点研究中，绵羊模型中的体内，最后是女性的体内。 在短期内，我们将提供数十万名卵巢癌高风险的妇女 有机会检测早期疾病并延迟或避免改变生活（可能缩短）预防性 Salpingo-opophororcorto术。 Saltingoscope也可能会发现其他盆腔疾病成像的广泛实用性。