Endoscopic optical coherence tomography and autofluorescence imaging for early cancer detection

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In Canada, lung cancer is the leading cause of cancer death accounting for over a quarter ofall cancer deaths in men and women. The National Lung Screening Trial showed that lowdosespiral CT imaging can reduce cancer mortality by 20% in high-risk smokers compared tostandard chest x-ray, primarily by detecting early stage cancer nodules, the majority of whichare small (<9mm) and located in the lung periphery. For definitive lung cancer diagnosis andtreatment planning, a physician must locate and sample suspected lung cancer nodules. Thesafest way to locate and sample lung nodules is using a bronchoscope; however, they are toolarge to access the small peripheral airways. We have recently pioneered a new fiber opticimaging catheter that is 0.9 mm in diameter that shows promise for locating peripheral lungnodules. This imaging modality, called optical coherence tomography autofluorescenceimaging (OCT-AFI) can image changes in the composition and structural features of lungtissue that occur in early lung cancer.The goal of this proposal is 1) to further develop innovations to improve the resolution andcontrast in OCT-AFI 2); to enable reflectance and narrow-band imaging via the samecatheter; 3) to miniaturize the catheters further (<0.5mm) to allow access to even smallerairways; and 4) to develop methods for quantifying lung tissue features. These innovationsshould increase the ability to locate lung nodules in almost all areas of the lungs. This nextgenerationendoscopic imaging instrument will be tested in a small study population.The research team comes from diverse backgrounds with extensive experience developingclinically proven optical imaging devices, and a wealth of clinical research history in thediagnosis and management of lung cancer. This research has great potential to affect clinicalpractice to improve patient care in Canada and worldwide by providing a sensitive andaccurate instrument for locating early lung cancer.