Endoscopic optical coherence tomography and autofluorescence imaging for early cancer detection

在加拿大，肺癌是癌症死亡的主要原因，占男性和女性所有癌症死亡人数的四分之一以上。国家肺筛查试验表明，与标准胸部X光检查相比，低剂量螺旋CT成像可将高危吸烟者的癌症死亡率降低20%，主要是通过检测早期癌症结节，其中大多数结节 ** 较小（<9mm）且位于肺周围。对于明确的肺癌诊断和治疗计划，医生必须定位和采样可疑的肺癌结节。最安全的定位和取样肺结节的方法是使用支气管镜;然而，它们太大而不能进入小的外周气道。我们最近率先推出了一种直径为0.9 mm的新型光纤成像导管，有望用于定位外周肺结节。这种成像方式称为光学相干断层扫描自体荧光成像（OCT-AFI），可以对早期肺癌中发生的肺组织的组成和结构特征的变化进行成像。本提案的目标是：1）进一步开发创新，以提高OCT-AFI的分辨率和 ** 对比度; 2）通过同一 ** 导管实现反射和窄带成像; 3）进一步扩展导管（<0.5 mm），以允许进入更小的 ** 气道; 4）开发量化肺组织特征的方法。这些创新 ** 应该增加定位肺结节的能力，几乎在肺的所有区域。下一代 ** 内窥镜成像仪器将在小规模研究人群中进行测试。**该研究团队来自不同的背景，拥有开发临床验证的光学成像设备的丰富经验，以及在肺癌诊断和管理方面的丰富临床研究历史。这项研究有很大的潜力影响临床实践，通过提供一种灵敏和准确的仪器来定位早期肺癌，改善加拿大和世界各地的患者护理。

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