Diagnosis of Ovarian Cancer by Confocal Microendoscopy

描述（由申请人提供）：

DESCRIPTION (provided by applicant): The objective of this research is to develop a screening tool for the early detection of ovarian cancer with the capability of diagnosing microscopic cancers or areas of abnormality in the ovary using minimally invasive surgical access. Ovarian cancer has the highest mortality of any of the gynecologic conditions because it is usually diagnosed in late stages leading to poor overall prognosis for survival. The fluorescence confocal microendoscope is a new type of instrument for visualizing tissue at the cellular level that has shown great promise for performing optical biopsy. Preliminary work suggests significant potential for this instrument in imaging and identifying pathology in the ovary. Confocal microscopy has the capability to enhance a physicians' diagnostic ability and ultimately provide an automated image analytic tool for real-time in vivo diagnosis of pathology. The specific aims of the work are as follows: 1) To build a third-generation confocal microendoscope instrument that can be used routinely and reliably in the clinic. The system will be compact, mobile, and incorporate high sensitivity grayscale and multi-spectral imaging capabilities. 2) To develop a reliable mechanism for localized delivery of exogenous fluorescence contrast agent. Ideally this will be a non- (or minimum) contact technique that will allow well-controlled exposure of tissue to the exogenous agents. 3) To incorporate automated real-time pattern recognition capability into the system. This capability will assist the operating physician in identifying pathology during continuous imaging of the surface of the ovary. 4) To evaluate the safety and efficacy of specific fluorescent compound(s) for use as contrast agents in the peritoneal cavity that will be delivered topically to the surface of the ovary. This work will be done in a rodent model. 5) To demonstrate the feasibility of using the instrument for in vivo imaging of human ovary. This will prove that the basic system concept works and to point out practical issues that need to be addressed. 6) To assess the efficacy of the clinical instrument for detection of pathology of the ovary. This will be a more extensive study to evaluate the sensitivity and specificity of this technique across a range of histologic diagnoses including normal ovary, benign neoplasms, and cancers. The clinical evaluations will be done in a cohort of women who are scheduled to undergo oophrectomy procedures.