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，占男性和女性癌症死亡人数的四分之一以上。国家肺部筛查试验显示，与**标准胸部x线相比，低剂量**螺旋CT成像可使高危吸烟者的癌症死亡率降低20%，主要是通过发现早期癌症结节，其中**大多数很小（<9mm），位于肺周围。为了明确的肺癌诊断和治疗计划，医生必须定位和取样疑似肺癌结节。最安全的肺结节定位和取样方法是使用支气管镜；然而，它们太大，无法进入周围的小气道。我们最近率先开发了一种直径为0.9毫米的新型光纤成像导管，有望用于定位周围肺结节。这种成像方式被称为光学相干断层扫描自身荧光成像（OCT-AFI），可以成像早期肺癌中肺组织成分和结构特征的变化。**本提案的目标是1)进一步发展创新，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)进一步缩小导管（<0.5mm），以便进入更小的气道；4)建立定量肺组织特征的方法。这些创新**将提高在肺几乎所有区域定位肺结节的能力。这种新一代内窥镜成像仪器将在小型研究人群中进行测试。**研究团队来自不同的背景，在开发**临床证明的光学成像设备方面有丰富的经验，在**肺癌的诊断和治疗方面有丰富的临床研究历史。这项研究具有很大的潜力，通过提供一个敏感和准确的仪器来定位早期肺癌，从而影响临床实践，改善加拿大和全世界的患者护理

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.**