Optical theragnostics: developing dedicated instruments to concurrently see and treat lesions

在过去的几十年里，光学技术在医学成像和激光手术中的应用取得了快速发展。该提案汇集了生物光子学，激光和光纤领域，致力于开发新设备，使成像和治疗集成在单个光纤探头内，用于同时诊断和治疗癌症：一个称为治疗诊断学的领域。自其首次出现在科学文献中以来，称为光学相干断层扫描（OCT）的成像模式已成为眼科疾病的诊断标准，并在健康科学中找到许多新的应用，如心血管和癌前病变的检测。对OCT的兴趣迅速增长源于其独特的非侵入性组织可视化能力，分辨率为10微米，深度高达3 mm，这意味着有可能跳过活检阶段进行现场诊断。OCT背后的核心技术（即激光和光纤）可以弥合诊断和治疗之间存在的差距。利用我实验室的激光-组织相互作用，光纤，光纤激光器设计和光学图像处理的综合专业知识，我建议为单光纤OCT监测激光组织凝固和消融奠定基础。换句话说，我建议开发一种基于新型光纤和激光的“看和治疗”工具。对于相干成像，例如OCT，使用单模光纤，而对于治疗，需要多模光纤来支持高功率密度。 我计划利用我的实验室开发的技术，双包层光纤（DCF）耦合器，通过DCF的核心，创建并发OCT成像和激光治疗的完美仪器，通过同一DCF的周围内包层。除了创建仪器，图像处理工具将被完善，以自动化激光治疗过程。当能量在纳秒级转化为热量时（或更快），我将使用OCT图像的特性（称为散斑）来自动指示治疗何时应该停止，从而避免关键解剖结构的速度超过眼睛所能看到的速度。该计划有可能在多学科环境中培养几名工程专业的学生，并向他们介绍将技术转化为临床套件和工业合作伙伴。我的学员在一个性别平衡、多元文化的环境中发展。他们通过在顶级期刊上发表文章，参加国际会议和合作，迅速成为国际生物医学光学科学家社区的公民。作为一个集团，我们专注于通过向工业转移技术和开发创新的治疗技术来改善加拿大人的福祉。

The past decades have witnessed a rapid evolution of optical technologies applied to medical imaging and laser surgery. This proposal brings together the fields of biophotonics, lasers and fiber optics towards the development of new devices enabling the integration of imaging and therapy within a single fiber optics probe for simultaneous diagnosis and treatment of cancers: a field called theragnostics. Since its first occurrence in the scientific literature, the imaging modality called optical coherence tomography (OCT) has become the standard of diagnosis for ophthalmic diseases and is finding many new applications in health sciences such as the detection of cardiovascular and precancerous lesions. The rapidly growing interest in OCT stems from its unique ability to visualize tissues non-invasively with a resolution of 10 microns and at depths of up to 3mm, which translates into the potential of skipping the biopsy stage for on-the-spot diagnosis. The core technologies behind OCT (i.e. lasers and fiber optics) allow bridging the current gap existing between diagnosis and treatment. Using my laboratory's combined expertise of laser--tissue interactions, fiber optics, fiber laser design, and optical image processing, I propose to set the cornerstone towards single fiber OCT-monitored laser tissue coagulation and ablation. In other words, I propose to develop a see-and-treat tool based on novel fiber optics and lasers.Laser delivery to inner organs is limited by the type of optics being used. For coherent imaging, such as OCT, single mode fibers are used, while for therapy, multimode fibers are required to support high power densities. I plan to leverage from the technology my laboratory developed, the double clad fiber (DCF) coupler, to create the perfect instrument for concurrent OCT imaging, through the core of the DCF, and laser therapy, through the surrounding inner cladding of the same DCF. In addition to creating the instrument, image-processing tools will be refined to automate the laser therapy process. As energy is converted to heat at the nanosecond regime (or faster), I will use properties of OCT images known as speckle to automatically dictate when treatment should stop, thus avoiding key anatomical structures faster than the eye can see.This program has the potential to train several engineering students in a multidisciplinary environment, and to introduce them to the translation of the techniques to the clinical suite and to industrial partners. My trainees evolve in a gender-balanced, multi-cultural environment. They rapidly become citizen of the international community of biomedical optics scientists through publications in top-tier journals, participation to international conferences and collaborations. As a group, we focus on improving the well-being of Canadians though technology transfer to industry and the development of innovative theragnostic techniques.