Fiber bundle-based divided-pupil confocal endoscope

基于光纤束的分瞳共焦内窥镜

基本信息

批准号：
8299417
负责人：
MILIND RAJADHYAKSHA
金额：
$ 62.68万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-06 至 2015-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8299417
关键词：
Alcohol consumption American Cancer Society Area Back Basal cell carcinoma Benign Biopsy Blood flow Cancerous Cellular Morphology Cessation of life Cheek structure Clinic Clinical Clinical Research Confocal Microscopy Connective Tissue Country Dermatologic Detection Development Diagnosis Diagnostic Distal Elements Endoscopes Engineering Epithelium Excision Face Fiber Goals Hand Head and Neck Cancer Head and Neck Surgery Hour Human Papillomavirus Image Incidence India Inflammatory Lamina Propria Lateral Lesion Light Lighting Lip structure Malignant - descriptor Malignant Neoplasms Malignant neoplasm of cervix uteri Maps Microscope Modification Mohs Surgery Molecular Motivation Noise Normal tissue morphology Nuclear Oncogenic Viruses Operative Surgical Procedures Optics Oral cavity Oral mucous membrane structure Pain Pathology Patients Performance Premalignant Primary Neoplasm Pupil Radiation Radiation therapy Reporting Resolution Risk Scanning Screening procedure Sensitivity and Specificity Skin Cancer Smoker Smoking Squamous cell carcinoma Staging Surgeon Survival Rate Syphilis Technology Testing Time Tissues Tongue Translating Tumor Suppressor Genes Visual Work World Health Organization advanced disease base clinically relevant cost design human subject human tissue imaging modality imaging probe improved in vivo instrument instrumentation iron deficiency light scattering malignant breast neoplasm malignant mouth neoplasm melanoma optical imaging oral lesion oral premalignancy prototype

项目摘要

The goal of this project is to create a divided-pupil line-scanning fiber bundle-based confocal endoscope for imaging nuclear and cellular morphology in oral mucosa in vivo with reflectance contrast, and to test feasibility for screening oral precancers and cancers versus normal tissue in a clinical study on patients in vivo. The endoscope is based on a divided-pupil configuration that may overcome the major limitation of existing fiber bundle-based and scanned single fiber-based confocal endoscopes: strong back-reflections from the proximal and distal faces of the fiber element, which produces strong background noise in the images. Quantitative endpoints will be determined in terms of sensitivity and specificity to validate the feasibility of the technology and justify further development toward clinical utility. The motivation is to create confocal endoscopes for real-time noninvasive imaging in reflectance for detection of oral precancers in vivo and intra-operative mapping to guide surgery of head-and-neck cancers. Oral cancer is the fifth most common malignancy in the world. Visual examination is routinely performed but remains deficient in detecting early-stage precancers or potentially cancerous lesions. Biopsy and pathology are the current standard. However, routine biopsies in the oral cavity are neither desirable nor practical. Consequently, patients are often seriously late in seeking and/or receiving treatment and the survival rate is much lower when the cancer is more advanced. Confocal microscopy, as a noninvasive optical imaging modality that shows pathology-like nuclear and cellular detail, may enable early screening of precancers, while minimizing the need for biopsy, minimizing pain and minimizing expense. During head-and-neck surgery which includes the oral cavity, intra-operative mapping may be possible directly on the patient, to enable adequate and rapid examination of cancer-to-normal tissue margins and to guide accurate and complete excision during surgery, while preserving normal tissue. Preliminary results with a divided-pupil line-scanning confocal microscope demonstrate excellent imaging in reflectance of nuclear and cellular detail in the epithelium, deeper connective tissue and blood flow in the inside lip-buccal mucosa in vivo. The optical sectioning is 1.7 ?m and lateral resolution is 1 ?m, which is comparable to that of pathology. Our hypothesis is that a divided-pupil line-scanning confocal endoscope with the use of two fiber bundles, one for illumination and one for detection, may overcome the major limitation of strong back-reflections in recently developed coaxial fiber-based confocal endoscopes. The divided-pupil configuration may enable imaging in reflectance contrast. Nuclear and cellular detail in the epithelium, connective tissue and blood flow may be noninvasively visualized in the oral cavity in vivo with sufficiently high contrast for diagnostic as well as for intra-operative use. The proposed technology may have broad clinical impact with long-term applications in detection in vivo and intra-operative mapping to guide surgery of skin, cervical and breast cancers.

该项目的目标是创建一种基于分瞳线扫描光纤束的共焦内窥镜，用于通过反射对比对体内口腔粘膜的核和细胞形态进行成像，并测试筛查口腔癌前病变和癌症与正常组织的可行性。对患者体内的临床研究。该内窥镜基于分瞳配置，可以克服现有基于光纤束和基于扫描单光纤的共焦内窥镜的主要限制：来自光纤元件的近端面和远端面的强烈背反射，从而产生强烈的背景图像中的噪声。定量终点将根据敏感性和特异性来确定，以验证该技术的可行性并证明进一步开发临床应用的合理性。其动机是创建用于实时无创反射成像的共焦内窥镜，以检测体内口腔癌前病变，并在术中绘图以指导头颈癌的手术。口腔癌是世界上第五大常见恶性肿瘤。目视检查是常规进行的，但在检测早期癌前病变或潜在癌性病变方面仍然存在缺陷。活检和病理学是当前的标准。然而，常规口腔活检既不理想也不实用。因此，患者在寻求和/或接受治疗时往往严重迟到，并且当癌症处于晚期时，生存率要低得多。共聚焦显微镜作为一种非侵入性光学成像方式，可以显示类似病理学的核和细胞细节，可以实现癌前病变的早期筛查，同时最大限度地减少活检的需要，最大限度地减少疼痛和费用。在包括口腔在内的头颈手术期间，可以直接在患者身上进行术中标测，以便能够充分、快速地检查癌症与正常组织的边缘，并在手术过程中指导准确、完整的切除，同时保留正常组织。分瞳线扫描共聚焦显微镜的初步结果表明，在体内上皮细胞核和细胞细节、更深的结缔组织和内部唇颊粘膜的血流方面具有出色的成像效果。光学切片为1.7μm，横向分辨率为1μm，与病理分辨率相当。我们的假设是，使用两根光纤束（一根用于照明，一根用于检测）的分瞳线扫描共焦内窥镜可以克服最近开发的基于同轴光纤的共焦内窥镜中强背反射的主要限制。分开的瞳孔配置可以实现反射对比度成像。上皮、结缔组织和血流中的核和细胞细节可以在口腔中以非侵入性方式在体内可视化，具有足够高的对比度以用于诊断以及术中使用。所提出的技术可能具有广泛的临床影响，可长期应用于体内检测和术中绘图，以指导皮肤癌、宫颈癌和乳腺癌的手术。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Video-mosaicing of reflectance confocal images for examination of extended areas of skin in vivo.

反射共焦图像的视频拼接，用于检查体内皮肤的扩展区域。

DOI：
发表时间：
2014-11
期刊：
影响因子：
0
作者：
Kose, K;Cordova, M;Duffy, M;Flores, E S;Brooks, D H;Rajadhyaksha, M
通讯作者：
Rajadhyaksha, M

A Marked Poisson Process Driven Latent Shape Model for 3D Segmentation of Reflectance Confocal Microscopy Image Stacks of Human Skin.

用于人体皮肤反射共焦显微镜图像堆栈 3D 分割的标记泊松过程驱动的潜在形状模型。

DOI：
发表时间：
2017-01
期刊：
影响因子：
0
作者：
Ghanta, Sindhu;Jordan, Michael I;Kose, Kivanc;Brooks, Dana H;Rajadhyaksha, Milind;Dy, Jennifer G
通讯作者：
Dy, Jennifer G

Feasibility of a Video-Mosaicking Approach to Extend the Field-of-View For Reflectance Confocal Microscopy in the Oral Cavity In Vivo.

视频拼接方法扩展体内口腔反射共焦显微镜视野的可行性。

DOI：
发表时间：
2019-07
期刊：
影响因子：
2.4
作者：
Peterson, Gary;Zanoni, Daniella Karassawa;Ardigo, Marco;Migliacci, Jocelyn C;Patel, Snehal G;Rajadhyaksha, Milind
通讯作者：
Rajadhyaksha, Milind

Evaluation of breast tissue with confocal strip-mosaicking microscopy: a test approach emulating pathology-like examination.

用共焦条状马赛克显微镜评估乳腺组织：一种模拟病理学检查的测试方法。

DOI：
发表时间：
2017-03-01
期刊：
影响因子：
3.5
作者：
Abeytunge, Sanjee;Larson, Bjorg;Peterson, Gary;Morrow, Monica;Rajadhyaksha, Milind;Murray, Melissa P
通讯作者：
Murray, Melissa P

Intraoperative imaging during Mohs surgery with reflectance confocal microscopy: initial clinical experience.

莫氏手术期间使用反射共焦显微镜进行术中成像：初步临床经验。

DOI：
发表时间：
2015-06
期刊：
影响因子：
3.5
作者：
Flores, Eileen S;Cordova, Miguel;Kose, Kivanc;Phillips, William;Rossi, Anthony;Nehal, Kishwer;Rajadhyaksha, Milind
通讯作者：
Rajadhyaksha, Milind