Increasing the diagnostic yield of low-risk bronchial biopsy in the evaluation of

提高低风险支气管活检评估的诊断率

基本信息

批准号：
8531402
负责人：
Brett E Bouma
金额：
$ 55.98万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-04-19 至 2018-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8531402
关键词：
Accounting Biopsy Biopsy Specimen Breast Bronchoscopes Bronchoscopy Cancer Etiology Catheters Cessation of life Chest Clinical Research Colon Desmoplastic Detection Development Diagnosis Diagnostic Early Diagnosis Early Intervention Enrollment Ensure Evaluation Excision biopsy Fibrosis Frequencies General Hospitals Goals Histopathology Image Image Guided Biopsy Imaging Device Imaging Techniques Lasers Lead Lesion Libraries Lung Malignant Neoplasms Malignant neoplasm of lung Massachusetts Medical Microscopic Microscopy Molecular Analysis Molecular Profiling Morbidity - disease rate Operative Surgical Procedures Optics Pathologist Pathology Patients Peripheral Physicians Procedures Prostate Pulmonary Coin Lesion Research Design Research Personnel Resources Risk Safety Sampling Sheep Site Specificity Specimen Symptoms System Techniques Testing Time Tissues Training Translating Translations Tumor Tissue Work X-Ray Computed Tomography arm design design and construction diagnostic accuracy high risk imaging modality improved in vivo mortality novel optical imaging preclinical study prototype public health relevance screening tool translational study tumor

项目摘要

DESCRIPTION (provided by applicant): Lung cancer is the leading cause of cancer related death accounting for more deaths than breast, prostate and colon combined. Early diagnosis is critical to patient survival, however the vast majority of lung malignancies are detected only once symptoms arise and the cancer has spread, at which time patients have little chance of cure. Macroscopic imaging modalities including CT and bronchoscopy have made significant strides in increasing early detection; however they do not have the required specificity to diagnose malignancy. Diagnosis must be made on the microscopic level, which at present can only be accomplished with excisional biopsy. Unfortunately, low-risk bronchoscopic techniques for retrieving biopsy samples are hampered by low diagnostic yields, and trans-thoracic and surgical approaches carry higher intrinsic risk of complications. Given the very high false positive rates of these macroscopic imaging platforms it is imperative that high-risk procedures are avoided and the diagnostic accuracy of lower-risk approaches is greatly improved. In this proposal we aim to dramatically increase the diagnostic yield of low-risk bronchial biopsy using novel optical imaging tools to locally guide biopsy site selection ensuring that diagnostic quality samples are obtained for both histopathology and molecular profiling. Specifically, we will develop and translate polarization-sensitive optical frequency domain imaging (PS-OFDI) systems, and novel catheters for conducting PS-OFDI of the airways and peripheral lung. We will develop and validate diagnostic criteria for evaluating the PS-OFDI images of lung cancer pathology, and we will conduct clinical studies to demonstrate the improvement in biopsy yield over conventional approaches. This work will leverage the expertise, resources and ongoing collaborative ties between investigators at Massachusetts General Hospital and NinePoint Medical. Together the strategic alliance already formed will ensure the successful translation and delivery of a powerful and robust new optical bronchoscopy tool that will likely result in an increase in the diagnostic yield of bronchial biopsy for the assessment of lung cancer.

描述（由申请人提供）：肺癌是癌症相关死亡的主要原因，死亡人数比乳腺癌，前列腺和结肠合并更多。早期诊断对患者的生存至关重要，但是仅在症状出现并且癌症扩散后才检测到绝大多数肺部恶性肿瘤，此时患者几乎没有治愈的机会。包括CT和支气管镜在内的宏观成像方式在提高早期检测方面已取得了显着的进步。但是，它们没有必要的特异性来诊断恶性肿瘤。诊断必须在显微镜水平上进行，目前只能通过切除活检来完成。不幸的是，用于检索活检样品的低风险支气管镜技术受到低诊断产率的阻碍，而经胸腔和外科手术方法具有更高的并发症的内在风险。鉴于这些宏观成像平台的非常高的假阳性率必须避免高风险程序，并且低风险方法的诊断准确性大大提高了。在此提案中，我们旨在使用新颖的光学成像工具来大大提高低风险支气管活检的诊断产量对于组织病理学和分子分析，获得样品。具体而言，我们将开发和翻译对极化敏感的光频域成像（PS-OFDI）系统，以及用于传导气道和周围肺PS-OFDI的新型导管。我们将开发和验证诊断标准，用于评估肺癌病理的PS-OFDI图像，我们将进行临床研究，以证明活检产量的提高而不是常规方法。这项工作将利用马萨诸塞州综合医院和尼尼波特医学的调查人员之间的专业知识，资源和持续的合作关系。共同组成的战略联盟将确保成功地翻译和交付强大而强大的新光学支气管镜工具，这可能会导致支气管活检的诊断产量增加，以评估肺癌。