Endogenous fluorescence lifetime endoscopy for early detection of oral cancer and dysplasia

内源性荧光终生内窥镜检查用于口腔癌和不典型增生的早期检测

基本信息

批准号：
9470668
负责人：
Javier Antonio Jo
金额：
$ 16.25万
依托单位：
TEXAS ENGINEERING EXPERIMENT STATION
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-02-02 至 2018-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9470668
关键词：
Adopted Algorithms American Cancer Society Benign Biological Markers Biomedical Engineering Biopsy Blinded Cancer Patient Carcinoma Characteristics Chicago Clinic Clinical Clinical Management Clinical Research Coenzymes Collagen Data Databases Dentists Detection Diagnosis Diagnostic Diagnostic Imaging Disease Drops Dysplasia Early Diagnosis Endoscopes Endoscopy Epithelial Evaluation Excision Face Fluorescence Frequencies Future Geometry Goals Gold Health Professional Histopathology Image Imaging Device In Situ Intraepithelial Neoplasia Lesion Life Expectancy Machine Learning Malignant Epithelial Cell Malignant Neoplasms Metabolic Metabolism Mild Dysplasia Minor Surgical Procedures Mitochondria Modality Monitor Monitoring for Recurrence Neck Operative Surgical Procedures Optics Oral Oral Stage Oral cavity Pathologic Patient Recruitments Patients Pharyngeal structure Pilot Projects Predictive Value Quality of life Recurrence Reporting Research Personnel Research Project Grants Salivary Screening for Oral Cancer Screening for cancer Screening procedure Sensitivity and Specificity Specificity Speed Stains Survival Rate System Technology Testing Time Tissues Work base cancer invasiveness clinically relevant computerized tools cost cost effective design early screening exfoliative cytology experience fluorescence lifetime imaging image processing imaging biomarker improved in vivo in vivo imaging malignant mouth neoplasm novel optical imaging oral dysplasia oral lesion precision medicine prospective success tool tumor tumor progression volunteer

项目摘要

The American Cancer Society estimates that 48,330 new cases of cancer in the oral cavity and pharynx will be reported this year. When diagnosed at early stages, the 5-year survival rate is 83%. However, when diagnosed at intermediate or advance stages, the 5-year survival rate drops to 62% and 38%, respectively. In addition, while early stage treatment may only require minor surgery to remove the localized tumor, later stage treatment could require surgical removal of parts of the face and neck, hence drastically reducing the patient’s quality of life. Unfortunately, benign oral lesions are sometimes difficult to distinguish from dysplasia or early invasive cancer even for healthcare professionals. As a result, only 31% of patients are diagnosed at early stages despite the fact that the oral cavity is easily accessible for direct examination. Hence, there is a critical need for new clinical technologies for reliable early diagnosis of oral cancer and dysplasia. Several screening tools for oral cancer have been commercially available, including exfoliative cytology, vital staining, salivary test, and optical interrogation; however, none of them have been demonstrated to be capable of clinically relevant sensitivity and specificity. We hypothesize that several biomarkers for oral cancer and dysplasia can be accurately quantified by endogenous fluorescence lifetime imaging (FLIM) thus enabling levels of sensitivity and specificity adequate for early detection. This bioengineering research grant focuses on developing and validating a cost-effective wide-field multispectral FLIM endoscope for noninvasive in situ detection of oral cancer and dysplasia. To that end we have developed three specific aims. Aim 1: To design and build a cost-effective multispectral FLIM endoscope for in vivo imaging of epithelial tissue in the oral cavity. Aim 2: To develop algorithms for fast and automated FLIM based early detection of oral epithelial cancer and dysplasia. Aim 3: To quantify prospectively in a pilot clinical study the capability of the proposed FLIM endoscopic tools for noninvasively early detection of oral epithelial cancer and dysplasia. The successful completion of these aims will result in a novel, accurate and cost-effective clinical tool for noninvasive in situ early detection of cancer and dysplasia. Such a tool could potentially help to improve significantly both the life expectancy and the quality of life for the more than 33,000 oral cancer patients being diagnosed each year at intermediate and advance stages. Beyond early diagnosis, this tool could also assist at every step involved on the clinical management of oral cancer patients, including treatment guidance and monitoring of disease recurrence. Finally, the demonstrated success of this clinical tool in oral epithelial cancer will herald future success with other cancers of epithelial origin, which accounts for more than 80% of all cancers.

美国癌症协会估计，今年将报道48,330例口腔和咽部癌症的新病例。在早期诊断时，5年的存活率为83％。但是，当在中级或提前阶段诊断时，5年生存率分别下降到62％和38％。此外，虽然早期治疗可能只需要轻微的手术即可去除局部肿瘤，但以后的治疗可能需要手术去除面部和颈部的部分，从而大大降低了患者的生活质量。不幸的是，即使对于医疗保健专业人员，良性口服病变有时也很难与发育不良或早期侵入性癌症区分开。结果，尽管口腔很容易接触到直接检查，但在早期阶段中只有31％的患者被诊断出来。因此，对于可靠的口腔癌和发育不良的可靠早期诊断的新临床技术至关重要。已商购的几种口腔癌筛查工具，包括极端细胞学，重要的染色，唾液测试和光学询问；但是，尚未证明它们能够具有临床相关的敏感性和特异性。我们假设可以通过内源性荧光寿命成像（FLIM）准确地量化了几种口腔癌和发育不良的生物标志物，从而实现了足够的敏感性和特异性水平，足以适应早期检测。这项生物工程研究补助金的重点是开发和验证具有成本效益的宽场多光谱FLIM内窥镜，用于非侵入性原位检测口腔癌和发育不良。为此，我们开发了三个具体目标。目标1：设计和建立一个具有成本效益的多光谱FLIM内窥镜，以在口腔中上皮组织的体内成像。 AIM 2：开发用于快速和自动化的FLIM早期检测口腔上皮癌和发育不良的算法。目标3：在试点临床研究中，前瞻性量化了拟议的FLIM内窥镜工具在非侵入性早期发现口腔上皮癌和发育不良的能力。这些目标的成功完成将导致一种新颖，准确且具有成本效益的临床工具，用于无创的原位癌症和发育不良。每年在中级和提前阶段被诊断出33,000名口腔癌患者的预期寿命和生活质量可能有助于显着改善。除了早期诊断之外，该工具还可以在口腔癌患者的临床管理中的每一步，包括治疗指导和监测疾病复发。最后，这种临床工具在口腔上皮癌中的成功取得了成功，将与其他上皮起源的癌症预示未来的成功，该癌症占所有癌症的80％以上。