Mobile Imaging for Oral Cancer Screening Programs in Rural US Settings

美国农村地区口腔癌筛查项目的移动成像

• 批准号: 10193591
• 负责人: Ann M Gillenwater
• 金额: $ 26.36万
• 依托单位: RICE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10193591
• 关键词: Address; Adult; Algorithmic Analysis; Algorithms; Area; Benign; Biomedical Engineering; Biopsy; Cancer Center; Cancer Patient; Cancerous; Car Phone; Characteristics; Classification; Clinic; Clinical; Data Set; Databases; Dental; Dental Care; Dental Hygienists; Dentists; Detection; Devices; Diagnosis; Disease; Early Diagnosis; Early treatment; Educational process of instructing; Evaluation; Gold; Head and Neck Surgeon; Health Personnel; Health Services Accessibility; Healthcare; Histology; Home; Human Resources; Image; Imaging technology; Incidence; Infrastructure; Lesion; Light; Location; Malignant - descriptor; Malignant Neoplasms; Medically Uninsured; Modeling; Morbidity - disease rate; Multimodal Imaging; Neighborhood Health Center; Nurses; Optics; Oral; Oral Diagnosis; Oral Examination; Oral Stage; Oral cavity; Oral health; Oral mucous membrane structure; Outcome; Palpation; Pathologist; Patients; Pilot Projects; Population; Population Heterogeneity; Primary Care Physician; Primary Health Care; Procedures; Prospective Studies; Provider; Resources; Rice; Risk; Rural; School Dentistry; Screening for Oral Cancer; Secure; Site; South Texas; Specialist; System; Tactile; Technology; Texas; Time; Training; Travel; United States; Universities; Visit; Visual; accurate diagnosis; advanced disease; automated analysis; automated image analysis; base; bioimaging; cancer diagnosis; cancer imaging; care seeking; clinical care; clinical examination; cost; experience; health care settings; high risk; imaging system; improved; innovation; instrument; malignant mouth neoplasm; malignant oropharynx neoplasm; medically underserved; mortality; oral lesion; point of care; premalignant; programs; rural area; rural counties; rural setting; rural underserved; scale up; screening program; tool; training aid; underserved area; urban area; usability

Abstract Oral cancer is the sixth most common malignancy worldwide. In the United States, 53,000 new cases of oral and oropharyngeal cancer are diagnosed annually. With early detection and treatment, patients with oral cancer can have excellent outcomes. However, most patients are not diagnosed until their disease is at a late stage when treatment is more invasive, more expensive, and less effective. Improving early detection of oral cancer and its precursors represents the best opportunity to reduce the incidence, morbidity, and mortality of oral cancer. In the US, rural areas are especially likely to lack effective programs for early detection of oral cancer. Early diagnosis of oral cancer in rural settings is frequently hampered by a lack of personnel with appropriate expertise, lack of health care infrastructure, limited access to health services, and long travel distances. Patients in rural counties experience longer delays and travel greater distances for diagnosis and treatment by a specialist, compared to patients in urban areas. In this project we will develop two new tools to improve early detection of oral cancer in rural areas of the US: (1) a low-cost, robust, mobile phone-based imaging system for mobile Detection of Oral Cancer (mDOC), and (2) a low-cost training model to aid in teaching oral cancer examination procedures, including the use of mDOC. These tools will provide the means to improve detection of oral cancer in rural areas through autofluorescence and white-light imaging technology, objective automated image analysis, and expert review by off-site dentists or doctors. In Aim 1 we will develop the mDOC instrument and the interactive oral exam training model. In Aim 2 we will use the mDOC device to image 120 patients referred to an oral specialist for evaluation of suspicious oral lesions. We will use this data set to develop and validate mDOC automated analysis algorithms to objectively identify high risk oral mucosal lesions. In parallel, we will conduct a usability study to evaluate and optimize the oral exam training model and the mDOC device. In Aim 3, we will use mDOC in a pilot study to image 50 patients seeking care at dental and primary care clinics in the Rio Grande Valley of south Texas, to evaluate the feasibility of oral cancer exam using mDOC in rural and underserved healthcare settings; and we will train local healthcare providers to perform oral exams using the training model and the mDOC device. Our partnership combines expertise in biomedical imaging with clinical expertise in detection, diagnosis, and treatment of oral cancer in diverse populations. The innovative mobile imaging technology to be developed in this proposal can enable scale-up of effective programs for early detection of oral cancer in rural and medically underserved regions of the United States.

抽象的 口腔癌是全球第六大最常见的恶性肿瘤。在美国，有53,000个新 每年诊断出口腔和口咽癌病例。与早期检测和 治疗，口腔癌患者可以取得良好的预后。但是，大多数患者是 直到治疗更具侵入性的晚期，才被诊断出来，更多 昂贵，效率较低。改善对口腔癌及其前体的早期检测 是降低口腔癌的发病率，发病率和死亡率的最佳机会。 在美国，农村地区尤其可能缺乏早期检测的有效计划 癌症。在农村环境中的早期诊断口腔癌经常因缺乏 具有适当专业知识的人员，缺乏医疗保健基础设施，有限的健康机会 服务和长途旅行距离。农村县的患者经历更长的延误和旅行 与城市地区的患者相比，专家的诊断和治疗距离更大。 在这个项目中，我们将开发两种新工具来改善农村地区口腔癌的早期发现 美国：（1）一种低成本，健壮的基于手机的成像系统，用于移动检测 口腔癌（MDOC）和（2）一种低成本训练模型，以帮助教学口腔癌检查 程序，包括使用MDOC。这些工具将提供改善检测的手段 通过自动荧光和白光成像技术在农村地区的口腔癌， 客观的自动化图像分析以及现场牙医或医生的专家审查。 在AIM 1中，我们将开发MDOC仪器和交互式口腔检查培训模型。在 AIM 2我们将使用MDOC设备对120名患者进行成像，该患者转介给口服专家 评估可疑口腔病变。我们将使用此数据集开发和验证MDOC 自动分析算法，以客观地识别高风险的口​​腔粘膜病变。并行，我们 将进行一项可用性研究，以评估和优化口腔检查培训模型和MDOC 设备。在AIM 3中，我们将在一项试点研究中使用MDOC来对50名在牙科护理中寻求护理的患者进行成像 以及南德克萨斯州里奥格兰德谷的初级保健诊所，以评估口服的可行性 在农村和服务不足的医疗机构中使用MDOC进行癌症检查；我们将训练当地人 医疗保健提供者使用培训模型和MDOC设备进行口腔检查。 我们的合作伙伴关系将生物医学成像方面的专业知识与检测的临床专业知识相结合， 诊断和治疗不同人群中的口腔癌。创新的移动成像 该提案中要开发的技术可以使早期的有效计划扩大 在美国的农村和医疗服务不足的地区检测口腔癌。