Low-cost mobile colposcopy and confocal imaging for global prevention of cervical cancer

低成本移动阴道镜和共聚焦成像用于全球宫颈癌预防

基本信息

批准号：
10672941
负责人：
Rebecca R. Richards-Kortum
金额：
$ 53.85万
依托单位：
RICE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10672941
关键词：
Ablation Acetic Acids Algorithmic Analysis Algorithms Area Biomedical Engineering Biopsy Brazil Cancer Center Cancer Etiology Cancer Hospital Cellular Phone Cervical Cervical Cancer Screening Cervical Intraepithelial Neoplasia Cervix Uteri Cessation of life Clinical Clinical Research Cold Therapy Collaborations Colposcopes Colposcopy Country Cytology Detection Devices Diagnosis Diagnostic Disease Equipment Excision Fiber Optics HPV-High Risk Health Sciences Hospitals Human Papillomavirus Human Resources Image Image Analysis Imaging technology Incidence Infrastructure Institution Instruction Lead Lesion Malignant Neoplasms Malignant neoplasm of cervix uteri Medical Medical Imaging Medically Underserved Area Medicine Modality Modeling Morbidity - disease rate Multimodal Imaging Nuclear Nuclear Atypia Pathology Patients Performance Prevention program Provider Research Personnel Resolution Resource-limited setting Resources Rice Sensitivity and Specificity Services Site Specificity Testing Thermal Ablation Therapy Time Training United States Universities University of Texas M D Anderson Cancer Center Visit Visual Woman World Health Organization accurate diagnosis automated algorithm automated image analysis automated visual evaluation cancer epidemiology cancer prevention cancer therapy cervical biopsy cervical cancer prevention college confocal imaging cost diagnostic tool digital experience follow-up global health high resolution imaging image archival system imaging capabilities imaging modality imaging probe improved industry partner innovation low and middle-income countries microendoscope microscopic imaging morphometry mortality multimodality optical fiber overtreatment point of care premalignant programs prospective public health relevance screening screening program standard of care treatment program usability

项目摘要

Abstract: Cervical cancer was once the leading cause of cancer death among women in the United States (U.S.). The implementation of comprehensive programs for screening, diagnosis, and treatment over the past 60 years has reduced cervical cancer incidence and mortality by more than 70% in the U.S. In contrast, cervical cancer remains the 1st or 2nd leading cause of cancer death among women in many low-and middle-income countries (LMICs). Cervical cancer prevention programs in low-resource settings are hampered by a lack of personnel with appropriate clinical expertise, lack of pathology services, and lack of associated infrastructure. Programs that involve multiple patient visits have a high rate of loss to follow-up. Screen-and-Treat approaches have been implemented in LMICs and include screening by HPV testing or visual inspection with acetic acid (VIA) followed by immediate treatment, reducing loss to follow-up; but these approaches lead to massive over-treatment due to the poor specificity of VIA and HPV testing. There is an urgent need for appropriate diagnostic tools to enable the implementation of a sensitive and specific Screen-Diagnose-Treat strategy that can be performed in a single patient visit in LMICs and in medically underserved areas of the U.S. We propose to develop and validate a low-cost Multimodal Mobile Colposcope (MMC) for global cervical Screen-Diagnose-Treat programs. This new device will combine the imaging capabilities of a smartphone- based colposcope developed by MobileODT with the microscopic imaging capabilities of a fiber-optic confocal imaging probe developed by Rice University. The MMC will image the entire cervix, automatically identify suspicious regions, and acquire co-registered high-resolution images of nuclear morphometry from suspicious areas. Multimodal image analysis algorithms will be developed in a study of 300 women referred for colposcopy at two sites in Brazil. The performance of the MMC with automated image analysis for detection of cervical precancer will be validated in a study of an additional 760 women referred for colposcopy in Brazil. We will determine the feasibility and usability of the MMC among low-resource setting providers by carrying out cancer prevention training courses using the MMC in Brazil. Our academic-industrial partnership includes expertise in bioengineering (Rice University), colposcopy and medical imaging (MobileODT), cervical cancer prevention and treatment (MD Anderson Cancer Center), and cervical cancer prevention and epidemiology (Albert Einstein College of Medicine), as well as the clinical expertise of our Brazilian clinical partners: Barretos Cancer Hospital and the Federal University of Health Sciences of Porto Alegre/Hospital Santa Casa. The innovative imaging technologies to be developed in this proposal will enable effective single-visit Screen-Diagnose-Treat programs to diagnose and treat women with cervical precancer while minimizing overtreatment.

抽象的：宫颈癌曾经是美国妇女（美国）癌症死亡的主要原因。在过去的60个相比之下癌症仍然是许多低收入和中等收入中女性癌症死亡的第一或第二大原因国家（LMIC）。低资源环境中的宫颈癌预防计划受到了缺乏具有适当临床专业知识，缺乏病理服务以及缺乏相关基础设施的人员。涉及多个患者访问的程序的随访率很高。屏幕和治疗方法已在LMIC中实施，包括通过HPV测试或视觉检查进行筛选乙酸（通过），然后立即进行治疗，将损失减少到随访；但是这些方法导致了由于VIA和HPV测试的特异性差，大量过度治疗。迫切需要适当的诊断工具，以实现敏感且特定的屏幕诊断治疗可以在LMIC和美国服务不足的LMICS访问中进行的策略我们建议开发和验证用于全球宫颈的低成本多模式移动阴道镜（MMC）屏幕诊断程序。这个新设备将结合智能手机的成像功能 - 由Mobiledt开发的基于纤维共聚焦的微观成像功能赖斯大学开发的成像探针。 MMC将图像整个子宫颈，自动识别可疑区域，并从可疑地获得核形态的共同注册的高分辨率图像区域。多模式图像分析算法将在一项针对300名女性的研究中开发巴西两个地点的阴道镜检查。使用自动图像分析的MMC的性能用于检测宫颈预科剂将在一项对巴西阴道镜检查的760名妇女的研究中进行验证。我们将通过执行低资源设置提供商中MMC的可行性和可用性使用巴西的MMC进行预防癌症培训课程。我们的学术工业合作伙伴关系包括生物工程专业知识（莱斯大学），阴道镜检查和医学成像（Mobiledt），宫颈癌预防和治疗（MD Anderson Cancer Center）和宫颈癌预防和流行病学（阿尔伯特·爱因斯坦医学院）以及临床我们的巴西临床合作伙伴的专业知识：巴雷托斯癌症医院和联邦卫生大学 Porto Alegre/Hospital Santa Casa的科学。在此开发的创新成像技术提案将使有效的单访问屏幕诊断计划能够诊断和治疗女性宫颈预科剂，同时最小化过度治疗。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Cervical lesion assessment using real-time microendoscopy image analysis in Brazil: The CLARA study.

DOI：
10.1002/ijc.33543
发表时间：
2021-07-15
期刊：
International journal of cancer
影响因子：
6.4
作者：
Hunt B;Fregnani JHTG;Brenes D;Schwarz RA;Salcedo MP;Possati-Resende JC;Antoniazzi M;de Oliveira Fonseca B;Santana IVV;de Macêdo Matsushita G;Castle PE;Schmeler KM;Richards-Kortum R
通讯作者：
Richards-Kortum R

Deployment and assessment of a deep learning model for real-time detection of anal precancer with high frame rate high-resolution microendoscopy.

DOI：
10.1038/s41598-023-49197-9
发表时间：
2023-12-14
期刊：
SCIENTIFIC REPORTS
影响因子：
4.6
作者：
Brenes, David;Kortum, Alex;Coole, Jackson;Carns, Jennifer;Schwarz, Richard;Vohra, Imran;Richards-Kortum, Rebecca;Liu, Yuxin;Cai, Zhenjian;Sigel, Keith;Anandasabapathy, Sharmila;Gaisa, Michael;Chiao, Elizabeth
通讯作者：
Chiao, Elizabeth

Automated In Vivo High-Resolution Imaging to Detect Human Papillomavirus-Associated Anal Precancer in Persons Living With HIV.

DOI：
10.14309/ctg.0000000000000558
发表时间：
2023-02-01
期刊：
Clinical and translational gastroenterology
影响因子：
3.6
作者：
通讯作者：

Hands-On Training Courses for Cervical Cancer Screening, Diagnosis, and Treatment Procedures in Low- and Middle-Income Countries.

DOI：
10.1200/go.21.00214
发表时间：
2022-01
期刊：
JCO global oncology
影响因子：
4.5
作者：
Phoolcharoen N;Varon ML;Baker E;Parra S;Carns J;Cherry K;Smith C;Sonka T;Doughtie K;Lorenzoni C;Richards-Kortum R;Schmeler K;Salcedo MP
通讯作者：
Salcedo MP