Optical Biopsy: Anatomic Mapping and functional Analysis
Despite improvements in early diagnosis and therapy, bladder cancer remains among the most expensive cancers in terms of patient quality-of-life and sustainability of health care costs. Adequate diagnostic modalities for early staging and grading of these tumors are lacking. Tissue biopsies obtained during transurethral resection are therefore necessary, but in over 45% of the cases a recurrence is developed. Moreover, due to heterogeneous presence of the tumor, large uncertainty exist in selecting biopsy sites, leading to large numbers of healthy tissue samples. Therefore, optimizing diagnostics by improving functional visualization of suspected lesions to guide and reduce the number of physical biopsies is paramount. Locations where tumor development occurs first are often difficult to reach using standard instruments. Thus, steerable probes are required. Successful clinical implementation highly depends on compatibility with existing procedures and instruments.
We will develop a novel, multi-steerable MEMS-based imaging catheter to provide ‘functional optical biopsies’ of suspected bladder lesions using functional optical coherence tomography (FOCT) and multiphoton fluorescence microscopy (MFM), in combination with conventional cystoscopy, compatible with current clinical workflow. The synergistic FOCT/MFM imaging modality will allow unprecedented quantification of local tissue morphology, function and composition. Precise steerability and location tracking of the catheter will allow unambiguous “virtual marking” of sites selected for physical biopsy.
WP2.3.1: Catheter based FOCT (AMC)
FOCT provides high-resolution volumetric images of anatomical structure in combination with localized measurements of spatio-temporal optical properties. These are directly related to cellular organization and dynamics (e.g. tissue perfusion). PhD1 will design of steerable-catheter-compatible FOCT system (main focus on common path-OCT) based on prototype OCT imaging catheter (available from Innoluce BV); realize a multimodal catheter-based imaging device (in collaboration with PhD 2 and industry); fully compatible with current diagnostic procedures and instruments in the urological clinic (e.g. long fiber lengths requiring a common path OCT system); setup automated FOCT data analysis for large data volumes; develop phantoms for testing, calibrating and validating the developed instrumentation; and evaluate the developed instrumentation and methods in small clinical study (initiated by the postdoc).
Deliverable: A catheter based FOCT imaging system and combined FOCT/MPM imaging catheter, ready for clinical evaluation.
WP2.3.2: Multiphoton microendoscopy (VU).
Multiphoton microscopy provides unprecedented localization of fluorescence signals, which are directly related to tissue composition. PhD2 will design a steerable-catheter-compatible MFM system (main focus on dispersion pre-compensation); realize a multimodal catheter-based imaging device (in collaboration with PhD 1 and industry); develop phantoms for testing, calibrating and validating the developed instrumentation; and finally evaluate developed instrumentation and methods in small clinical study (initiated by the postdoc).
Deliverable: a fiber-catheter based multiphoton micro-endoscope and combined FOCT/MPM imaging catheter, ready for clinical evaluation.