Early Detection and Diagnosis of Lung Cancer with Endomicroscopy

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

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Principal Investigator: Brett E Bouma
Organization: MASSACHUSETTS GENERAL HOSPITAL
Fiscal Year: 2024
Award: $597,127
Funding agency: National Cancer Institute

PROJECT SUMMARY
Early diagnosis of lung cancer is critical to patient survival. Unfortunately the vast majority of cases are
detected once symptoms arise and the cancer has spread offering patients little hope for cure (average 5-year
survival rate < 15%). The U.S. Preventive Services Task Force recommends individuals at high risk of
developing lung cancer undergo yearly screening with low dose computed tomography (LDCT). Screening is
highly sensitive at detecting lung nodules and has resulted in a reduction in mortality of these patients,
however only 5% of nodules detected are likely to be cancer. Diagnosis of lung cancer must be made on the
microscopic level which is traditionally done by obtaining tissue specimens for subsequent histopathology
examination. Methods for biopsy generally fall under two categories; high-risk surgical and transthoracic
procedures that provide a higher diagnostic yield, and low-risk bronchoscopy based procedures that generally
have a lower yield. Given that the vast majority of nodules detected by LDCT screening are benign it is critical
that the high-risk procedures for diagnosis are avoided. The low diagnostic yields of bronchoscopy based
biopsy procedures can be attributed to insufficiently large, inappropriately located, or non-diagnostic tissue
sampling. Therefore there is a critical need to dramatically increase the diagnostic yield of low-risk bronchial
biopsy approaches. In our laboratory we have developed novel optical coherence tomography (OCT) imaging
approaches to provide high-resolution images of tissue microstructure. We have additionally developed and
disseminated OCT interpretation criteria for the diagnosis lung cancer. In this proposal we aim to further
develop our endobronchial OCT imaging catheters to provide images with superior resolution and contrast with
the goal of microscopically guiding biopsy site selection to increase tumor yield (Aim 2), and to use our
endomicroscopy images and previously developed image interpretation criteria to provide a preliminary
diagnosis of the lesion within the procedure room (Aim 3). The intra-procedural diagnostic endomicroscopy
images could be useful complementary information provided to pathologists in addition to the tiny physical
biopsy specimens for diagnosis, or to enable immediate diagnosis and treatment of small lesions without
requiring a second procedure.

Terms: <Accuracy of Diagnosis><Address><Benign><Biopsy><Biopsy Sample><Biopsy Specimen><Blinded><Body Tissues><Breast><Bronchoscopy><CT screening><Cancer Cause><Cancer Etiology><Cancers><Categories><Catheters><Cessation of life><Chest><Clinical><Clinical Research><Clinical Study><Colon><Custom><Death><Development><Diagnosis><Diagnostic><Diagnostic Method><Diagnostic Procedure><Diagnostic Technique><Doppler OCT><Early Diagnosis><Early Intervention><Enrollment><Evaluation><Feasibility Studies><Goals><Histopathology><Image><Image Analyses><Image Analysis><Individual><Laboratories><Lesion><Lung nodule><Malignant Neoplasms><Malignant Tumor><Malignant Tumor of the Lung><Malignant neoplasm of lung><Methods><Microscopic><Microscopy><Morbidity><Morbidity - disease rate><Nodule><OCT Tomography><Operative Procedures><Operative Surgical Procedures><Optical Coherence Tomography><Optics><Ovine><Ovis><Pathologist><Pathology><Patients><Physicians><Procedures><Prostate><Prostate Gland><Prostatic Gland><Pulmonary Cancer><Pulmonary malignant Neoplasm><Randomized><Reader><Recommendation><Research Design><Research Specimen><Resolution><Risk><Sheep><Site><Specimen><Structure><Study Type><Surgical><Surgical Interventions><Surgical Procedure><Survival Rate><Symptoms><Techniques><Technology><Therapeutic Intervention><Thorace><Thoracic><Thorax><Time><Tissue Sample><Tissue imaging><Tissues><U.S. Preventative Services Task Force><U.S. Preventative Task Force><U.S. Preventive Services Task Force><U.S. Preventive Task Force><US Preventative Services Task Force><US Preventative Task Force><US Preventive Health Services Task Force><US Preventive Services Task Force><US Preventive Task Force><USPSTF><United States Preventative Services Task Force><United States Preventative Task Force><United States Preventive Services Task Force><United States Preventive Task Force><Unnecessary Surgery><Visualization><Work><arm><cancer diagnosis><cancer microenvironment><computed tomography screening><customs><developmental><diagnostic accuracy><early detection><endomicroscopy><enroll><high resolution imaging><high risk><human subject><image evaluation><image interpretation><imaging><imaging approach><imaging based approach><imaging platform><improved><in vivo><intervention therapy><low dose computed tomography><low dose computerized tomography><low-dose CT><lung cancer><malignancy><microendoscopy><minimally invasive><mortality><neoplasm/cancer><novel><optic imaging><optical><optical Doppler tomography><optical coherence Doppler tomography><optical imaging><participant enrollment><patient enrollment><public health relevance><pulmonary nodule><randomisation><randomization><randomly assigned><resolutions><safety and feasibility><screening><screenings><study design><surgery><surgery risk><surgical risk><tech development><technology development><tool><tumor><tumor microenvironment>