Cancers of the upper aero-digestive tract, which includes the oral cavity, oropharynx, and esophagus, are associated with rising incidence and uniformly poor survival, primarily due to diagnosis at a late, incurable stage. While visual screening and biopsy are recommended for at-risk individuals, the standard white-light exam frequently misses areas of early neoplasia. Moreover, incomplete resection leads to frequent recurrence. There is an important need for new imaging tools to improve early diagnosis and to guide effective treatment. Optical molecular imaging provides a unique solution to greatly improve clinical outcome. Over the last 5 years, we have developed optically active contrast agents, delivery formulations, and imaging systems which provide the ability to monitor and quantify molecular, functional, and morphologic biomarkers of early neoplasia. In this renewal, we propose to solve the clinical and technical challenges needed to realize these potential advantages in one organ system - the upper aero-digestive tract.
In Aim 1, we will optimize and translate contrast agents and imaging systems for early diagnosis of intraepithelial neoplasia, culminating with pilot in vivo studies to assess sensitivity and specificity. Once lesions are identified, neoplastic tissue must be completely resected to prevent progression or recurrence.
In Aim 2, we will develop molecular imaging systems to enable image-guided therapy of intra-epithelial neoplasia. We will develop and test guidance approaches for: image-guided open surgery in the oral cavity;image-guided endoscopic resection in the esophagus;and image-guided robotic surgery in the oropharynx. In the next 20 years, the number of cancer deaths worldwide will double. As successful cervical cancer screening programs indicate, early detection and treatment using optical molecular imaging could reduce cancer mortality and incidence by 4 times--a result equal to or better than any blockbuster drug! The translational bioengineering studies proposed here will result in low-cost, portable tools to improve early detection and image-guided therapy of intraepithelial neoplasia in the upper aero-digestive tract, providing a foundation to extend these tools to other organ sites.

Public Health Relevance

Cancer is a major global health problem. More than 10,000,000 malignancies are diagnosed each year, and 80% of these arise on epithelial surfaces. Improved identification and treatment of early cancers and precancerous lesions represents the most important opportunity to reduce the morbidity and mortality of cancer.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA103830-08
Application #
8516465
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (55))
Program Officer
Baker, Houston
Project Start
2004-08-01
Project End
2016-07-31
Budget Start
2013-08-20
Budget End
2014-07-31
Support Year
8
Fiscal Year
2013
Total Cost
$905,973
Indirect Cost
$106,111
Name
Rice University
Department
Biomedical Engineering
Type
Schools of Engineering
DUNS #
050299031
City
Houston
State
TX
Country
United States
Zip Code
77005
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