Esophageal adenocarcinoma (EAC) has one of the fastest rising rates of incidence in the US. Unfortunately, the five-year-survival for patients diagnosed with EAC is only 10%. EAC develops primarily in patients with Barrett's esophagus (BE). Endoscopic screening and biopsy is recommended for at-risk individuals. However, standard white-light endoscopic examination frequently misses areas of early neoplasia, which are often clinically indistinguishable from normal mucosa and/or inflammatory changes. Studies have shown that as many as 43-57% of early cancers can be missed by this method. Thus, there is an important need for new endoscopic technologies which improve the ability of clinicians to identify precancerous lesions and early cancers with high sensitivity and specificity. The goal of this proposal is to develop, optimize and validate novel multi-modal, multi-scale optical imaging platforms for non-invasive, early detection of esophageal neoplasia based on optical imaging. We will collaborate with colleagues at Pentax, Inc. to design and test multi-modal endoscopic imaging systems for early detection of neoplasia in Barrett's esophagus. Widefield endoscopic imaging will be used initially to screen the surface area at risk to identify abnormal sites with high sensitivity;suspicious areas will then be imaged with much higher spatial resolution to achieve high diagnostic specificity. Both wide field and high resolution technologies will be integrated into a single endoscopic platform to increase the ease and accuracy of endoscopic cancer screening and surveillance. In sequential clinical studies, we will first separately optimize the performance of wide field endoscopic imaging and high resolution imaging. We will then integrate the wide field and high resolution imaging systems and validate their accuracy for the detection of neoplasia in subjects with Barrett's esophagus, the precursor to esophageal adenocarcinoma. Lastly, we will develop an image atlas of typical wide-field and high-resolution images, interpretation criteria, and histopathology to train future users and serve as an educational resource.

Public Health Relevance

Improved identification and treatment of early cancers and precancerous lesions represents the most important opportunity to reduce the morbidity and mortality of cancer. This is particularly true for esophageal adenocarcinoma, a malignancy with a rapidly rising incidence rate and uniformly poor survival, primarily due to diagnosis at a late, incurable stage.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA140257-05
Application #
8676459
Study Section
Special Emphasis Panel (ZRG1-SBIB-U (50))
Program Officer
Baker, Houston
Project Start
2010-08-16
Project End
2015-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
5
Fiscal Year
2014
Total Cost
$716,800
Indirect Cost
$65,382
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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Thekkek, Nadhi; Pierce, Mark C; Lee, Michelle H et al. (2013) Modular video endoscopy for in vivo cross-polarized and vital-dye fluorescence imaging of Barrett's-associated neoplasia. J Biomed Opt 18:26007

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