Multimodal Optical Probe for Skin Cancer Detection and Therapy Guidance

Project Summary AbstractThe primary goal of this research project is to develop and translate to clinical use a novel optical imaging technology based on combined Optical Coherence TomographyOCTand Confocal MicroscopyCMfor noninvasive real time diagnosis of non melanoma skin cancersNMSCstumor subtyping and margin mapping that will assist physician patient decision in treatment planningbiopsy vsno biopsysurgery vsnon surgicalas well as on performing the therapyThe increasing incidence and prevalence in skin cancerespecially among the aging populationcombined with the high costs of surgery and subsequent reconstructionand the physical and psychological trauma that patient endures with surgical interventionhas led to an increasing adoption and implementation of alternative non surgical treatments that can be highly effective and less invasiveLaser ablation and radiotherapy have been proven to be effective therapies for common skin cancers and have the additional benefits that are easily tolerable and not associated with less scarring or disfigurementThereforetheir clinical use has substantially increased within the recent years to treat skin cancersHoweverthe primary challenge in delivering effective laser fluence or radiotherapy dose for skin cancer is accurate delineation of the cancer targetboth in depth and laterallyFortunatelythe unique capability of OCT CM to visualize tissue morphology with micron scale resolution can be used in real time in the clinics to aid therapy target delineation and enable more precise delivery of therapy without need toestimatethe subclinical extent of spreadthereby minimizing side effectsIn additionCM OCT can be used to confirm eradication of skin cancerwhich is currently limited to visual inspectiona highly insensitive and subjective methodThe preliminary evaluation of the feasibility of this technology for aiding accurate target delineation will be performed during the Phase I programBased on Phase I conclusionsthe technology will be refined in Phase II and evaluated clinically on a large pool of patient populationBoth therapy decision aiding and therapy guidance capabilities will be evaluated Project NarrativeCM and OCT are powerful optical imaging technologies for imaging biological tissue at the micron scale levelThe combination of these technologies into an integrated probe enables noninvasive and real time screening of skin cancers to determine cancer marginsOptical imaging enhances patient care allowing physician throughD mapping to calculate precision dosage when energy based therapiesradiationlasersare appliedthusreducing the unnecessary tissue damageOptical imaging also provides the benefits of post therapy non invasive monitoring allowing early detection of clinically occult residual tumor or recurrenceIn addition to the reduction of emotional costs and patient discomfortless tissue damage may result in rapid recovery and less complications associated with surgical trauma and prolonged healingReal time bedside diagnosis and triage for the treatment planning may reduce the frequency of skin biopsy and patient visitsthusmay reduce the overall health care cost incurred by skin cancers