Multidimensional endoscopy for early cancer detection

Each year in the UK, over 55,000 patients will be diagnosed with oesophageal or lung cancer; a staggering 44,000 will die from their disease. The majority of patients are currently diagnosed when their disease is at a late stage (with regional or distant spread), yielding less than 10% survival over 5 years. Therefore, a key clinical unmet need remains for early disease diagnosis.

To detect these cancers early, patients that are at a high risk of disease might undergo endoscopy. An endoscope is a long, thin, flexible tube with a light source and video camera at one end to relay images from inside the body. They replicate what our eye could see if we were able to look inside the body. Endoscopy is vital for surveillance and diagnosis of cancer, however, many cancers of the oesophagus (food pipe) and lung start out as small abnormalities that are hard to spot using conventional endoscopes.

The focus of this research is to augment the vision of the endoscopist by designing a specialist video camera that detects the properties of light that our eyes are blind to. We will also use this new camera in a benchtop system that can analyse tissue that has been taken out of the body (biopsied) very quickly, before it is sent to a pathologist to check for cancer. Our new cameras are designed to be cost effective and provide extra information to help doctors with diagnosing cancer in the oesophagus and lung, and could ultimately replace the current standard-of-care.

Stakeholders that will benefit from this research include:
- Patients, through: more accessible testing (lower cost, less specialist equipment); reduced anxiety (better informed at point of test); improved outcomes (reduced mortality); and improved quality of life (fewer invasive interventions).
- Endoscopists and bronchoscopists, through: better imaging contrast that improves interpretation; reduced procedure time; and improvements in patient management.
- Endoscopy manufacturers, such as Olympus, Fuji and Pentax, and start-ups, such as Endochoice, who may benefit from our IP generation by increasing the capability of endoscopes to incorporate new techniques, involving additional research in image processing, visualisation, augmented reality as well as hardware, creating new jobs not currently present in the endoscopy field.
- Pathologists and surgeons, through: application of the MITA system, which could be deployed cost effectively, to help guide pathological sectioning and surgical margin delineation.
- Public service providers, such as the NHS, through: cost reductions in terms of procedure time as well as capital equipment. Our "5 in 1" endoscopy enables short procedures and cost effective deployment. Our MITA system has been designed through user engagement with endoscopists so is small, portable, and can fit into current facilities. Nanoplasmonic metapixel arrays should be highly robust so could also reduce service costs.
- General public, through: research engagement activites to demonstrate the power of multidisciplinary research, increasing awareness of the role of physical sciences in healthcare.