Laparoscopic contrast enhanced ultrasound for cancer detection

Pancreatic cancer is the tenth most common cancer in the UK, with an incidence that has increased by 30% over the last 40 years but persistently low 5-year survival of approximately 8% that has not improved over the same time period. Currently only around 10% of patients are suited to surgery. Earlier detection of disease could play a significant role in patient outcomes by increasing the number of patients whose cancer remains suited to surgical resection. Those patients whose tumour is not accessible or too advanced for surgery are reliant on chemotherapy or immune-therapy treatments. However, pancreatic ductal carcinoma is characterised by the evolution of a dense fibrotic stroma and collagen-rich extra-cellular matrix that can severely limit the penetration of drugs available to treat it. This has led to considerable interest in the development of therapeutics that can target this dense stroma to enable treatment. Our group is working on developing tools that can allow better imaging of stroma to support earlier diagnosis and minimally invasive treatments. This has focussed on new contrast agents to improve imaging sensitivity, but the full potential of these new imaging enhancement and functionality can only be effectively realised with the advent of new ultrasound hardware and transducers to exploit them. New ultrasound transducers that can access tissues endo- or laparoscopically to deliver imaging more sensitive to the detection of microscale tissue alterations in cancer are urgently required to improve patient outcomes.
Photoacoustic (PA) imaging is an emerging biomedical imaging modality based on laser-generated US. Compared to conventional US, PA imaging is capable of providing functional information of soft tissue for treatment monitoring and tumor detection. The US/PA dual-modality imaging has been studied and employed for PA microscopy. In recent years, such dual-modality imaging has been implemented with miniature transducers and catheters for intravascular and endoscopic applications in terms of catheter design, transducer configuration, and extended functions. The topic of laparoscopic PA imaging device development is further new, in which only a few prototype designs have been reported. There remains considerable opportunity to further enhance the device specifications including size and performance. This project will investigate the development of advanced laparoscopic PA devices using both theoretical and experimental approaches. Realization of such multi-modal imaging will be further supported through collaboration with US4US, who specialize in new product development providing the drive systems that capable of operating our devices to deliver novel ultrasound imaging applications.
This project will benefit from association with another FUSE project and the research groups of the academics, including pancreatic cancer experts, involved across each of these. The outcome will be new laparoscopic devices optimised for contrast enhanced imaging of the pancreas to deliver better and earlier detection of disease for treatment and improved patient outcomes.

Key Objectives
1. To identify the imaging mechanisms, device configuration, and materials for the design of a laparoscopic PA device
2. To simulate the US transducers and optical setup to theoretically estimate and aid design of device properties
3. To fabricate and characterize US transducers for the proposed laparoscopic PA device
4. To evaluate the basic PA imaging performance, say resolution, optical fluence and signal-to-noise ratio, of developed devices via phantoms
5. To evaluate the imaging performance of developed devices via ex vivo and in vivo studies.