Images: High-resolution fiber-optic endoscopic microscope reveals some of the same tissue features as conventional histology on a biopsied sample. Healthy oral mucosa: (a) endoscopic microscope; (b) conventional histology. Oral cancer: (c) endoscopic microscope; (d) conventional histology (Photo courtesy of the US National Institute of Health).
An inexpensive, portable and reusable endoscopic microscope has been developed that will help clinicians detect and diagnose early-stage disease, primarily cancer.
An endoscopic microscope is a tool or technique that obtains histological images from inside the human body in real-time and some clinicians consider it as an optical biopsy.
An engineering scientist at the University of Arkansas (Fayetteville, AR, USA) has developed an inexpensive, endoscopic microscope capable of producing high-resolution, subcellular images of tissue in real time. The fiber-optic device, which is portable, reusable and easily packaged with conventional endoscopes, will help clinicians detect and diagnose early-stage disease, primarily cancer.
The system, developed also serves as an intraoperative monitoring device by providing a preview biopsy that is, helping clinicians target ideal locations on lesions prior to and during surgical biopsies and by capturing high-resolution images of tumor margins in real time. The latter will help surgeons know whether they have totally removed a tumor. The microscope is built from a single fiber optic bundle that includes thousands of flexible, small-caliber fibers. This bundle is roughly one millimeter in diameter and could be inserted into the biopsy channel of a standard endoscope.
The system requires a topical contrast agent to facilitate fluorescent imaging. It can produce images at sub-cellular resolution, which allows clinicians to see the early stages of cell deformations that could lead to precancerous conditions. The probe can be sterilized and reused. The entire system, which fits into a conventional-sized briefcase, costs approximately USD 2,500.
A prototype of the system has been tested at the M.D. Anderson Cancer Center (Houston, TX, USA). Studies there focused on various conditions leading to esophageal cancer. The work provided high-resolution images of cell structure and morphology, specifically nuclear-to-cytoplasmic ratio, a critical indicator of cell behavior leading up to a precancerous condition. Results obtained from the endoscopic microscope were confirmed by standard histopathological examination of biopsied tissue.
Timothy Muldoon, MD, PhD, an assistant professor of biomedical engineering who developed the endoscopic microscope, said, “My dream is to disseminate this technology to a broad scope of medical facilities, hospitals and various clinics, of course, but also to take it into underserved and rural, even remote, areas. Its compactness and portability will allow us to do this.”
University of Arkansas
M.D. Anderson Cancer Center