Minimally invasive endoscope, enabled by photonics, finds colon tumors quickly

Recognizing that colonoscopies are invasive and costly, a team of researchers in Europe is developing an endoscopic device that will identify and diagnose precancerous polyps and early colorectal cancer without the need for tissue biopsy. The endoscope, being developed by the Horizon 2020-funded PICCOLO Project consortium, pairs optical coherence tomography (OCT) and multiphoton tomography (MPT) to detect at the cellular level.

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Colorectal cancer affects approximately one in 10 people during their life and causes almost 700,000 annual deaths globally. Almost 95% of these cases are adenocarcinomas, which typically start as a growth of tissue called a polyp. While up to 40% of patients under routine-analysis colonoscopy present one or more polyps, almost 30% of these polyps are not detected, especially in the case of flat polyps. Of those detected, 29-42% are generally hyperplastic, and will not develop into cancer. The remainder are neoplastic polyps, which are of primary importance because they harbor malignant potential and represent a stage in the development of colorectal cancer. For this reason, it is essential to identify these polyps at an early stage.

The OCT/MPT endoscope will provide high-resolution structural and functional imaging, giving details of the changes occurring at the cellular level comparable to those obtained using traditional histological techniques," explains Dr. Artzai Picon, who is leading the PICCOLO Project. "Furthermore, when multiple polyps are detected in a patient, the current gold standard procedure is to remove all of them, followed by microscopic tissue analysis. Removal of hyperplastic polyps, which carry no malignant potential, and the subsequent costly histolopathological analysis might be avoided through the use of the PICCOLO endoscope probe, which could allow image-based diagnosis without the need for tissue biopsies."

The long-term potential for this project could not only provide a new approach in colon cancer detection, but could also be applied to diseases in other organs of the body. The PICCOLO Project team hopes to have refined their first prototype by the end of 2018, and targets clinical trials to begin around 2020.

For more information, please visit www.piccolo-project.eu.