Fibre Optic Technology Has Potential to Improve Colorectal Cancer Risk Assessment

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Title: Fibre Optic Technology Has Potential to Improve Colorectal Cancer Risk Assessment
URL: http://www.pslgroup.com/dg/22E032.htm
Doctor's Guide
October 2, 2008

CHICAGO -- October 2, 2008 -- Fibre optic technology can effectively measure blood levels in the colonic lining in humans, thus having potential applications for analysing risk of colon cancer, according to a study in the October issue of Gastroenterology.

The study used fibre optic technology to map microvascular blood content in patients during colonoscopy. The results provide the first indication that the early increase in blood supply (EIBS) is detectable in humans and that a high blood level mirrors proximity to neoplasia.

The findings also suggest that this technology could be a valuable screening tool for enhancing polyp detection and could lead to improvements in colon cancer prevention.

"Our premise is that since the lining of the large intestine -- rectum and colon -- is contiguous, if you see an abnormality in one part of the colon, then somewhere else in the colon you have a higher likelihood of harbouring an adenoma or carcinoma," said principal researcher Hemant K. Roy, MD, NorthShore University HealthSystem, Evanston, Illinois, and Northwestern University, Chicago, Illinois.

"EIBS strengthens our premise thanks largely to the unique and accurate ability of Four Dimensional Elastic Light Scattering Fingerprinting (4D-ELF)."

The probe was developed by Vadim Backman, Northwestern University's McCormick School of Engineering and Applied Science. It utilises a revolutionary light scattering technology that can detect subtle abnormal changes in cells lining the colon long before those changes can be seen under a microscope, and even before polyps form.

"It's fascinating to very precisely know that you're looking at the most superficial layer of tissue -- which is where all polyps and cancer start -- and the accuracy with which these things can be measured," said Dr. Roy.

Researchers used the optic probe to measure oxygenated (OHb) and deoxygenated (DHb) haemoglobin (Hb) specifically in the colonic lining in 222 patients undergoing colonoscopy screening at NorthShore's Evanston Hospital between 2006 and 2007.

Of these patients, 175 had no adenomas detected, 35 had nonadvanced adenomas, and 12 had advanced adenomas. The mean age was 56.6 years, and 40% were female. There were no significant differences in gender. The groups did not significantly differ in tobacco or alcohol history.

The study found that the total Hb concentration was elevated 75.3% above control levels at the adenoma site and persisted in the uninvolved mucosa area. Moreover, tissue sites located within 10 and 30 cm of an adenoma also manifested a highly statistically significant increase in total Hb, OHb, and DHb concentration.

"We are not determining whether an abnormality is cancer or not cancer," said Dr. Roy. "What we are doing is using optical technology to determine if we can assess risk through looking at field carcinogenesis. The potential clinical applications include enhanced polyp detection during colonoscopy."

"While the technology is still in the clinical trial phase," notes Michael Goldberg, MD, NorthShore University HealthSystem, "it could be available to patients at NorthShore in 5 years."

SOURCE: Northwestern University

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