{"id":27338,"date":"2021-08-10T23:01:50","date_gmt":"2021-08-10T23:01:50","guid":{"rendered":"https:\/\/news.cancerresearchuk.org\/?p=23392"},"modified":"2024-11-03T15:14:32","modified_gmt":"2024-11-03T15:14:32","slug":"zooming-in-fine-tuning-the-picture-to-diagnose-oesophageal-cancer-earlier","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/zooming-in-fine-tuning-the-picture-to-diagnose-oesophageal-cancer-earlier\/","title":{"rendered":"Zooming in: Fine-tuning the\u00a0picture\u00a0to\u00a0diagnose oesophageal cancer earlier\u00a0"},"content":{"rendered":"
\"Hyperspectral<\/p>\n

Credit: Dale Waterhouse<\/span><\/p>\n<\/div>\n

Our eyes function like a camera, capturing light and sending data for processing and storage.<\/span><\/p>\n

But as incredible as it is, the eye has its limits. It\u2019s sensitive to three colours \u2013 red, green and blue. While this is enough to distinguish everyday objects, it is not enough to differentiate a cancerous cell from a healthy one.<\/span><\/p>\n

Cameras used by scientists in surgery are limited in the same way.<\/span><\/p>\n

Now, some of our researchers have developed specialised cameras that can be used to detect cancer cells that can be hard for both surgical cameras and the naked eye to spot.<\/span><\/p>\n

We spoke to Dr Dale Waterhouse who led this exciting research, recently published in<\/span> Cancer Research<\/span><\/em><\/a>, about how this new technology could illuminate the future of the early detection of oesophageal cancer.<\/span><\/p>\n

What\u2019s the problem?<\/span><\/h2>\n

Oesophageal cancer<\/span><\/a> occurs when abnormal cells in the food pipe, the tube that carries food from your mouth to your stomach, grow in an uncontrolled way.<\/span><\/p>\n

Around 9,100 people are diagnosed with oesophageal cancer each year in the UK. And unfortunately, many people are diagnosed with later stage cancer, when the disease tends to be more advanced.<\/span><\/p>\n

But there can be early warning signs, in the form of a condition known as<\/span> Barrett\u2019s oesophagus<\/span><\/a>. Most people with Barrett\u2019s oesophagus won\u2019t develop cancer, but the cellular changes seen in Barrett\u2019s oesophagus can sometimes develop into oesophageal cancer, giving doctors the opportunity to spot abnormal cells early.<\/span><\/p>\n

The standard diagnostic tool to detect Barrett\u2019s oesophagus, an<\/span> endoscopy<\/span><\/a>, involves a long, flexible tube with a tiny camera and light at the end, which passes down the oesophagus.<\/span><\/p>\n

People with Barrett\u2019s oesophagus will then have follow-up endoscopies every 3 to 5 years, to look for signs of the condition changing.<\/span><\/p>\n

\u201cAn endoscopy looks around the oesophagus using standard white light imaging, which is the same kind of imaging you get in a phone or digital camera. The endoscopist will look for some suspicious signs that might indicate whether Barrett\u2019s oesophagus is developing towards cancer,\u201d says Waterhouse.<\/span><\/p>\n

Waterhouse explains the challenges that arise using this kind of imaging. \u201cIt\u2019s actually quite difficult to see those changes with the standard white light imaging we use, because as you can probably imagine, everything in the oesophagus looks a kind of pinkish-red colour.\u201d<\/span><\/p>\n

So, the team at the University of Cambridge decided to investigate whether it was possible to increase the sensitivity of the standard endoscopy camera, and by doing so increase the accuracy of detecting when the condition is progressing towards cancer.<\/span><\/p>\n

A spectral \u2018fingerprint\u2019 of cancer<\/span><\/h2>\n
\"A<\/p>\n

Spectral fingerprint<\/p>\n<\/div>\n

When light is shone onto tissue, like the inside of your oesophagus, it is absorbed by the different biological components it\u2019s made from. Each of these absorbs different colours and proportions of light. When light leaves the tissue again, it has a distinctive colour composition, which Waterhouse describes as a \u2018fingerprint\u2019, which can tell us about the underlying biology.<\/span><\/p>\n

This unique fingerprint is also known as a spectrum. Just like a fingerprint, the spectrum can be used to identify the tissue that created it, and the spectral fingerprint of cancer is likely to be different to that of healthy tissue.<\/span><\/p>\n

The special cameras Waterhouse and his team designed were able to reveal this valuable additional information that a typical camera would leave out, using something called hyperspectral imaging.<\/span><\/p>\n

\n

What is hyperspectral imaging?<\/span><\/h3>\n

Hyperspectral imaging is a technique that analyses a wide and finely sampled spectrum of light instead of just the 3 primary colours (red, green, blue).<\/span><\/p>\n

\u201cYou are able to capture much narrower \u2018bands of light\u2019, each collecting a much narrower range of wavelengths, and you take more of those. So rather than 3, you could collect 10s, or even 100s of different colours.\u201d<\/span><\/p>\n

And detecting more colours means that scientists are able to pick up a more detailed fingerprint.<\/span><\/p>\n

Hyperspectral imaging isn\u2019t new. This unique kind of imaging has many applications, from observing space through the latest advanced telescopes, to monitoring emissions produced by coal and oil power plants.<\/span><\/p>\n<\/p><\/div>\n

\u201cThe problem with hyperspectral imaging is we don\u2019t know which of the colours we detect will actually be useful, and no one\u2019s really collected this data in the oesophagus,\u201d explains Waterhouse.<\/span><\/p>\n

The team set about collecting some of that missing information from the oesophagus. \u201cWe needed that data to assess whether there are any spectral differences between the pre-cancerous tissue and the tissue with Barrett\u2019s oesophagus. This will help us determine which of those colours are most diagnostically useful.\u201d<\/span><\/p>\n

Who, what and where?<\/span><\/h2>\n

The pilot study recruited 20 patients with Barrett\u2019s oesophagus, who would be having a surveillance endoscopy as part of their standard of care. From these 20 people, the team captured 715 spectral images.<\/span><\/p>\n

\u201cThe patients enrolled in the study came in for a standard procedure, and the endoscopist marked two regions. One which they were very sure was Barrett\u2019s oesophagus tissue, and then another region, which they were suspicious about, because they thought it might be early cancer,\u201d says Waterhouse.<\/span><\/p>\n

\u201cAnd then we inserted our device through the working channel of his endoscope. The endoscopist then directed that towards these two regions, and we captured spectral information from the tissue.\u201d<\/span><\/p>\n

Following that, and this is the really important part, the team took biopsies of those same two regions, so that they could get a diagnosis based on gold-standard histopathology.<\/span><\/p>\n

\u201cAnd that\u2019s important, because actually, in three of the cases, the initial diagnosis from the endoscopist, was incorrect, which is the challenge we\u2019re trying to solve,\u201d explains Waterhouse. \u201cTo be specific, one region the endoscopist marked as healthy was actually pre-cancer, and 2 cases marked as suspicious were actually healthy. This is why matching our spectral data with gold-standard diagnosis from histopathology is so important.\u201d<\/span><\/p>\n

Significantly, the team found that there are some distinct spectral differences between tissue that was Barrett\u2019s oesophagus, and the tissue that was developing into cancer.<\/span><\/p>\n

\u201cWe did some modelling to find that there are differences in the blood distribution in the tissue between the different disease states, which the camera is able to pick up.\u201d<\/span><\/p>\n

What\u2019s more, using the results from the spectral imaging, they developed an algorithm to try to tell the two apart. The algorithm had 84.8% accuracy in distinguishing between Barrett\u2019s oesophagus tissue, and tissue that was precancerous, which Waterhouse says \u201cis good compared to the current standard of care and promising for the future development of this tool\u201d.<\/span><\/p>\n

Looking beyond oesophageal cancer<\/span><\/h2>\n

While Waterhouse and the team were going technicolour, another group was working on new ways to detect oesophageal cancer earlier, using a<\/span> \u2018sponge on a string\u2019<\/span><\/a>. So how does this new research fit in?<\/span><\/p>\n

\u201cThese two technologies, as far as I see them, are very much complementary,\u201d says Waterhouse. \u201cYou can screen the general population with Cytosponge, because it\u2019s such a cheap and easy technique that can be done in a GP surgery. And then once you\u2019ve found patients with Barrett\u2019s oesophagus, that\u2019s when they get put into the surveillance pathway.\u201d<\/span><\/p>\n

But Waterhouse explains how this new imaging technology has huge potential beyond the diagnosis of oesophageal cancer.<\/span><\/p>\n

\u201cThis kind of technology would be useful anywhere that imaging is used,\u201d he says. \u201cIt could be used in the lower gastrointestinal tract to detect precancerous lesions, or polyps, in the bowel.\u201d<\/span><\/p>\n

Beyond detection, these cameras could also be utilised in surgery. The idea would be that the cameras could detect, real-time, whether there was any residual cancer during the operation.<\/span><\/p>\n

Up next for the team, a number of researchers are looking to build a second, improved prototype of the camera, \u201cone with higher resolution and potentially one that detects more colours\u201d. Waterhouse himself has turned his attention to glioma \u2013 a type of brain tumour \u2013 and using the same camera to assist in open brain surgery at the National Hospital of Neurology and Neurosurgery and the Wellcome \/ EPSRC Centre for Interventional and Surgical Sciences.<\/span><\/p>\n

While it\u2019s still early days, there\u2019s huge scope for this exciting technology. The sky\u2019s the limit for Waterhouse and the teams at the University of Cambridge and UCL.<\/span><\/p>\n

More on this topic<\/h3>\n<\/p>\n

Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"

Credit: Dale Waterhouse Our eyes function like a camera, capturing light and sending data for processing and storage. But as incredible as it is, the eye has its limits. It\u2019s sensitive to three colours \u2013 red, green and blue. While this is enough to distinguish everyday objects, it is not enough to differentiate a cancerous […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-27338","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27338","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=27338"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27338\/revisions"}],"predecessor-version":[{"id":43668,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27338\/revisions\/43668"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=27338"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=27338"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=27338"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}