Researchers at Imperial College London have developed an ultra-tiny endo-microscope that could help improve breast cancer treatment and cut NHS waiting lists. The endo-microscope, a microscope designed to be inserted into the body to provide views of tissues and organs, can be steered through extremely small, tight spaces in the body during surgery, producing images with unprecedented speed.
“A key focus of this EPSRC-funded work has been the development of hardware and software enabling the new system to generate 120 frames per second, a huge leap forward in terms of image acquisition during surgery,” says Dr. Khushi Vyas. “Our aim is to proceed to clinical trials with a view to the system becoming available for deployment in around five years.”
When exploring spaces such as breast ducts, the instrument can pinpoint features smaller than a single cell. The scope will aid high-precision breast-conserving surgery by enabling surgeons to identify, extremely accurately and much more quickly than currently possible, suspicious tissue around tumors as well as cancerous cells just a hundredth of a millimeter across.
“By reducing the time it takes to identify cancerous cells and improve the accuracy of imaging, the endo-microscope developed by Dr. Vyas and his team could benefit patients and the NHS by reducing waiting lists,” Dr. Kedar Pandya, EPSRC director for cross-council programs. “This illustrates the important role that cutting-edge research and innovation will play in helping us to detect and treat the most common cancer in the UK.”
Breast-conserving surgery is preferred over mastectomy (complete breast removal) because it involves localized tumor removal, less patient trauma, good outcomes from a cosmetic perspective and shorter hospital stays (saving NHS resources). But this option often involves the need for further operations.
The endo-microscope is also designed to be used in the lungs, urinary tract, digestive system, and brain, for instance. It is being developed by Dr. Vyas and colleagues at Imperial College London, supported by the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation.
Higher Patient Throughput
The instrument will reduce the need for follow-up operations to remove cancerous cells that previously evaded detection, benefiting the patient and helping to reduce pressure on NHS resources.
Up to 20 percent of breast cancer patients treated through breast-conserving surgery currently need such operations. Patients will also benefit from shorter recovery times as a result of the unnecessary removal of tissue being minimized.
A key advantage of the instrument is its ability to produce real-time high-resolution images of the tissue micro-architecture an order of magnitude quicker than existing commercially available systems. This ability will reduce the duration of operations and potentially further increase patient throughput.
The researchers have used their system for preliminary studies on human cancer tissue, and surgeons and pathologists are now testing its use on laboratory samples of cancerous tissue.
Extremely Easy to Use
Compact, portable, and easy to use, the endo-microscope comprises a tiny lens assembly fitted to the end of a flexible polymer fiber-bundle the width of 25–30 human hairs. The system is designed to be set up next to the patient in the operating theater.
The surgeon will then carefully insert the fiber into the patient by hand, holding it like a pen. Alternatively, the endo-microscope can be fitted into a robotic scanner to precisely scan the entire breast cavity for suspicious tissue.
The scope can be navigated around very easily, with instant large-area mosaic image generation of whatever the fiber-tip comes into contact with, similar to the panorama feature on smartphones.
The high-resolution images are displayed in real time on a high-definition monitor that surgeons consult as they work.