Grant: Project Grant

Lung cancer continues to be the leading cause of cancer death in Canada, accounting for nearly 1 in 4 of cancer deaths. Low-dose spiral computed tomography (CT) scanning can identify potentially cancerous lung nodules earlier than ever before. However, for definitive diagnosis, these lung nodules must be biopsied - a difficult task since these nodules are often located in the lung periphery and are inaccessible using standard video bronchoscopy. Radial endobronchial ultrasound probes can be used with bronchoscopes to extend imaging into smaller airways, but this technique suffers from low diagnostic yield (~70%). Patients with nodules that cannot be endoscopically sampled often undergo CT-guided needle biopsy through the chest wall, but this method has a higher rate of serious complications such as collapsed lung and internal bleeding. Thus, there is an unmet clinical need for endoscopic biopsy devices that can provide high diagnostic yield for peripheral lung nodules. This proposal will develop two types of integrated imaging-biopsy catheters that will be deployable through the bronchoscope instrument channel and be able to image during biopsy to ensure accurate and precise biopsy sampling. The imaging catheters will use OCT-AFI, an imaging modality we developed that provides co-registered optical coherence tomography and autofluorescence imaging, giving both structural and biochemical information simultaneously. We will also develop realistic lung models to test and evaluate the ability of the imaging/biopsy catheters to locate and biopsy peripheral lung nodules. Safety and efficacy of the devices will also be tested in a feasibility trial using pigs. Success in this project will improve patient care by providing proof-of-principle demonstrations of technology to safely and accurately diagnosis peripheral lung nodules endoscopically, avoiding complications and radiation exposure incurred during CT-guided transthoracic lung biopsy.