Grant: Canada Postdoctoral Research Award (CPRA) program

The most common and aggressive ovarian cancer subtype begins in the ends of the fallopian tubes before spreading to the ovaries and peritoneal cavity. This work will assess whether a small catheter that can collect images and a fluid sample from the fallopian tubes can locate early ovarian cancers. This study will be the first time this technique is tested in people. I have previously demonstrated that optical imaging catheters can visualize early cancers in surgically resected fallopian tubes. These devices capture detailed 3D images of the structures below the tissue surface (optical coherence tomography, OCT) at the same time as a 2D snapshot of tissue chemistry (autofluorescence, AFI). These catheters are less than 1 mm in diameter and would be inserted into the fallopian tubes through the uterus while the patient is asleep. Placing a catheter in the fallopian tubes also provides an opportunity to collect cells and DNA closest to where ovarian cancers first form. Using the same imaging catheter, a washing ('lavage') of the fallopian tube will be collected and sequenced to detect mutations associated with ovarian cancers. While imaging or lavage alone may miss early signs of cancer, combining both could lead to better detection. I will assess whether fallopian imaging and lavage is feasible using commercially available OCT-only catheters. Images will be collected from patients with advanced-stage tubo-ovarian cancers in the operating room immediately before their scheduled surgery. After the surgery, the fallopian tubes will be imaged again with an improved version of the imaging device that combines OCT and AFI. This will help guide development of a device tailored towards imaging the fallopian tubes. Currently, there are no effective ways to screen for early-stage tubo-ovarian cancers. If successful, this approach has potential to enable earlier diagnosis, aid surgical decision making, and provide greater care pathways for patients.