Title: Next Generation Biopsy
Funder: The Academy of Medical Sciences

Abstract: The goal of the project is to develop a novel non-invasive diagnostic technique for suspected basal cell carcinoma (BCC) skin cancer based on extending the functionality of the conventional optical coherence tomography (OCT). Optical Coherence Tomography is an optical imaging technique that has led to impressive developments during the last decade. Although OCT has the potential to non-invasively provide high-depth histology images, without tissue excision, so far, it has been used extensively for retinal imaging only with little developments for skin imaging. The commercial existing equipment, (a) Does not provide reliable images as needed in the investigation of skin diseases, where cellular resolution is needed. (b) Cannot be used to reveal vascular related diseases of the skin. (c) Does not offer diagnostic capabilities by measuring biomechanical variations in the skin. The proposed project aims to develop a novel portable tool to tackle the deficiencies of the current OCT based solutions tailored for imaging the back of the eye. A portable OCT instrument will be developed which will, 1. Produce real-time cellular resolution structural images of skin, possible by implementing the Master-Slave technique I co-patented (MS-OCT biopsy). 2. Visualise the blood flow in skin by equipping the instrument with motion sensing capabilities (OCT-A biopsy). 3. Map the biomechanical properties of the skin by implementing an optical coherence elastography procedure (OCE biopsy). 4. Combine structural, microvascular blood flow and skin elastography maps to produce BCC signatures, which will be analysed and documented, then used to diagnose BCC in the clinic.

Lay abstract: Basal Cell Carcinoma (BCC) is the most common form of skin cancers. In most of the cases, the tumour appears in the head and neck region and can induce disfiguring and destructive effects when occurring in the region surrounding the eyeball. The burden of skin lesion management in dermatology outpatient services is overwhelming. 20% of GP consultations relate to skin disease but only 20% of GP training schemes include dermatology. As a result, only 12% of all specialist referrals result in a cancerous diagnosis, hence need for tools to help unnecessary referrals. So far, various techniques to diagnose BCC have been developed, however none of them are accepted as being capable of providing the assurance required for correct diagnostic. Currently, the gold standard in BCC diagnosis involves biopsy, a medical procedure requiring tissue removal. In this project, the diagnoses will be performed in a non-conventional way, without removing tissue, by employing the optical beam of light delivered by an Optical Coherence Tomography (OCT) instrument. As current available OCTs are specifically designed to image the back of the eye, they cannot produce optical biopsies equivalent to the conventional ones. Therefore, the project will: 1. Develop a portable OCT instrument capable of producing high-definition images, comparable to those obtained using conventional biopsy. 2. Add extra-functionalities to the instrument allowing to capture information on the distribution of blood vessels an stiffness of the tissue, not available from conventional biopsy. 3. Create a database of BCC signatures to diagnose BCC in a clinical environment.

Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES
Health categories: CANCER AND NEOPLASMS