Title: Multi-modal Theranostic Endoscope for Intra-operative guidance and Focussed Ultrasound Therapy
Funder: The Academy of Medical Sciences

Abstract: Cancer is expected to be the leading cause of premature death over the next 50 years. Due to cancer heterogeneity, treatment approaches have moved from a cancer centric model towards a tumour microenvironment (TME) centric model. Minimally invasive techniques such as focussed ultrasound (FUS) can control local cancer with reduced invasiveness, lower morbidity and low impact on the patient life quality. However, current image-guided FUS procedures lack volumetric mapping of anatomy, temperature, and TME in real-time. Further, minimally invasive image guided FUS endoscopes that can perform localised treatment are not yet well established. Therefore, there is an acute need to develop a miniaturised, faster, sensitive volumetric imaging technique that can perform simultaneous mapping of anatomy, temperature and TME at the target site. A multi-modal imaging device that performs anatomy, temperature and TME mapping of the treatment site can enable closed-loop control of the FUS to maintain the required temperature and provide personalised treatment. In this fellowship, I aim to develop, validate, and begin the exploitation of an integrated photoacoustic-ultrasound image-guided FUS platform that can address the current fundamental and technological gaps. The proposed device will be designed and used for future brain and prostate cancer treatments. Objectives 1)Development of a multi-modal theranostic endoscope to provide real-time volumetric maps of anatomy, temperature, tissue oxygenation, collagen, lipid and water content of tumour during a FUS procedure. 2)Perform the technical validation of the endoscope using tissue-mimicking phantoms 3)Conduct the biological validation of the endoscope using freshly excised human tissue samples

Lay abstract: Cancer is a highly heterogeneous disease that necessitates personalised treatment strategies for individual patients. Current treatment approaches have limited capabilities to provide personalised therapies, which often results in poor prognosis and lower survival rates for cancer patients. Although advanced treatment approaches such as focussed ultrasound (FUS) therapy can offer minimally invasive treatment options with shorter hospital stays, their therapeutic efficacy is limited. This is because the clinician often has very limited information on the targeted disease site's energy dosage and tumour composition, which results in sub-optimal and inadequate treatment strategies. Further, due to the lack of precise anatomical visualisation, FUS can also introduce damage to surrounding healthy tissues, leading to complications and reduced life quality for patients suffering from cancers in the brain and prostate. With the AMSSpringboard award, I will develop a novel image-guided FUS platform that can precisely map the organ anatomy, energy dosage, and tumour composition during a FUS procedure. I will work with world-leading industrial and academic collaborators to develop and validate an image-guided FUS endoscope. I will then work with a neuro-onco surgeon and an uro-onco surgeon to characterise and establish this probe for brain and prostate cancer treatment procedures. The proposed device will provide objective and quantitative information on the anatomical, functional and molecular composition of the diseased tissue, thereby enabling the clinician to make accurate and informed therapeutic decisions. This work will provide an effective cancer treatment approach with reduced invasiveness, lower morbidity and low impact on the patient life quality.

Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES;5.5 RADIOTHERAPY AND OTHER NON-INVASIVE THERAPIES
Health categories: GENERIC HEALTH RELEVANCE