Lay Summary

Proposal No. IBD-0196R
Principal Investigator:  Caroline Cao, Ph.D.
Applicant Organization:  Tufts University (Medford, Massachusetts, U.S.A.)
Project Title:  Image-guided research in colonoscopy to improve diagnosis of inflammatory bowel disease
Period of Award:  February 1, 2007 – January 31, 2009

Currently, colonoscopy is the most sensitive test for diagnosing IBD and screening for colon cancer.  Colonoscopy, a diagnostic and therapeutic procedure performed to examine the inner wall of the colon for lesions and tumors, is now widely used for the investigation of suspected IBD and colon cancer, and (in North America) as a general screening procedure for individuals over the age of 50.  Even though colon cancer is 85-95% successfully treated if detected at an early stage, the compliance rate for screening is only 30% in the US.  This resistance to regular colonoscopies is due largely to the uncomfortable nature of the procedure which arises from the difficulties in navigating a flexible endoscope through the colon.  These difficulties result in mis-detection of lesions and incorrect localization.  In addition, the procedure may be abandoned before completion due to difficulty in near-blind navigation (i.e., 2D, restricted forward-field of view only).  Therefore, a robust tracking and guidance system that can provide meaningful position and shape information for the colonoscopist is needed.

The aim of the project is to develop an innovative, affordable, and easy to implement, flexible sensor that can track its own position and shape, using a modified single optical fiber with embedded fluorescent markers to differentiate the locations and degree of bends along the fiber length.  The fiber can be integrated into the shaft of the colonoscope, or inserted into the biopsy channel of the scope.  Once coupled to the colonoscope, the proposed endoscopic fiber optic shape tracker can track the entire length of the endoscope (as opposed to a single point at the end of the scope) and provide information about the relative 3D position and shape of the scope in real time. This information will then be used to design a navigational aid to augment the current endoscopic view.  Such a visual guide can: 1) improve the endoscopist’s ability and confidence in performing the procedure, 2) reduce the amount of discomfort and unnecessary pain inflicted on the patient due to scope manipulation, 3) enable the accurate localization of lesions, and 4) increase the screening and diagnosis of IBD.