Endo-microscope could improve breast cancer treatment

The endo-microscope, a microscope designed to be inserted into the body to provide views of tissues and organs, can be steered through extremely small, tight spaces in the body during surgery, producing images with ‘unprecedented’ speed, researchers claim.

When exploring spaces such as breast ducts, the instrument can pinpoint features smaller than a single cell.

It aims to aid high-precision breast-conserving surgery by enabling surgeons to quickly and accurately identify suspicious tissue around tumours as well as cancerous cells just a hundredth of a millimetre across.

Breast conserving surgery is preferred over mastectomy because it involves localised tumour removal, less patient trauma, good cosmetic outcomes and shorter hospital stays.

However, up to 20 per cent of breast cancer patients treated through breast-conserving surgery need follow-up operations to remove cancerous cells that previously evaded detection.

The endo-microscope – also designed for use in the lungs, urinary tract, digestive system and brain – could address this issue, reducing the need for follow-up surgery and easing pressure on NHS resources.

It is being developed by Dr Khushi Vyas and colleagues at Imperial, supported by the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation.

Researchers have used the system for preliminary studies on human cancer tissue and are now testing its use by surgeons and pathologists on laboratory samples of cancerous tissue.

Described by the team as compact, portable and easy to use, the endo-microscope comprises a tiny lens assembly fitted to the end of a flexible polymer fibre-bundle the width of 20 to 30 human hairs.

The system is designed to be set up next to the patient in the operating theatre. The surgeon will carefully insert the fibre into the patient by hand, holding it like a pen. Alternatively, the endo-microscope can be fitted into a robotic scanner to precisely scan the entire breast cavity for suspicious tissue.

According to the team, the instrument can be navigated around very easily with instant large-area mosaic image generation of whatever the fibre-tip comes into contact with.

High-resolution images are displayed in real-time on a high-definition monitor that the surgeons consult as they work.

“A key focus of this EPSRC-funded work has been the development of hardware and software enabling the new system to generate 120 frames per second, a huge leap forward in terms of image acquisition during surgery,” said Dr Vyas.

“Our aim is to proceed to clinical trials with a view to the system becoming available for deployment in around five years.”