Colonoscopy augmentation with Fluorescence Lifetime Imaging (FLIm): colorectal cancer detection in humans

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality globally, with current screening techniques, such as colonoscopy, demonstrating limitations in accurately detecting subtle structural abnormalities and biochemical changes in colorectal lesions. These limitations contribute to missed diagnoses and incomplete resections, which account for over 85% of post-colonoscopy CRC cases. This project aims to address these challenges by integrating label-free fluorescence lifetime imaging (FLIm) into standard colonoscopy procedures to enhance the detection and characterization of colorectal lesions in real-time. FLIm offers a novel approach to providing detailed biochemical information by capturing autofluorescence signals that reflect changes in tissue composition, metabolism, and structure. We hypothesize that FLIm can capture biochemical changes associated with inflammation and carcinogenesis, facilitating better staging of colorectal lesions. The proposed research is based on three specific aims and will first build a comprehensive database of in vivo FLIm signatures from colorectal lesions in 200 patients undergoing routine colonoscopy, correlating these signatures with histopathological findings to establish robust markers for lesion detection and classification (Aim 1). We will then develop advanced, user-friendly algorithms to enable rapid, real-time analysis and visualization of FLIm data during colonoscopy, making the system practical for clinical use (Aim 2). Finally, we will evaluate FLIm's sensitivity and specificity in identifying and staging a range of colorectal lesions, from benign polyps to malignant tumors, using machine learning techniques (Aim 3). By integrating FLIm into colonoscopy, this project seeks to overcome the current limitations of endoscopic imaging, providing clinicians with real-time biochemical insights that improve lesion detection, diagnosis, and decision-making. The expected outcomes include a fully developed FLIm-colonoscopy system that can significantly enhance CRC screening accuracy and early-stage diagnosis. The long-term impact of this work will be the reduction of CRC incidence and mortality through improved screening technologies and better clinical management of colorectal diseases. Project Number: 1R37CA292595-01A1 | Fiscal Year: 2025 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Alba Alfonso-Garcia | Institution: UNIVERSITY OF CALIFORNIA AT DAVIS, DAVIS, CA | Award Amount: $297,074 | Activity Code: R37 | Study Section: Clinical Translational Imaging Science Study Section[CTIS] View on NIH RePORTER: https://reporter.nih.gov/project-details/11225529