Research by: GE Healthcare is a manufacturer and distributor of diagnostic imaging agents and radiopharmaceuticals, R&D collaborations with Leiden University MC for early detection of colorectal tumors.
Modulight products: ML7710 series clinical laser system (635 nm, 3 W)
Laser use: Clinical single-wavelength laser device used for exciting novel fluorescence probe used to detect colorectal polyps.
Research topics: Professor Hardwick’s research has contributed to many key improvements in the detection and treatment of colorectal tumors and his group has published the findings in many top journals of the field. Research on colorectal cancer focuses on prognostic factors, tumor microenvironment, optimization of surgical techniques especially for elderly patients, intraoperative fluorescence imaging, and intracellular signaling associated with the use of statins.
Motivation for the study
Polyps are small growths on the inner lining of the colon or rectum, affecting around 1 in 4 people over the age of 50. Certain types of polyps may eventually become cancerous, and colon cancer prevention relies on colonoscopy using white light to detect and remove the polyps. However, small and flat polyps are difficult to detect and frequently missed with this technique. More precise methods to detect polyps before they progress to colorectal cancer are urgently needed.
GE Healthcare’s patented EMI-137 (previously known as GE-137) fluorescent probe has the potential to improve early detection of cancers including ovarian, esophageal, thyroid, bile duct, and lung cancer. EMI-137 is labeled with a modified Cy5 dye and binds selectively to c-Met tyrosine kinase, which is a polyp biomarker. This intravenous agent might enable surgeons to remove polyps more precisely during surgery using fluorescence colonoscope in contrast to the standard white light colonoscope. In this first-in-human pilot study, the use of GE-137 for improved polyp detection was evaluated in 15 patients at high risk of colorectal cancer.
Study setup
A high-power ML7710 series clinical laser at 635 nm (3W) was utilized in a fluorescence imaging setup. Modulight also provides flexible multi-wavelength light engines to enable detection of multiple fluorescent dyes.
Fluorescence colonoscopy setup with Modulight clinical laser.
Results
A total of 101 polyps were detected using standard colonoscopy, and all of these polyps were also visible in fluorescence colonoscopy with GE-137. However, GE-137 enabled detection of 22 additional polyps (22% improvement over standard colonoscopy). These additional polyps were mostly small (<6 mm in diameter) and flat. GE-137 was well tolerated and safe.
Large polyps (marked with arrows) are clearly visible in both standard colonoscopy and fluorescence colonoscopy with GE-137.
Small polyps (marked with arrows) that have either low or no visibility in standard colonoscopy can be visualized in fluorescence colonoscopy with GE-137.
Related Publications
Detection of colorectal polyps in humans using an intravenously administered fluorescent peptide targeted against c-Met
Nature Medicine, 2015, 21 (8)
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