Innovative multiphotonic endoscope to address technological challenges in current colonoscopy procedure

Colorectal cancer is one of the most common types of cancer in the world. The main method used to detect colorectal cancer is an exploration of the colon through a colonoscopy, but enhancements in endoscopes are essential to improve this procedure. New diagnostic techniques are required to differentiate in situ hyperplastic and neoplastic polyps. With this purpose, a “focus group” with gastroenterologists has been developed to identify medical needs related to the limitations of endoscopic technology and the colonoscopy procedure, and to optimize the design and development of new technologies. The “focus group” was carried out with four gastroenterologists, following a semi-structured interview of 30 minutes. Analysis of comments of the clinicians shows several main topics to perform improvements: (a) equipment related to image quality and colon lighting; (b) problems in polyp detection and classification; (c) provide visual information; and (d) physical characteristics of the endoscope. The European PICCOLO project is addressing these technological needs, in which an innovative multiphotonic endoscope will be developed to enhance the diagnosis of colorectal cancer. This endoscope, based on Optical Coherence Tomography (OCT) and Multi-Photon Tomography (MPT) technologies, will allow performance of image-guided “optical biopsies” for in-vivo real-time diagnosis. It will provide high resolution OCT/MPT images, white light and fluorescence wide field images and a Computer Aided Diagnosis (CAD) software. With this technology, neoplastic and hyperplastic polyps would be better detected and classified in real time, especially flat polyps. This software will support decision-making in diagnosis by providing visual information of polyps’ characteristics.