Diagnosis Of Colorectal Polyps Using OPT

Name of Project:

Diagnosis of colorectal polyps using OPT

Investigators:

MRC Technology, in collaboration with University of Dundee, NHS Tayside, Tayside Tissue Bank and the MRC Biostatistics Unit.

Aim:

The purpose of this study is to investigate whether, and in what way, OPT can be used in the pathological assessment of colorectal polyps.

Background:

Colorectal cancer (CRC) is the third most common cancer in the UK (61 new cases per 100,000 population in 2005) and is the second most common cause of death from cancer in the UK (causing 16,000 deaths in 2006). Screening using faecal occult blood (FOB) and colonoscopy decreases mortality in colorectal cancer by detecting early stage disease, and the National Health Service Bowel Cancer Screening Programme (NHSBCSP) is currently being rolled out across the UK.

Colonic polypoid cancers are the earliest detectable form of CRC and their complete excision can offer a potential cure. The diagnosis can be problematic, however, as it may be mimicked by displaced epithelia in an otherwise non-malignant polyp (pseudo-invasion). Diagnostic accuracy may be improved using OPT, and this is the focus of our current project.

In addition to investigating whether virtual serial OPT 2D sections in three orthogonal planes improves conventional histological diagnosis, we are also investigating whether rendered 3D OPT images provide diagnostically useful information on polyp morphology.  We are specifically investigating the value of OPT in the assessment of pit pattern and the classification of polyps into tubular, villous and tubulovillous categories, as accurate assessment of polyp morphology may eventually inform call-back times in the NHSBCSP.

The image below shows a representation of each colorectal polyp subtype and what features were demonstrable using OPT.