When diagnosed at an advanced stage, the survival rate of patients with oesophageal cancer is around ten per cent. If detected early, around 90 per cent of patients survive.
The new technology – O2E – promises to identify changes in oesophageal tissue at much earlier stages.
Optical coherence tomography is effective at capturing tissue structures, whilst optoacoustic imaging – a method that stimulates tissue with light pulses and detects ultrasound signals resulting from the illumination – can visualise the smallest blood vessels in deeper tissue layers.
By merging these techniques, high-resolution 3D images of tissue structure and function in the oesophagus are generated. Both sensors are integrated into an endoscopy capsule that scans the tissue in a full 360-degree angle.
“Our dual imaging system uncovers critical features of early cancer lesions, including microscopic structural changes beneath the mucosal surface and subtle microvascular alterations within the cancerous tissue, that previous methods were unable to detect,” said Prof. Vasilis Ntziachristos, director at the Institute of Biological and Medical Imaging at Helmholtz Munich and chair at TUM.
In their pilot study, the researchers examined the oesophagus of animals and tissue samples from patients with Barrett’s oesophagus, a precursor to oesophageal cancer.
They identified distinct differences between healthy tissue, tissue with abnormal cellular changes, precancerous stages, and malignant tumours. Initial proof-of-principle tests were carried out on the inner lip of a volunteer, as it shares similar tissue characteristics with the oesophagus.
Optimisation for Clinical Application
Building on these results, a new EIC (European Innovation Council) pathfinder project called ESOHISTO was granted and started in February 2025.
The researchers are now working to further refine the capsule technology to ensure it delivers high-quality imaging for use in humans.
“We also plan to integrate confocal endo-microscopy – a technique that provides high-resolution, real-time visualisation of cellular structures – to enable more detailed analysis during examinations,” said Dr. Qian Li, first author of the study from the Medical University Vienna. “This could pave the way for high-resolution endoscopic molecular imaging, allowing us to target specific molecular markers in cancer.”
Ultimately, the researchers hope their approach will reduce the need for multiple biopsies and accelerate diagnostic processes in the future.
In addition to the benefits for patients, the researchers believe that the healthcare system would benefit from this technology; the treatment of advanced oesophageal cancer typically costs around €140,000 per patient, but early detection could reduce this to approximately €10,000.
The researchers’ work is detailed in Nature Biomedical Engineering.
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