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Dual ultrasound-laser scanner targets thyroid cancer

23 May 2016

Hand-held probe expected to cut huge number and cost of unnecessary surgeries ‘dramatically’.

The European Commission is funding a new “innovation action” project via the photonics public-private partnership (PPP) that it is hoped will greatly improve thyroid cancer diagnosis.

Based around a hand-held analyzer probe incorporating laser and ultrasonics, the €4 million “LUCA” project will see physicians, radiologists and physicists develop a low-cost point-of-care screening system.

It is claimed that by reducing the number of unnecessary thyroidectomies undertaken across Europe, the probe could save around €450 million every year.

The problem is that while thyroid nodules – which in 5-15 per cent of cases are a precursor to thyroid cancer – are extremely common, using current biopsy techniques it is very difficult to ascertain which nodules will lead to cancer development.

“The sensitivity and specificity of this [fine needle aspiration biopsy] process in thyroid cancer are limited, with a large number of non-diagnostic and false positive results that lead to unnecessary surgeries,” notes the LUCA “objectives” abstract on the EC’s Cordis web site.

“With as [many] as 30 per cent of adults in Europe, or 128.9 million people having to deal with a thyroid nodule at some point in their lives, accurate diagnosis has never been so important,” adds the project team, led by the Barcelona-based Institute of Photonic Sciences (ICFO).

“Each year in Europe alone, around 800,000 cases of detected thyroid nodules will be non-diagnostic, or indeterminate,” they continue. “Of all these cases, 150,000, or nearly 19 per cent, will end up being benign and could have avoided surgery altogether.”

High cost burden
ICFO professor and the LUCA project’s scientific coordinator Turgut Durduran says that, at €3000 per operation, excluding any additional medical requirements, that number of unnecessary procedures represents a huge cost burden of €450 million for healthcare systems across the continent to bear each year.

Mireia Mora from the August Pi i Sunyer Biomedical Research Institute (IDIBAPS), also in Barcelona, added: “Current technology does not allow us to know whether a nodule is malignant or benign, before surgery takes place. We cannot take the risk of a misdiagnosis, so we operate. LUCA will eliminate a lot of this guesswork.”

Mora explained that the dual-mode probe would use ultrasound to image the nodule structure and optical spectroscopy to “see” its physiology, meaning doctors will be able to observe thyroid nodules in much more detail than is currently possible.

Durduran explained: “By combining information about tissue hemodynamics, chemical constitution as well as anatomy, the technique used by this device will overcome the shortcomings of present techniques while screening for malignant thyroid nodules.”

In fact, the LUCA probe will feature two optical techniques – near-infrared diffuse correlation spectroscopy (DCS) and time-resolved spectroscopy (TRS) - to screen for signs of malignancy.

DCS is able to measure changes to normal thyroid tissue such as local angiogenesis and hypermetabolism – both signs of malignancy.

ICFO spin-out partner
Among the other partners involved in the four-year project, which will also look at whether the same probe might be useful for diagnosing other types of cancer, is ICFO spin-out HemoPhotonics. The firm says that it is the first to deliver commercial DCS devices, and it has a budget of €465,000 from the LUCA project.

HemoPhotonics is also involved in the “BabyLux” European research project, which is developing an optical probe to monitor oxygenation in the brains of new-born babies.

The French companies ECM Echo Control Medical, which specializes in portable ultrasound equipment, and piezoelectric component maker Vermon are also taking part in LUCA, alongside the UK’s University of Birmingham, Italy’s Politecnico di Milano, and the European Institute for Biomedical Imaging Research in Vienna, Austria.

Official LUCA project explainer video:

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