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NEMO<br />
Nano based capsule-Endoscopy with<br />
Molecular Imaging and Optical biopsy<br />
Summary<br />
Gastrointestinal (GI) malignancy imposes a signifi cant<br />
impact on the well-being of the European members. Ageing<br />
of the population means that death rate will continue to<br />
rise. A report of the IARC (France) indicates insuffi cient<br />
compliance to colorectal cancer prevention programs, due<br />
to the lack of a simple, patient friendly diagnosis method.<br />
The objective of the NEMO project is to develop an advance<br />
cancer screening method friendly enough to signifi cantly<br />
increase compliance , simplify the diagnosis procedure and<br />
increase the sensitivity and specifi city of early detection.<br />
The concept of the NEMO approach is to combine capsule<br />
endoscopy with nano-based molecular recognition that will<br />
highlights cancerous and precancerous lesions in the GI<br />
tract thus considerably increases the accuracy and ease of<br />
diagnosis. The system will merge few technological platforms:<br />
Nanotechnology for targeting and marking the<br />
infected organ, Capsule Endoscopy to detect the marked<br />
disorder, Capsule manoeuvring technologies to move the<br />
autonomous NEMO capsule backwards and forwards in the<br />
gastrointestinal tract, as well as miniaturization and low<br />
power technologies.<br />
A major task of the project is to develop nanocontainers,<br />
labelled with targeting agents and fi lled with dyeing material.<br />
The administered nanocontainers will be tailored to<br />
react with the target and mark the infected organ. Another<br />
task is to develop a capsule based on Narrow Band Imaging.<br />
This advanced capsule will provide both: visual images<br />
of the GI tract and molecular characterization of the disorder.<br />
Fusing image and molecular information together,<br />
a new medical tool for early cancer detection with high<br />
sensitivity and specifi city will be developed.<br />
Problem<br />
Keywords | <strong>Cancer</strong> | cancer screening | capsule endoscopy | biosensing |<br />
Earlier detection of cancer using screening methods is likely<br />
to be the most practical way of addressing the epidemic of<br />
gastrointestinal cancers. Gastrointestinal cancers are detected<br />
mainly by gastroscopy or colonoscopy followed by biopsy.<br />
There is good evidence that such screening can fi nd early<br />
cancers and that lives can be saved if such early cancers are<br />
discovered and removed. Many patients however are reluctant<br />
to have screening gastroscopies and colonoscopies because<br />
of the discomfort of the procedures. Women especially are<br />
reluctant to undergo screening colonoscopy.<br />
The acceptability of capsule endoscopy, which is pain free,<br />
requires no sedation and does not necessarily entail a hospital<br />
visit, is attractive for patients. It is likely that they would<br />
fi nd such a screening method much more acceptable than<br />
screening colonoscopy for example.<br />
It would be very helpful if capsule endoscopic video imaging<br />
could be combined with more sensitive and specifi c methods<br />
for detection of early cancer to avoid the need for biopsy.<br />
Aim<br />
The aim of the NEMO project is to develop a new advanced<br />
cancer screening method friendly enough to signifi cantly<br />
increase compliance, simplify the diagnosis procedure and<br />
increase the sensitivity and specifi city of early detection.<br />
The system will miniaturize and merge a variety of technological<br />
platforms: Nanotechnology for targeting and marking<br />
the precancerous tissue capsule endoscopy and capsule<br />
manoeuvring technologies to detect the marked disorder.<br />
By fusion of image with data of molecular analysis a new<br />
medical diagnostic tool may be formed. The use of specifi c<br />
optical fi lters used in conjunction with light emitting diodes<br />
(LEDs) will be explored to make a miniature narrow band<br />
imaging device which can be contained within a capsule<br />
endoscope. Narrow band imaging reduces the surface<br />
refl ection of broad band illumination and can allow small or<br />
fl at precancerous lesions to be seen clearly when they are<br />
diffi cult to see with conventional illumination. The combination<br />
of conventional and narrow band imaging may be able<br />
to provide an overview of the gastrointestinal tract indicating<br />
one of many sites of interest. It could be alternated with<br />
conventional imaging.<br />
Expected results<br />
It is expected that the new Capsule Endoscopy screening<br />
method will provide information on the presence or absence<br />
of cancerous or precancerous situations with high sensitivity<br />
and specifi city. We hope to develop a combination of miniature<br />
spectral and Magnetic Resonance nanotechnology to<br />
create ‘virtual biopsy’ methods and incorporating these<br />
within the capsule endoscope.<br />
It is also expected that the new autonomous NEMO capsule<br />
will be able to move backwards and forwards in the gastrointestinal<br />
tract, for example to re-examine a suspicious lesion.<br />
Potential applications<br />
Conventional endoscopies are usually performed in hospitals;<br />
require trained doctors and a nursing staff for monitoring and<br />
cleaning the equipment. Endoscopy generally requires insuffl<br />
ations to expand the folds of tissue and enhance examination.<br />
142 CANCER RESEARCH PROJECTS FUNDED UNDER THE SIXTH FRAMEWORK PROGRAMME
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