Date of Award
Doctor of Philosophy (PhD)
Audi, Said H.
Schmidt, Taly Gilat
Cervical cancer remains the leading cause of death for women in low middle-income countries (LMICs), where the incidence and mortality of cervical cancer are disproportionately high. Due to the poor medical conditions and lack of resources, the benefits of early screening methods such Pap smear and HPV test have yet to be realized in these areas. The more viable screening option - visual inspection with acetic acid (VIA) is relatively easier to implement and lower in cost. However, the effectiveness of VIA on the early detection of cervical cancer is still in question because of its low specificity, which may lead to many unnecessary follow-up diagnoses and treatments.Optical endoscopy is a powerful tool for detecting pre-cancerous changes in the epithelial tissue of the cervix. In this dissertation, we report the design and development of a dual-modality fiber-optic microendoscope system (SmartME) that integrates high-resolution fluorescence imaging (FLI) and quantitative diffuse reflectance spectroscopy (DRS) onto a smartphone platform. A smartphone App has also been developed to control the SmartME, pre-process the data, and wirelessly communicate with a remote server where the image and data are processed to extract diagnostically meaningful tissue parameters. The SmartME device has been thoroughly tested and calibrated. The FLI has a spatial resolution of ~3.5 µm, which allows imaging of subcellular organelles and determining the nuclear-cytoplasmic ratio of epithelial tissues. The DRS has a spectral resolution of 2 nm and is capable of measuring optical properties of epithelial tissues with a mean error of ~5%, which is comparable to what can be achieved with a commercial spectrometer. The feasibility of the device in measuring biological samples has been verified ex vivo using monolayer cervical cancer cells, tumor tissue from xenograft solid tumor models and other normal tissues. In vivo study on healthy human oral mucosa tissues has demonstrated that the SmartME can noninvasively quantify the tissue parameters and distinguish between different tissue types. The SmartME may provide a compact, cost-effective, and globally connected solution for early detection of neoplastic changes in epithelial tissues.
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