Motivation for the study
Polyps are small growths on the inner lining of the colon or rectum, affecting around 1 in 4 people over the age of 50. Certain types of polyps may eventually become cancerous, and colon cancer prevention relies on colonoscopy using white light to detect and remove the polyps. However, small and flat polyps are difficult to detect and frequently missed with this technique. More precise methods to detect polyps before they progress to colorectal cancer are urgently needed.
GE Healthcare’s patented EMI-137 (previously known as GE-137) fluorescent probe has the potential to improve early detection of cancers including ovarian, esophageal, thyroid, bile duct, and lung cancer. EMI-137 is labeled with a modified Cy5 dye and binds selectively to c-Met tyrosine kinase, which is a polyp biomarker. This intraveneous agent might enable surgeons to remove polyps more precisely during surgery using fluorescence colonoscope in contrast to standard white light colonoscope. In this first-in-human pilot study, the use of GE-137 for improved polyp detection was evaluated in 15 patients at high risk of colorectal cancer.
A high-power ML7710 series clinical laser at 635 nm (3W) was utilized in a fluorescence imaging setup. Modulight also provides flexible multi-wavelength light engines to enable detection of multiple fluorescent dyes.
A total of 101 polyps were detected using standard colonoscopy, and all of these polyps were also visible in fluorescence colonoscopy with GE-137. However, GE-137 enabled detection of 22 additional polyps (22% improvement over standard colonoscopy). These addiotional polyps were mostly small (<6 mm in diameter) and flat. GE-137 was well tolerated and safe.
Large polyps (marked with arrows) are clearly visible in both standard colonoscopy and fluorescence colonoscopy with GE-137.
Small polyps (marked with arrows) that have either low or no visibility in standard colonoscopy can be visualized in fluorescence colonoscopy with GE-137.
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