Abstract
Early stage cancer detection technologies can provide functional information and potentially decrease the mortality rate caused by cervical cancer. In our previous work, a miniaturized ultrasound and photoacoustic endoscopic system has been developed to image the cervical tissue through the cervical canal to fulfills the need for a safe, low-cost, and high-resolution functional diagnostic system. However, the miniaturized size of endoscope and American National Standards Institute safety limits cause constraints of using high-intensity illumination during imaging. In addition, the strong light scattering of tissues limits the light penetration depth. Fortunately, the cervix anatomy allows for the delivery of additional light from the ectocervix by using an external illumination system. Here we propose a dual, co-planar illumination system, which can provide adequate illumination to the cervical tissue via combined internal and external light delivery strategies. Therefore, an increase in the area of light-tissue interaction allows us to raise the laser light energy while keeping fluence under safety limits. Thus, a reliable PA imaging can be obtained for the whole cervical tissue thickness. The system performance was tested using a Monte Carlo simulation, and laser-light fluence was calculated and compared at different depths within a simulated cervical-tissue model. The results indicated a higher and more uniform fluence in the Monte Carlo simulations. In addition, the photoacoustic imaging of the proposed system was evaluated by two cervical tissue-mimicking phantoms with human blood and graphite rods as inclusions inside it. In accordance with the simulations, the phantom study revealed a more reliable photoacoustic signal for the entire depth of the phantoms with an improved contrast to noise ratio and signal to noise ratio, and a higher coverage ratio of the imaging field of view. In summary, the dual-mode illumination system can provide more realistic information of inclusions within the tissue while considering safety limits, which can lead to more accuracy in biomarker detection for cervical cancer diagnostics.
Highlights
According to the American cancer society report, around 1.8 million new patients will be diagnosed with cancer in the United States in 2020 [1]
A miniaturized ultrasound and photoacoustic endoscopic system has been developed to image the cervical tissue through the cervical canal to fulfills the need for a safe, low-cost, and high-resolution functional diagnostic system
The light fluence for each illumination strategy was evaluated by placing a perfect absorber sheet inside the simulated cervical tissue, and ray fluence was calculated at different depths using the Monte Carlo method
Summary
According to the American cancer society report, around 1.8 million new patients will be diagnosed with cancer in the United States in 2020 [1]. Cervical cancer is diagnosed through routine screenings or pelvic examinations. For cancer screening and diagnosis the cervix and vaginal mucosa is visualized by speculum examination and evaluated with pap smear, the cervix might appear normal when the disease is microinvasive or inside the endocervical canal [4]. The existing imaging modalities, including ultrasound (US), magnetic resonance imaging (MRI), and computed tomography, are limited by key factors, including cost-effectiveness, compactness/point-of-care, and accuracy. These unmet clinical needs call for the development of a simple, accurate diagnostic imaging system which can acquire high-resolution images of regions in close proximity to the cervical tissue in the point of care setting
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