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TerminatedNCT03285841Updated Mar 18, 2024

OCT-AF Imaging of Pre-cancers of Vulva and Cervix

An observational study in Cervical Dysplasia, Vulvar Dysplasia and Precancerous Lesions, sponsored by British Columbia Cancer Agency. Terminated at 1 site in Canada. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-03-18.

Sponsored by British Columbia Cancer Agency · Observational

Why this study was terminated
No funding
Study type
Observational
Model
Other
Time perspective
Other
Enrollment
20
Ages
18 Years and older
Sex
Female
01

Study summary

The multimodal imaging technology, OCT-AFI, will be used to image sites on the cervix, the endocervical canal and vulva. The imaging probe is small enough, it can be inserted into the endocervical canal for imaging. The probe can also be placed in a conformable holder that can be shaped to conform the the folds of the vulva for vulvar imaging. The resultant images will be compared to histology images.

The objectives are to determine

  1. feasibility of the technology in imaging vulva and its capability in detecting vulvar intraepithelial neoplasias
  2. feasibility in imaging cervix from endocervical canal to transformation zone to ectocervix
  3. if combined OCT with AFI increases the sensitivity of detecting high grade lesions in the cervix compared to just AFI alone (previous work was AFI alone).
Read the detailed description

The multimodal optical imaging technology, OCT-AFI, has demonstrated the ability to image the small peripheral airways of the lung, allowing for high resolution of structural and functional details of airway tissue and the vasculature. Through the OCT (optical coherence tomography) component, the bronchial epithelium can be visualized and its thickness quantifiable. Micro invasion of the basement membrane can be seen in the acquired images. The AFI (autofluorescence imaging) component showed the vascular network, areas of pulmonary fibrosis and areas with loss of endogenous fluorescence beside pulmonary nodules.

The investigators anticipate OCT-AFI to be able to see subsurface structures in the cervix and vulva as well. Through previous work, the investigators found AFI to be sensitive to detecting high grade cervical lesions but the technology was confounded by normal subsurface tissue structures. By combining OCT with AFI, the investigators anticipate a higher sensitivity to detecting high grade lesions on the cervix than with just AFI. The OCT-AFI imaging probe is also small enough to fit into the endocervical canal and will allow for imaging of neoplasias that originate in the canal. These abnormalities are on the rise. Vulvar neoplasias are also on the rise and visually difficult to identify and determine surgical margins. OCT-AFI may help clinicians locate and determine the extent of vulvar lesions.

The objectives are to determine

  1. feasibility of the technology in imaging vulva and its capability in detecting carcinoma and vulvar intraepithelial neoplasias
  2. feasibility in imaging complete cervix from endocervical canal to transformation zone to ectocervix
  3. if combined OCT with AFI increases the sensitivity of detecting high grade lesions in the cervix compared to just AFI alone (previous work was AFI alone).

This study will image 10 subjects for endocervical canal and ectocervix sites. Another 10 subjects will be imaged for vulvar sites. Imaging will not affect where standard of care biopsies will be taken from. Imaging results will be correlated with histology.

No statistical analysis will be performed. This feasibility study will look at the quality and utility of the acquired image sets. If possible, the investigators will quantify the images in terms of epithelium thickness, basement membrane location, presence of vasculature and sub-epithelial structures.

02

Conditions studied

  • Cervical Dysplasia
  • Vulvar Dysplasia
  • Precancerous Lesions
  • Vulvar Cancer
  • Cervical Cancer

Keywords

  • cervical cancer
  • vulvar cancer
  • optical coherence tomography
  • autofluorescence imaging
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Participants will be recruited from VGH Women's Clinic. They will have a scheduled appointment for an initial visit colposcopy for cervix or vulva (that is, a biopsy will be done) or they will have a scheduled LEEP appointment.

Inclusion criteria

  • indicates understanding of study
  • provides informed consent to participate
  • 18 years or older
  • not pregnant and have negative urine pregnancy test
  • be scheduled for initial visit colposcopy for cervix or vulva or LEEP (loop electrosurgical excision procedure) for treatment of abnormalities on cervix at the Women's Clinic at Vancouver General Hospital (VGH)

Exclusion criteria

Exclusion Criteria:

  • breastfeeding
04

Study design

Observational model
Other
Time perspective
Other
Enrollment
20 participants (actual)
Patient registry
No

Groups and cohorts

  • Cervical Sites

    Imaging complete cervix from endocervical canal to transformation zone to ectocervix.

    Device: OCT-AFI

  • Vulvar sites

    Imaging vulvar lesions

    Device: OCT-AFI

Interventions

  • DeviceOCT-AFI

    Both groups will be imaged with the OCT-AFI device. Imaging will not influence standard of care biospies, treatment and procedures.

    Also known as: Multimodal imaging

05

What researchers measure

Primary outcomes

  1. Determine ease of use of OCT-AFI in imaging cervix or vulva lesions.

    The ability to image complete cervix including endocervical canal or vulvar lesions in one continuous imaging run will indicate the device is feasible for use in the clinical setting for cervix and vulva. Note whether a complete image scan was collected or not after each imaging session.

    Time frame: Total imaging session of cervix and canal or vulva should take no more than 5 minutes

Secondary outcomes

  1. Correlate OCT-AFI images with histology images

    Correlate sub-epithelial structures seen in OCT-AFI with histology images

    Time frame: 6 months

  2. Quantify OCT-AFI images by examining epithelial thickness

    Measure epithelial thickness along entire scanned image. Units of measure in millimeters.

    Time frame: 6 months

  3. Locate basement membrane invasion and loss of normal endogenous fluorescence

    Locate basement membrane in OCT-AFI images and note presence or absence of invasion. Note presence or absence of fluorescence in epithelial layer in images.

    Time frame: 6 months

  4. Note extent of vasculature and its features

    Make notes regarding vasculature patterns seen in the OCT-AFI images.

    Time frame: 6 months

06

Study locations

1 site
  • Vancouver General Hospital Women's Clinic
    Vancouver, British Columbia V5Z 1M9, Canada
07

References and documents

Publications

  • Lee AM, Ohtani K, Macaulay C, McWilliams A, Shaipanich T, Yang VX, Lam S, Lane P. In vivo lung microvasculature visualized in three dimensions using fiber-optic color Doppler optical coherence tomography. J Biomed Opt. 2013 May;18(5):50501. doi: 10.1117/1.JBO.18.5.050501. PubMed 23625308 ↗
  • Pahlevaninezhad H, Lee AM, Ritchie A, Shaipanich T, Zhang W, Ionescu DN, Hohert G, MacAulay C, Lam S, Lane P. Endoscopic Doppler optical coherence tomography and autofluorescence imaging of peripheral pulmonary nodules and vasculature. Biomed Opt Express. 2015 Sep 30;6(10):4191-9. doi: 10.1364/BOE.6.004191. eCollection 2015 Oct 1. PubMed 26504665 ↗
  • Pahlevaninezhad H, Lee AM, Shaipanich T, Raizada R, Cahill L, Hohert G, Yang VX, Lam S, MacAulay C, Lane P. A high-efficiency fiber-based imaging system for co-registered autofluorescence and optical coherence tomography. Biomed Opt Express. 2014 Aug 6;5(9):2978-87. doi: 10.1364/BOE.5.002978. eCollection 2014 Sep 1. PubMed 25401011 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03285841
Lead sponsor
British Columbia Cancer Agency
Collaborators
Canadian Institutes of Health Research (CIHR)
Responsible party
Sponsor
First posted
Sep 18, 2017
Start date
Jul 25, 2019
Primary completion
Jun 30, 2020
Completion
Dec 30, 2020
Last update
Mar 18, 2024

Study contacts

Calum MacAulay, Ph.D.
principal investigator · British Columbia Cancer Agency

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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