Using AI to detect Oesophageal Cancer earlier

Professor Barbara Braden is a Consultant Gastroenterologist and Interventional Endoscopist working at the Translational Gastroenterology Unit (hosted within the Nuffield Department of Medicine) at John Radcliffe Hospital (Oxford University Hospitals NHS Foundation Trust (OUHFT) ), before which she trained at Universities in Cologne and Frankfurt. Barbara is part of a large multi-disciplinary team who are researching better ways of treating and detecting patients with early cancer and pre-cancerous conditions in the oesophagus, using advanced endoscopic imaging methods and endoscopic resection techniques.

Most Oesophageal Cancers are detected by endoscopy when they have reached an advanced stage and endoscopic, surgical, radiotherapy and chemotherapy treatment are less effective and patient prognosis is poor. Detecting early cancer on the other hand, offers a significantly higher chance of cure, as the tumour can be easily removed during an endoscopic examination. Using methods such as radiofrequency ablation to treat pre-cancerous stages can prevent from progressing to cancer.

Unfortunately, during conventional endoscopy the more easily treated pre-cancerous changes and early stage cancers are harder to observe and often missed, especially by less experienced endoscopists. If the endoscopic detection of early neoplastic changes and early Oesophageal Cancers were improved, it would be possible to intervene earlier and dramatically increase the chance of a curative outcome for the patient. Barbara and her colleagues work on a real-time computer algorithm-aided analysis of endoscopic images and videos, which will enable earlier identification of neoplastic changes automatically during endoscopy. The hope is that advanced imaging techniques and computer algorithms will be able to highlight neoplastic changes in the oesophageal lining during the examination, to guide the endoscopist to the best area from which to take biopsies and focus their attention. This new approach could also provide a more standardised high-quality examination that is less dependent on the experience of the endoscopist. With early detection of pre-cancerous changes and early stage cancer, more patients will be offered curative treatment by endoscopic resection, which will reduce the number of people progressing to advanced and potentially incurable cancer.

 

The image above is from an endoscopic oesophageal examination of an individual with Barrett’s Oesophagus, a pre-cancerous condition associated with acid reflux disease.

Barbara is part of a multidisciplinary team of scientists across the UK, trying to bring this technology into the clinic.
In Oxford this team draws from a group of clinicians at the TGU (including Dr. Adam Bailey, Prof. Simon Leedham, and Dr. James East), molecular biologists from the Ludwig Institute for Cancer Research, Oxford Branch (including Prof. Xin Lu), informaticians from the Weatherall Institute for Molecular Medicine (Stephen Taylor) and computer vision expertise from the Big Data Institute (Prof. Jens Rittscher, Dr. Sharib Ali and Dr. Felix Zhou).
Both Prof. Xiaohong Gao (Department of Computer Science at Middlesex University) and Dr. Wei Pang (Department of Computer Science at Aberdeen University) bring additional expertise in computer science to the team.
Barbara’s research is funded by the CRUK Oxford Centre Development Fund and the NIHR Oxford Biomedical Research Centre.