High-grade serous cancer, the most common type of ovarian cancer, typically starts in the fallopian tube and can spread to the ovary when the primary tumour is very small and before symptoms develop.

Dr. Neilson and her team are exploring whether the use of advanced imaging catheters – combined with flushing and collecting a saline wash (called “lavage”) for genetic sequencing – can detect very early or otherwise undetectable high-grade serous cancers in the fallopian tube, before they are able to spread. If successful, this approach may be particularly useful in high-risk women with inherited mutations in BRCA1/2, as screening techniques that can provide confidence in the presence or absence of early lesions could provide alternative care strategies such as delaying risk-reducing surgeries – potentially preserving fertility or delaying medically-induced menopause.

Imaging catheters developed by the research team rotate and retract a low power laser beam in a cylindrical scanning pattern to image the inside of fallopian tubes. The reflected light is measured, and microscopic structures within the inner surface of the fallopian tubes are displayed as a three-dimensional image and a second two-dimensional image of biochemical changes. This allows doctors to see small changes in the first few millimeters of tissue inside the fallopian tubes where high-grade serous cancers form. The team is looking to further miniaturize the imaging catheters so that a lavage can be acquired at the same time; the collected genetic material or cells can then be sequenced, to detect mutations related to ovarian cancers.

Through this OCC-funded study, the research team will:

(1) develop a sub-millimeter diameter imaging and lavage catheter

(2) conduct an imaging trial on surgically removed hysterectomy specimens (“ex vivo”) to assess device performance

(3) conduct a small imaging study on patients during surgery (“in vivo”) with commercial imaging catheters of the same size to inform device design for future clinical translation.

Samples from women with suspected advanced cancers will be used for both the ex vivo and in vivo trials as they will likely contain precursor lesions in addition to advanced cancers. By the end of this study, the team aims to have a miniaturized device capable of imaging and lavage, and feasibility testing to support further translation of this device.