The LUCA project will develop a device based on a novel technological concept that will combine diagnostic standard ultrasound techniques with upcoming modalities based on photonics, that is, two diffuse optical modalities known as time resolved spectroscopy (TRS) and diffuse correlation spectroscopy (DCS).
Birth of a new collaboration
In 2010, Prof. Durduran was invited to give a talk to the department of endocrinology led by Dr Ramon Gomis at Hospital Clinic Barcelona. As Durduran clearly remembers, “I knew very little about the topic so I did a bit of research and decided to focus my talk on potential applications in diabetes. However, since most of my work to date has focused on brain monitoring and breast cancer, I had many examples in these areas. After my talk, Dr. Gomis and Dr. Mireia Porta approached me and asked me whether we could measure the thyroid”. Consequently, they started a collaboration with a pilot study, where the preliminary results, published in PLOS ONE, showed that it was feasible to probe the depth of thyroid tissues and it was possible to differentiate types of nodules, thus demonstrating that diffuse optics was a promising clinical tool that could provide outstanding diagnosis improvements.
Hence, Prof. Durduran “put together a consortium that includes specialists in diffuse optics (instrumentation and algorithms), partners from industry (Ultrasound and diffuse optics), and Hospital Clinic Barcelona and other representatives as end-users” and responded to an ICTKET call by the European Commission, which was granted. Prof. Durduran is the project’s Scientific Coordinator and his research group is contributing to the project with expertise in diffuse correlation spectroscopy modality. Durduran also emphasizes that “we will also be playing a role in data acquisition and interpretation with our colleagues at the hospital”.
Is this device and technology the first to be developed?
Durduran comments “So far the team has published the first study on thyroid cancer screening using diffuse optics and this project will actually be the first professional system being developed for research and the markets. The primary goal of this device will concentrate not on the detection of tumor cells but on the characterization of large nodules that are screened with ultrasound. It is a low-cost device, implying minimal additional costs due to the optics and therefore in the price range as of conventional ultrasound systems; it is a point-of-care machine, meaning that it is portable and can be used in the same way clinicians use ultrasound equipment; is it multi-modal because it combines the two diffuse optical modalities with ultrasound; it will definitely be faster because the results will be available in real-time; and it will be non-invasive, meaning that it will be able to reach up to two centimeters deep into most tissues”.
The device is being built in a modular configuration so that, as other technologies improve, such as different versions of ultrasound or photo-acoustics techniques, the device will be able to adapt and combine its modalities to these newer versions and provide higher quality diagnosis. In addition to the morphological information clinicians obtain using ultrasound in nodule screening, Durduran states that “they will also obtain information about the constituents (e.g. collagen, lipid, and water content), physiology (blood flow, blood oxygen saturation, oxygen metabolism) and vascularization of the nodule. Together, all this information will provide a more accurate, non-invasive discrimination between benign and malignant nodules”.
What challenges do you expect to face and when do you envision a robust clinically approved device ready to be used on patients?
Durduran remarks that “the biggest challenge that I believe we will face is to see what true positive and false negative rates we obtain when we begin using the system in the clinics. We do not expect a failure on data quality, system signal-to-noise ratio or its usability, so we believe that this multi-modal approach that brings physiological, morphological and structural information to the early stages of screening will reduce the number of false-positives. Now, as for timings, if I am really optimistic about when it will be ready, I would say five to ten years to complete all the clinical trials, CE and FDA certification. But this is the multi-million Euro question”.