Development of endoscopic Optical Coherence Tomography for Laryngeal cancer screening

ISRCTN ISRCTN32637181
DOI https://doi.org/10.1186/ISRCTN32637181
Secondary identifying numbers 8939
Submission date
16/08/2011
Registration date
02/03/2012
Last edited
12/12/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Larynx (voicebox) cancer is one of the most common head and neck cancers. The main risk factors are smoking and drinking alcohol. Early larynx cancer can be treated by laser, which has a cure rate of over 90% and avoids the side effects of radio/chemotherapy. Later stage larynx cancer is hugely expensive to treat and wasteful of healthcare resources, often requiring mutilating treatment resulting in loss of ability to speak or swallow. Optical Coherence Tomography (OCT) is a relatively new technology where light is used to scan a tissue’s surface and a few millimetres deep into it, obtaining accurate information about the tissue’s characteristics, without the need to physically cut into tissue in order to microscopically examine if it is normal, precancerous or cancerous. We aim to test whether new OCT probes can distinguish normal from unhealthy larynx tissue and determine whether it is acceptable for clinicians and patients.

Who can participate?
Patients aged over 18 with suspicious larynx appearances on endoscopy.

What does the study involve?
Participants will have endoscopic OCT images taken before going on to have biopsies (samples) of the larynx tissue taken under anaesthetic. One pathologist will compare the OCT results with the standard biopsy results to determine the effectiveness of OCT in distinguishing cancerous from noncancerous tissue. Patient acceptability of the process will be established through a patient experience questionnaire.

What are the possible benefits and risks of participating?
Following this study we aim to use the results to develop a non-invasive, patient-friendly and safe laryngeal cancer screening tool. With this we aim to increase the early detection and treatment of larynx cancer.

Where is the study run from?
North West London Hospitals NHS Trust (UK).

When is the study starting and how long is it expected to run for?
October 2011 to February 2012.

Who is funding the study?
National Institute for Health Research (UK).

Who is the main contact?
Taran Tatla
ttatla@nhs.net

Contact information

Mr Taran Tatla
Scientific

North West London Hospitals NHS Trust
Watford Road
Harrow
London
HA1 3UJ
United Kingdom

Email ttatla@nhs.net

Study information

Study designNon randomised trial
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeDiagnostic
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleDevelopment of endoscopic optical coherence tomography for laryngeal cancer screening: a non-randomised trial
Study acronymOCTiLarynx
Study objectivesOCTiLarynx (Optical Coherence Tomography in Larynx). This 'proof of concept' project has a primary objective to determine if recent and continuing advances in the technology of Optical Coherence Tomography (OCT) can result in a clinically useful out-patient based diagnostic tool for endoscopic laryngeal disease screening.

We aim to validate the clinical efficacy of novel endoscopic OCT imaging probes for distinguishing normal from unhealthy laryngeal mucosa (inflamed, dysplastic, malignant) and determine clinician/patient acceptability for the same.
Ethics approval(s)Central London Research Ethics Committee, 28/07/2010, ref: 10/H0718/55
Health condition(s) or problem(s) studiedLaryngeal cancer screening
InterventionClinical recruitment of up to 40 patients for in vivo study shall occur initially at a single site (Northwick Park ENT-Head & Neck Department). Patients attending the outpatient service for secondary / tertiary care consult in relation to prolonged voice change and noted to have a suspect laryngeal mucosal lesion shall be recruited prospectively for the study. Following informed consent, these patients shall have standard endoscopic digital photographic images and endoscopic OCT images of the lesions taken under topical local anaesthesia (LA) in the out-patient department. As is standard practice presently, all such patients shall then proceed on to direct biopsies of the laryngeal lesions under general anaesthesia to allow “gold standard” histological diagnosis with routine Haematoxylin and Eosin stains of wax-embedded tissue sections.

A single pathologist trained in OCT tissue imaging techniques shall make a blinded comparison, comparing and correlating the OCT diagnostic modality with the standard biopsy histological technique for distinguishing laryngeal mucosal disease category. Preliminary statistical analysis will determine the efficacy and repeatability of the OCT tool in distinguishing cancer from non-cancer. Patient acceptability of the process will be established through a patient experience questionnaire and clinician feedback shall be sought on practicality and ease of use of the endoscopic OCT tool.
Intervention typeOther
Primary outcome measureCharacterisation & correlation of mucosal pathology (OCT images vs Histopathology) following direct microlaryngoscopy and biopsy of laryngeal lesion under general anaesthesia (GA)
Secondary outcome measuresPatient Experience Questionnaire at initial out-patient visit , immediately following nasendoscopy examination and image capture under LA
Overall study start date03/10/2011
Completion date29/02/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsUK Sample Size: 40
Key inclusion criteria1. All patients over the age of 18 years (no upper age limit)
2. Male or female gender
3. Patients able to provide informed consent to OCT-adapted flexible nasendoscope examination under topical local anaesthesia and completing a patient experience questionnaire provided at the end of procedure
4. Smokers and non-smokers
Key exclusion criteria1. All patients under the age of 18 years
2. All patients from whom informed consent has not been obtained prior to tissue resection or OCT-adapted flexible nasendoscopy respectively
Date of first enrolment03/10/2011
Date of final enrolment29/02/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

North West London Hospitals NHS Trust
London
HA1 3UJ
United Kingdom

Sponsor information

North West London Hospitals NHS Trust (UK)
Hospital/treatment centre

Watford Road
Harrow
London
HA1 3UJ
England
United Kingdom

Email alanwarnes@nhs.net
Website http://www.nwlh.nhs.uk/
ROR logo "ROR" https://ror.org/04cntmc13

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/12/2012 Yes No

Editorial Notes

12/12/2017: Publication reference added.