Conclusions and Outlook

Abstract

This thesis establishes three optical imaging techniques based on two endoscopic device architectures to address unmet clinical needs in two indications: detection of dysplasia in endoscopic surveillance of Barrett’s oesophagus; and delineation of pituitary adenomas in transphenoidal endoscopic surgery. In establishing these techniques, close attention was paid to the translational characteristics (Chap. 1) to ensure these techniques were appropriate for translation. The first, a flexible endoscope for oesophageal imaging (Chap. 3), was paired with NIR fluorescence optical molecular imaging (Chap. 4) and later SRDA-based multispectral imaging (Chap. 5) for detection of dysplasia in Barrett’s oesophagus. The second, a rigid endoscope for intraoperative imaging during transphenoidal surgery, was paired with SRDA-based multispectral imaging for intraoperative delineation of pituitary adenoma (Chap. 6). In addition to the design of the devices, and the development of software for their control, correction methods were established to remove the comb structure associated with the fibre bundle of the flexible endoscopes, and to demosaic the images acquired with SRDAs (Chap. 3). Each of these three techniques was validated and compared with gold standards on measurements across a broad range of biological and non-biological samples. Finally, the two multispectral techniques were translated to in vivo clinical trials. This Chapter summarises this work and outlines suggestions for future work in this area.