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Functional Anatomical Molecular Optical Screening

Integrated Project funded by ICT-FP7 for the period 2012–2016

FAMOS Concept & Objectives

In clinical and medical diagnostic procedures, excisional biopsy and histopathology remain the golden standard. Unfortunately, in some organs, e.g. the human retina, information is not available in real time and diagnostics based on biopsies can suffer from unacceptable false negative rates due to sampling errors. Existing minimally invasive imaging techniques, e.g. X-ray computed tomography (CT), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), radioisotope imaging (position emission tomography PET) have revolutionized diagnostic medicine throughout recent decades. These techniques permit three-dimensional visualization, but their spatial resolution is limited to a few millimetres, they use either ionizing radiation or toxic markers and they are expensive and potentially hazardous to the patient.

Optical imaging and diagnostics have recently offered great promise to address unmet clinical needs due to the combination of non-invasive, real-time capture of biomedical information. Optical imaging provides new, clinically relevant biomarkers such that point-of-care decisions can be made with the use of safe (non-ionizing) levels of optical radiation at a much lower cost than with MRI, CT and PET. Therefore, emerging non-invasive optical imaging approaches may enable faster and earlier treatment, reduced therapy costs, improved clinical outcomes and a better patient experience. Optical coherence tomography, multiphoton tomography, and photo-acoustic tomography are considered established or emerging clinical modalities, and retinal OCT imaging – the fastest developed and adopted imaging technique in the history of ophthalmology – is regarded as a huge clinical and commercial success.

Why have optical techniques not become more widespread?

Insufficient 'sensitivity and specificity'
Optical imaging methods are very sensitive but suffer from poor specificity, resulting in high numbers of false positive diagnoses. Alternatively, optical methods have high specificity, but insufficient sensitivity, leading to missed diagnoses.
Poor utility
Optical imaging systems can be difficult to use by non-specialists, and data or images are difficult to interpret.
Breadth of application
Aspects of the disease may prevent effective use of optical imaging, i.e., the lesion is difficult to access, or is located too deep for imaging.
Regulatory issues
In certain diseases, clinically accepted procedures exist, which make introduction and approval of novel methods difficult.
High costs
It is often incorrectly assumed that improvements from introducing optical techniques are ‘incremental’ as opposed to ‘game-changing’. Hence, the cost of new instrumentation and the cost of performing the diagnosis cannot be justified.

FAMOS addresses these core problems

The objective of FAMOS is to provide easy-to-use, cost-effective optical technologies with high sensitivity and specificity, to enable a step-change in diagnostics for a range of diseases. In addition, earlier diagnosis will be possible with improved performance and widespread implementation of these low-cost, easy-to-use modalities. The investment in new technology can be firmly justified by a substantially improved diagnostic ability.

This will be achieved by:

Developing enabling core photonics technologies for optical imaging
A key aspect of our research and development program is reduction in size, ease-of-operation, and cost-effectiveness as the cornerstone for imaging systems. Moreover, the new light source technology is capable of supplying more than one imaging modality.
Combining imaging technologies
Combining optical imaging modalities offering high sensitivity with modalities offering high specificity fulfills diagnostic requirements. Furthermore, critical parameters (imaging speed, penetration depth and resolution) are significantly improved. These parameters are essential for the successful introduction of a new diagnostic standard.
Enhancing imaging and therefore diagnostic performance
Improving core photonic technology reinforces imaging performance per se, and through combined modalities, diagnostic demands are met or even surpassed. Furthermore, by size-reduction and improved use-of-operation, the optical imaging modalities become available for widespread point-of-care use.
Cost-effectiveness improves treatment
Cost reduction facilitates widespread application throughout the healthcare system; this enables earlier diagnosis, which, in turn, means treatment earlier on in the disease process and improved prognosis.

The concept of FAMOS is to develop a multidisciplinary partnership between 7 world leading research institutions, 9 top SMEs and a company with indispensable, complementary know-how in biophotonics and medical end-users that are proactive in exploitation. FAMOS aims to establish a cost-effective, innovative multi-modal photonic imaging platform based on optical coherence tomography, adaptive optics, photoacoustic tomography, coherent anti-Stokes Raman scattering and multiphoton tomography enabling the fusion of anatomic and functional (‘anatofunctional’) and anatomic and molecular (‘anatomolecular’) point of care diagnosis with improved sensitivity, specificity and enhanced depth of penetration in the field of ophthalmologic and cancer diagnosis.

Main outcome of FAMOS

FAMOS radically improves the capacity of biophotonic technologies for point-of-care diagnosis and functional imaging by developing a new generation of advanced light sources for ophthalmic and oncologic diagnostics, which will provide step-changes in performance beyond state-of-the-art. This translates into optical diagnostic with far greater sensitivity, specificity, reliability, clinical utility, and at reduced cost to the medical end-user.

Multi-scale, multi-resolution imaging is recognized as the future of biomedical and biophotonic sciences and medical diagnosis. This requires multi-scale three-dimensional morphologic imaging at different resolutions and should provide molecular and functional tissue information. Hence, the outcome of FAMOS will establish a novel generation of non-invasive, point of care imaging modality that enables a ‘step change’ to address unmet clinical needs and has the potential to revolutionize fundamental biological research, medical diagnosis and treatment monitoring. This will enable widespread implementation, will provide major societal benefits and will give European industry leading edge technologies in a rapidly expanding product market.