The primary concern with bladder cancer is how invasive the tumour is when diagnosed. The more invasive, the higher the stage. If the tumour has not yet invaded as far as the muscle wall of the bladder when diagnosed, the tumour can be surgically excised through transurethral resection (TURBT), and 5-year survival is around 80%. If the tumour has invaded through the muscle wall when diagnosed, then treatment should instead be focused on complete bladder removal (cystectomy) and chemotherapy, or even a combination of radiotherapy, chemotherapy and surgery. 5-year survival if diagnosed at this later stage drops to around 40% when treated with radical cystectomy. About 20-25% of bladder cancers have invaded beyond the muscle wall by the time they are diagnosed. Bladder cancer has higher recurrence rates than any other cancer type, and so for bladder cancer, effective surveillance during and after treatment is especially important. It is essential that bladder cancers, whether primary or recurring, are diagnosed quickly and correctly to ensure the correct magnitude of treatment is provided, proportional to the severity of the tumour. A delay of just a few months can severely impact patient survival. Currently, the best practices for diagnosing bladder cancer rely on cystoscopy and cytology. Determining the severity of bladder cancer is particularly challenging though, as distinguishing between urothelial tumour stages is not always possible with conventional imaging techniques. Earlier stage aggressive carcinomas may be often undistinguishable from advanced deeply penetrating tumours from the surface view. Indeed, the plain stage of bladder cancer (CIS), which is often particularly aggressive if left alone, can go unseen entirely with traditional white light endoscopy. The Amplitude project (Advanced Multimodal Photonics Laser Imaging Tool for Urothelial Diagnosis in Endoscopy) began in January 2020, with the aims to develop new, advanced multi-modal imagining tools to diagnose bladder cancer faster and more accurately. The stand-out feature of Amplitude is the ability to view far deeper into tissue than traditional spectroscopy tools. Current imaging tools use light wavelengths less than 1350nm to target two distinct ‘biological windows’, which penetrate only a short distance through tissue. Hence the difficulty distinguishing bladder cancer stages. Enabled by novel laser technologies and expertise, Amplitude will target the third biological window, covering wavelengths between 1550-1870nm. In this window, light can penetrate deeper into tissue at high resolution. By viewing this deep into tissue, cancer staging will be far less ambiguous, improving the speed and accuracy of diagnosis. However, this window is currently only accessible using broad-application supercontinuum lasers, which are far beyond the budget and requirements for biomedical imaging. Amplitude is instead developing fibre lasers designed specifically to access the third biological window in an affordable and compact package, bringing the technology to the clinic and the patients. The earlier patients are diagnosed with cancer, the better their chance of survival, the less severe the treatment, and the lower the impact on their quality of life. Equally as important though is correct diagnosis, as cancer treatments are far too harsh to make light of false positives, and the consequences too severe to allow for false negatives. Amplitude aims to develop the tools necessary to ensure that these diagnoses are as rapid and accurate as possible, to protect as many cancer patients as possible. New advanced technologies and world leading multidisciplinary expertise grants Amplitude the potential to revolutionise the cancer diagnostics landscape.
Bladder Cancer, Photonics, Microscopy, Endoscopy, Diagnostics, Clinical, Cytoscopy, Multi Modal Imaging System