Raman Microendoscopy and Functionalized SERS Nanoparticles to Detect Dysplasia and Malignancy in Patients with Ulcerative Colitis.

Patients suffering from IBD, especially UC, are at an increased risk of the life-threatening colorectal cancer, and early detection is critical. The standard of care for prevention and early treatment is to inspect the colon with white-light endoscopy, however, the appearance of the tissue is often insufficient for early identification of cancer. While the intensity of inflammation and the occurrence of high-grade dysplasia are predisposing conditions for cancer, these are also difficult to evaluate by white-light endoscopy. Raman spectroscopy is a tool that can identify molecular determinants of disease, but the generally weak endogenous Raman signals have prevented effective clinical translation due to the long scan times that are required. We have designed an ultrafast Raman-based microendoscope that will enable screening at rates compatible with conventional endosocopic exams. We use these instruments to detect functionalized surface enhanced nanoparticles that are targeted to molecular markers of inflammation, dysplasia and malignancy. This would provide the endoscopist with a rapid and highly sensitive detection system that can identify hidden lesions or even discriminate between low- and high-grade dysplasia. This would have a significant impact on treatment versus surveillance and would improve overall survival and quality of life for patients suffering with IBD.