Dynamic Evaluation of Colitis-Associated Colorectal Cancer Using Multimodal US-OCT-NIRF System

Objective: Colitis-associated colorectal cancer (CAC) poses a significant clinical challenge due to its poor prognosis and difficulty in distinguishing malignancy from inflammation with current imaging methods. This study aims to evaluate a multimodal endoscopic imaging system combining optical coherence tomography (OCT), ultrasonography (US), and near-infrared fluorescence (NIRF) to improve the detection of CAC. Methods: The proposed imaging system integrates OCT, US, with NIRF imaging enhanced through the administration of BSA-ICG nanocomplexes. The NIRF component enables visualization of capillary networks within the intestinal wall, while OCT and US assess morphological changes during CAC progression. The system applied in a CAC mice model to monitor both vascular and structural changes from inflammation to tumor formation. Results: The system successfully detected early morphological and vascular changes associated with CAC, including alterations in capillary networks, tissue thickening, and tumor formation. Fluorescence imaging provided high-resolution visualization of the smallest capillaries in the colon, while OCT and US offered valuable insights into the progression from inflammation to malignancy. Conclusion: The system shows strong potential for early and accurate detection of CAC by simultaneously visualizing vascular and morphological changes in vivo. This approach enables dynamic monitoring of disease progression and offers valuable insights into the inflammatory mechanisms underlying carcinogenesis. Significance: This study presents an imaging technique that could improve early diagnosis of CAC, ultimately leading to better clinical outcomes. By enhancing our ability to detect tumor-related changes at an early stage, this multimodal system may help guide therapeutic interventions and improve patient management.