Medical Design Briefs - March 2022 - 31

n Saving Many Lives, Improving
Others
The American Cancer Society estimates
that, in 2022, about 19,880
women in the United States will receive
a diagnosis of ovarian cancer, and about
12,810 will die from the disease. Barton
hopes her falloposcope will help save
the lives of some women and vastly
improve quality of life for others.
With early-stage detection, doctors
could perform prophylactic salpingooophorectomies
- removal of the
ovaries and fallopian tubes - before
ovarian cancer spreads. Because
researchers believe ovarian cancer usually
starts in the fallopian tubes, many
physicians recommend that women at
risk for ovarian cancer have their ovaries
and fallopian tubes removed. Many
women opt for the surgery because of its
potentially lifesaving benefits, but it isn't
without drawbacks. The procedure
thrusts women into surgically induced
menopause, with side effects including
hot flashes, mood swings, and higher
risk of heart and bone disease.
Barton cited one example of a study
in which 122 patients who were known
carriers of genes that increased their risk
for cancer had their fallopian tubes
removed as a precaution. Analysis of the
tubes after removal showed that only
seven of the women were in the process
of developing cancer.
" This device could allow us to tell those
other 115 women, 'Hey, you are perfectly
normal, and we'll come back and check
on you every couple of years to make sure
everything is OK,' " Barton explains.
Regular falloposcope screenings could
mean that even patients who do ultimately
opt for the removal procedure could
do it later in life - for example, after
childbearing years.
" Anecdotally, I can tell you that when
a patient has her ovaries removed at a
young age - almost always for cancer
risk reduction - she is placed on supplemental
hormones, and a significant
percentage of them come back and say,
'You know, I just don't feel as good as I
did,' " Heusinkveld says. " And there's
nothing you can do about that, aside
from fiddling around with dosage. So, if
we can delay removing ovaries until an
age where they're truly inactive, that's
going to be a pretty big health benefit. "
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n Years in the Making
The falloposcope's effectiveness
stems from a combination of multiple
imaging techniques. Through a
method called fluorescence imaging,
which measures the way different molecules
absorb and emit light, the
device examines metabolic and functional
changes in tissue. With optical
coherence tomography, the device
observes structural changes at high
resolution. A third technique - white
light reflectance imaging - gathers information
about tissue based on the way it
reflects light.
In the initial study, the research
team hopes to image 20 sets of fallopian
tubes before removal. As the surgeon,
Heusinkveld will provide feedback
to the engineering team about
how to make the device easier to use
and more effective.
" The goal here is to show that we can
get into the fallopian tubes - which is
nontrivial itself - take images, assess the
quality of the images and get physician
feedback, " Barton says. " This study will
help establish a baseline of the range of
what normal looks like. "
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Medical Design Briefs - March 2022

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