Molecular Imaging

Respiratory infections and diseases are some of the most common medical conditions in the world and are a leading cause of chronic ill-health. At the moment we have to rely on investigations such as x-rays and blood tests to help guide us and let us understand the processes that may be occurring in the deep areas of the lung. Hence, more accurate ways of assessing what is going on in the deep parts of the lung, to provide better treatment and diagnosis of lung disease, are desperately needed.

Molecular imaging offers the opportunity to immediately and directly visualise underlying problems within the lung, with the potential to rationalise or re-direct therapy. Given the limitations of existing approaches, this technology could revolutionise the way clinicians address certain conditions of the lung and provide a bedside solution to a very real clinical problem. To date, we have developed a programme of clinical research which includes the imaging of bacterial infections, lung scarring and cancer.

So far, our imaging agents (BAC ONE, BAC TWO, FIB ONE and NAP) have been delivered directly into the lung at very low concentrations and have been able to specifically detect their target within sixty seconds, thereby ‘lighting up’ the lung. Our early clinical studies using these agents have all shown that bedside pulmonary molecular imaging is both safe and feasible. Our novel endomicroscopy platform has also been clinically tested in a small number of patients and can image the delicate architecture of the distal lung and detect the presence of active enzymes in fibrotic lung tissue.

From Left to Right: Green channel – shows the natural fluorescence of lung tissue. Red channel – shows SmartProbe labelled bacteria. Multi-coloured – Combining the previous two images, it is possible to pick out the labelled bacteria that have gathered along the strands of lung tissue.

What is the advantage of using these imaging agents?

Immediate in situ bedside optical molecular imaging of the distal lung is a novel approach which will be of widespread utility especially in critical care but also in experimental medicine. Direct in situ imaging of several lung conditions offers the prospect of accurately diagnosing disease and monitoring patient outcomes and response to treatment in real-time.

What happens during these studies?

Eligible patients will undergo a bronchoscopy which is an examination that allows a doctor to look at a patient’s lungs. A bronchoscope, which is a fine flexible tube with a light/camera at the end, is passed into the patient’s windpipe (trachea) and then into the breathing tubes (bronchi). A small imaging fibre is then passed into the deep parts of the lung. This allows doctors to ‘see’ the lung tissue and after adding a tiny dose of the imaging agent, potentially the cause or consequence of the patient’s condition. The whole procedure takes about half an hour to perform.


Feeding the imaging fibre though the bronchoscope
A clinician demonstrates how to insert the Panoptes fibre into a bronchoscope.