Endoscopy technology enhances early detection of esophageal cancer

Esophageal cancer is one of the most lethal cancer types. If diagnosed late, the survival rate is only around ten percent. However, when detected early, about 90 percent of patients survive. The newly developed O2E endoscopy technology could enable physicians to identify tissue changes at much earlier stages, offering patients a better prognosis.

O2E integrates two complementary imaging techniques in one capsule-based endoscopy system:

• Optical Coherence Tomography (OCT): Captures microscopic structures of tissue.
• Optoacoustic Imaging: Uses light pulses and ultrasound signals to visualize blood vessels, even in deeper layers.

Together, these methods create high-resolution 3D images of the esophageal tissue. The capsule scans in a full 360-degree angle, allowing clinicians to examine tissue comprehensively.

“Our dual imaging system uncovers critical features of early cancer lesions, including microscopic structural changes beneath the mucosal surface and subtle microvascular alterations within the cancerous tissue, that previous methods were unable to detect,” says Prof. Vasilis Ntziachristos, Director at the Institute of Biological and Medical Imaging at Helmholtz Munich and Chair at TUM.

In pilot studies, the team examined animal esophagi as well as tissue samples from patients with Barrett’s esophagus, a known precursor to esophageal cancer. They identified clear distinctions between healthy tissue, precancerous lesions, and malignant tumors. A proof-of-principle study was also conducted on the inner lip of a volunteer, since this tissue closely resembles the esophagus.

In 2025, the EU-funded EIC Pathfinder project ESOHISTO was launched to further develop this technology. The goal is to refine the capsule for clinical use and ensure high-quality imaging for patient care.

“We also plan to integrate confocal endo-microscopy — a technique that provides high-resolution, real-time visualization of cellular structures — to enable more detailed analysis during examinations,” explains Dr. Qian Li from the Medical University of Vienna. “This could pave the way for high-resolution endoscopic molecular imaging, allowing us to target specific molecular markers in cancer.”

Future applications may reduce the number of biopsies needed, streamline diagnostic procedures, and lower healthcare costs. While advanced esophageal cancer treatment can cost up to 140,000 euros per patient, early detection could reduce costs to about 10,000 euros.

MEDICA-tradefair.com; Source: Helmholtz Munich