Detecting oral cancer earlier through infrared imaging: Dr Janet Risk

Dr Janet Risk, a biologist and senior lecturer from the University of Liverpool, has teamed up with physicists and translational scientists to improve techniques to diagnose oral cancer at an early stage. Her team has been awarded a CRUK Early Detection Project Award to design a new tool based on infrared imaging that will more accurately determine which pre-malignant lesions in the oral cavity will then go on to transform into cancer.

Here, Janet describes the excitement and challenges of the project and why it is essential to work with scientists from other disciplines.

I wasn’t completely new to the world of physics – I studied it at A-level. So, when Professor Peter Weightman, a colleague from the Department of Physics, gave a talk on using infrared (IR) imaging in oesophageal cancer, I began to wonder if it could be applied to the detection of oral pre-malignant lesions, one of my key clinical areas of interest.

I invited Peter to present his data to my research group, who are a mix of biologists, clinicians, pathologists, medical oncologists and translational scientists. From there, Peter and I began to discuss how we could use IR imaging to specifically target clinical challenges in oral cancer, and we saw a niche area we might move into: early detection of oral cancer.

A challenge of specificity

Current IR technologies are only of limited efficacy in the oral cavity. Talking to Peter made me wonder how we could make the IR instrumentation more sensitive, so that we could visualise oral cells at single-cell resolution.

I also attended Peter’s group meetings to learn about the capabilities and shortcomings of the technology. It’s difficult to understand the how IR waves can be used to detect different molecules until you learn some of the background and immersing myself in the world of Peter and his team helped me better understand what was going on.     

Only 1 in 10 pre-malignant lesions in the mouth go on to transform into oral cancer, so it’s vital that we develop ways to discriminate between those that will go on to form cancer, and those that will not.

Alongside improving the imaging specificity, we are developing an algorithm that analyses the data to identify potentially transforming oral pre-neoplastic lesions. To me, this is the most important part, as we’ll be able to target the right patients with early treatment and de-escalate the impact that long term screening has on all our patients.

Clinial applications

We see our method being a first screen in a pathology lab as part of a technical analysis of biopsy tissue to decide if the sample needs to be assessed by an oral pathologist. People with low-risk lesions would then be offered screening using alternative clinical samples, such as oral scrapes, which could be collected at the patient’s GP or GDP surgery.

Our approach would reduce the number of screenings in hospital clinics across the UK, which are costly and an unnecessary worry for a large proportion of individuals who are not at immediate risk of developing cancer.

And looking to the future, I envisage that our instrument and our algorithm could also have great potential in other cancers where there are pre-malignant lesions.

Working across disciplines to make a difference to patients

Interdisciplinary projects are definitely hard work, but potentially very rewarding.

I’ll be honest, we all found working with scientists from other disciplines initially quite hard –everyone had to understand the complexities of each other’s field. However, the time and effort we invested was necessary for all of us to appreciate the nuances of the biological and physical sciences aspects of the project.

I certainly encourage researchers to take up interdisciplinary projects. In my experience, physicists are keen to explore biological research and want to use technology in real-life situations. They can really bring new expertise to cancer research and open up new avenues for clinical applications.

Before we submitted our project application to CRUK, we got helpful feedback from the Early Detection team. This gave us the opportunity to clearly highlight the importance of the clinical and translational aspects of our project.

There is a pressing need for those of us working in pre-cancer to develop new tools that will enable us to detect and treat cancer earlier and increase survival. The investment from CRUK in early detection research is going to make a significant impact, and I’m excited to get to work!