Targeted detection of cancer at the cellular level during biopsy by near-infrared confocal laser endomicroscopy

Gregory T. Kennedy, Feredun S. Azari, Elizabeth Bernstein, Bilal Nadeem, Ashley Chang, Alix Segil, Sean Carlin, Neil T. Sullivan, Emmanuel Encarnado, Charuhas Desphande, Sumith Kularatne, Pravin Gagare, Mini Thomas, John C. Kucharczuk, Gaetan Christien, Francois Lacombe, Kaela Leonard, Philip S. Low, Aline Criton, Sunil Singhal

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Suspicious nodules detected by radiography are often investigated by biopsy, but the diagnostic yield of biopsies of small nodules is poor. Here we report a method—NIR-nCLE—to detect cancer at the cellular level in real-time during biopsy. This technology integrates a cancer-targeted near-infrared (NIR) tracer with a needle-based confocal laser endomicroscopy (nCLE) system modified to detect NIR signal. We develop and test NIR-nCLE in preclinical models of pulmonary nodule biopsy including human specimens. We find that the technology has the resolution to identify a single cancer cell among normal fibroblast cells when co-cultured at a ratio of 1:1000, and can detect cancer cells in human tumors less than 2 cm in diameter. The NIR-nCLE technology rapidly delivers images that permit accurate discrimination between tumor and normal tissue by non-experts. This proof-of-concept study analyzes pulmonary nodules as a test case, but the results may be generalizable to other malignancies.

Original languageEnglish (US)
Article number2711
Pages (from-to)2711
JournalNature Communications
Issue number1
StatePublished - May 17 2022


  • Biopsy
  • Endoscopy
  • Humans
  • Lasers
  • Microscopy, Confocal/methods
  • Pancreatic Neoplasms/pathology

ASJC Scopus subject areas

  • Physics and Astronomy(all)
  • Chemistry(all)
  • Biochemistry, Genetics and Molecular Biology(all)


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